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Diversity and Mental Health
- 2. Social Issue Mental Illness Origin of Discrimination
- 6. Impact on MI Individuals Agents of Socialization
- 7. Framework of Perception Education & Awareness Future Career Personal Mental Health
- 8. Diversity in Mental Health Treatment Layers of Diversity
- 9. Society • Ethics • Diversity Training
- 10. • Better decision making • Improved problem solving • Idea generation • Expand scope of practice Benefits • Changed power dynamics • Diversity of opinions • Perceived lack of empathy • Participation Challenges
- 12. References Armache, J. (2012). Diversity in the Workplace: Benefits and Challenges. Journal of International Diversity, 2012(1). American Psychiatric Association. (2016). Ethical principles of psychologists and code of conduct. https://www.apa.org/ethics/code/ Capuzzi, D., & Stauffer, M. D. (2016). Foundations of addictions counseling (3rd ed.). New York, NY: Pearson. Gardenswartz, L. & Rowe, A. (2015). Dimensions of diversity. In J. Bennett (Ed.), The SAGE encyclopedia of intercultural competence (pp. 234-238). Thousand Oaks,, CA: SAGE Publications, Inc. doi: 10.4135/9781483346267.n84 Harmon, A. (2020). Mental health stigma. Salem Press Encyclopedia of Health. https://ezproxy.snhu.edu/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ers&AN=100259349&site=eds- live&scope=site Kessler, R., Mickelson, K., & Williams, D. (1999). The Prevalence, Distribution, and Mental Health Correlates of Perceived Discrimination in the United States. Journal of Health and Social Behavior, 40(3), 208-230. Retrieved June 11, 2020, from www.jstor.org/stable/2676349 Osborn, L. A. (2009). From Beauty to Despair: The Rise and Fall of the American State Mental Hospital. Psychiatric Quarterly, 80(4), 219–231. https://doi-org.ezproxy.snhu.edu/10.1007/s11126-009-9109-3 Parekh, R. (2018). What is mental illness? American Psychiatric Association. https://www.psychiatry.org/patients-families/what-is- mental-illness Preston, S. (2006). “Representing Reality.” Stage of the Art, 17(3), 10. Stock photos retrieved from https://www.pexels.com/ and are available for use by the public domain.
Editor's Notes
- Mental Illness and Diversity: Exploring the significance of mental health and its influence on society.
- Mental illnesses, as defined by the American Psychiatric Association, are “health conditions involving changes in emotion, thinking or behavior (or a combination of these). Mental illnesses are associated with distress and/or problems functioning in social, work or family activities” (Parekh, 2018). The level of functioning for an individual with mental illness may vary on the severity of their symptoms and their interactions with their environment. Considering nearly 1 in 5 adults, or 19%, of adults in the United States experience some form of mental illness, this issue has significance when considering discrimination as a social issue (Parekh, 2018). Discrimination against the mentally ill community is not a contemporary phenomenon. Historically, persons with mental illness have been subjected to grotesque treatment prior to advances in ethics, treatment, and long-term psychiatric care. Many insane were confined to prisons, jails, poorhouses, and almshouses before the creation of state-run asylums (Osborn, 2009). Rather than seek accommodations for MI individuals, they were ostracized by their communities. Ameliorations to the mental health care system progressed rapidly following the dawn of the 19thcentury. Asylums became unethical housing options and the foundation modern psychiatric care blossomed as changes continued to be applied to the mental health system. However, the origin of current stigma and discriminatory practices cannot be ignored.
- According to Salem Press Encyclopedia of Health, “Stigma is a set of negative beliefs that people hold about another individual or group of individuals” (Harmon, 2020). Currently, there are two forms of stigma surrounding mental illness: social stigma and perceived stigma. Social stigma is the way that society feels about, labels, and treats those with mental illness. Perceived stigma is the attitude of shame that an individual with a mental health condition feels toward themselves. Both social stigma and perceived stigma have negative impacts on stigmatized populations. While stigma itself is a social issue for consideration, it also perpetrates acts of discrimination that are equally concerning. Persons with mental health conditions are subjected to discrimination when seeking equitable housing and employment. Furthermore, mental illness is often misrepresented via the media and this misrepresentation reinforces negative stereotypes. The following tables will further explore perceived discriminatory practices.
- Table One was retrieved from an article published in Journal of Health and Social Behavior. This research explored The Prevalence, Distribution, and Mental Health Correlates of Perceived Discrimination in the United States. The subjects of this research were individuals with a diagnosed mental illness. This table conveys the perceived stigma these individuals experienced across their lifespans. Examples of common discriminatory practices include being denied for a job, not receiving a promotion, being discouraged from pursuing higher education, denial of equitable housing, etc. Furthermore, this table elucidates the prominence of these discriminatory practices by age, race, and gender. Males may have experienced more perceived discrimination by law enforcement, but females were more likely to be denied other services. Overall, non-Hispanic Black individuals experience significantly more perceived discrimination that non-Hispanic Whites (Kessler, Mickelson, & Williams, 1999).
- Table 2 explores everyday experiences of perceived discrimination. These practices involve being insulted, patronized, or threatened. While some participants reported never being subjected to specific types of day-to-day perceived discrimination, statistically significant percentages located under “Sometimes” suggests that microaggressions toward persons with mental health conditions are of worthy concern (Kessler, Mickelson, & Williams, 1999).
- The impact these discriminatory practices have on the mentally ill community in addition to persistent stigma are salient. Stigma leads people to perceive those with mental health conditions as dangerous and unpredictable. Agents of socialization, depicted by the image on the right, are influenced by social stigma and discrimination (Parekh, 2018). Focusing specifically on the impact of mass media, these misrepresentations frequently portray people as lunatics, psychopaths, and murders despite overwhelming evidence that majority of individuals with MI are not violent towards others. Popular television programs and films often focus on extreme cases of mental illness rather than working to portray the reality of living with mental illness (Preston, 2006). Dr. Sheila Preston, professor at Central School of Speech and Drama in London, explains that the consequences of stigma and discrimination are that “people with mental health problems are often denied the opportunity to represent their perspective about the world in which they live and often they too internalize the negative values of the dominant hegemony” (Preston, 2006). Without the ability to represent themselves accurately, this community is vulnerable to adopting societal stigma as perceived stigma. This adoption of ideals can prevent the individual from receiving help and in more extreme circumstances, act as a self-determinant.
- As a future mental health professional, it is important to understand the impact that stigma and discrimination have on mental illness. Furthermore, it is vital to recognize that this social issue is diverse and may impact patients of various demographics in different ways. Table 1 from the previous slide illuminated racial bias in addition to mental health discrimination. Both concepts are significant to consider when treating a diverse cliental. Continuing to educate myself on the extent of diversity through the lenses of history, the humanities, applied sciences and social sciences, will increase my personal awareness and ability to enact applicable change. Individually, I have a diagnosed mental health condition and understand that in the future I will play a role in both the treatment of mental illness and may possibly experience discrimination as part of this community. While I must remain objective as a professional, my personal experiences will be a powerful tool to use in the treatment of my clients. My perseverance and empathy of the diverse struggles of the MI community will strengthen my resolve as an individual.
- A critical analysis of diversity will strengthen my understanding of the impact that diversity has on mental health treatment and the personal interactions I have with patient of several demographics. Understanding that diversity exists within the mental health field will help me to provide the best care for my clients in addition to respecting their rights as individuals. As the science of psychology continues to progress, diversity may be a focus for accommodation in updated psychiatric diagnosis and practices. Currently, as a professional moving into the field of addiction psychology, counselors are encouraged to remain sensitive to personal identities as “each cultural, racial, and ethnic group has its own history, experience, and cultural perspective on the use of alcohol and illicit substances” (Capuzzi & Stauffer, 2016). Remaining sensitive to the various characteristics of individuals and the impact that these characteristics have on the prognosis of addiction is vital to providing quality care as a counselor. The layers of diversity, depicted by the image to your right, provides insight as to how diversity impacts the individual. As a professional, understanding the intersectionality of these layers and the relationship it has with mental illness is a must. For example, under the internal dimensions of diversity, characteristics of gender, ethnicity and race, directly impact the diagnosis of psychiatric disorders, how they manifest in clients, the experiences and trauma that my clients may have experienced, in addition to the treatment plans I will develop for my clients (Gardenswartz, & Rowe, 2015). Treatment plans must be individualized and accommodated all layers of diversity to best serve the client.
- Strategies for accommodating diversity include acknowledgment of ethical guidelines established by the American Psychiatric Association and diversity training provided by employers. Section 3 of the Ethical Principles of Psychologists and Code of Conduct established in 2016, highlights unfair discrimination “based on age, gender, gender identity, race, ethnicity, culture, national origin, religion, sexual orientation, disability, socioeconomic status, or any basis proscribed by law” (American Psychiatric Association, 2016). Discrimination based on these characteristics is forbidden by mental health professionals. Furthermore, these guidelines provide guidance on how to address situations where counselors may not be able to remain objective based on personal beliefs. In these cases, it is recommended that counselors release clients from their care so they may seek services elsewhere. As an employee of a mental health service provider, attending trainings on diversity and other applicable topics will keep my knowledge updated. There may be instances of discrimination not yet evident to professionals in the field. Receiving current training will eliminate my participation as a professional of the discrimination of diverse characteristics. Participating in these programs will strengthen my ability to work as a provider for individuals with mental health conditions.
- Diversity is “generally defined as acknowledging, understanding, accepting, valuing, and celebrating differences among people with respect to age, class, ethnicity, gender, physical and mental ability, race, sexual orientation, spiritual practice, and public assistance status” (Armache, 2012). Several benefits and challenges accompany incorporating diversity into the mental health field. Diversity brings substantial potential benefits such as better decision making and improved problem solving. Diversity also boosts idea generation which in turn leads to better care for patients, and ability to expand scope of practice. In the mental health field, an organization's success depends upon its ability to embrace diversity and realize the benefits of such for both clients and professionals. A diverse cliental and professional community will attract qualified professionals, provide equal opportunity for clients and staff, avoid conflicts, and increase individual performance. However, challenges such as changed power dynamics, diversity of opinions, perceived lack of empathy, and participation may prove difficult to navigate. Both clients and professionals may experience hesitation to adopt and embrace changed power dynamics in the mental health field. A change in power dynamics may pose difficult for older clients and staff to adjust to. For example, working with a therapist much younger than the client may pose challenges for the client-counselor relationship, especially if the individual has existing stereotypical opinions of the other. The diversity of opinions stresses the relationship between clients and professionals. If this occurrence inhibits treatment, it is recommended that another professional help the client so that the best care may be provided. Likewise perceived lack of empathy between clients and counselors will inhibit the course of treatment. Empathy is a significant factor for a positive relationship with treatment professionals which may not exist if the extent of diversity between clients and counselors is extensive. Furthermore, a lack of participation within the mental health community to embrace and adopt diversity will further perpetrate existing stigmas and discriminatory practices.
- Understanding that mental health and attributable characteristics are not an equal opportunity phenomenon is a vital component to providing the best care as a counselor. Differential characteristics in cultural norms, practices, and beliefs have been shown to affect the ability and desire for individuals to seek treatment for persons from each cultural group. The link between diversity and mental health supports the knowledge that some groups experience discriminatory practices more often and have less access to resource based on individual diversity; “Understanding the reasons behind these differences and working to erase these disparities is an important thrust of current research” (Capuzzi & Stauffer, 2016). Considering the focus of my career will specific to addiction psychology, remaining sensitive to the various characteristics of individuals and the impact of these characteristics on addiction and quality of care is pertinent. Personally, studying diversity has enhanced the level of empathy I have toward other demographic groups that I cannot individually relate with. I now recognize that my experiences with mental heath discrimination evoke similar feelings of inferiority that other individuals may have experienced. I will use this empathy in my interactions with others to listen to their struggles, embrace the beautifully unique nature of their person, and work toward solutions for promoting a diverse human experience.
- Armache, J. (2012). Diversity in the Workplace: Benefits and Challenges. Journal of International Diversity, 2012(1). American Psychiatric Association. (2016). Ethical principles of psychologists and code of conduct. https://www.apa.org/ethics/code/ Capuzzi, D., & Stauffer, M. D. (2016). Foundations of addictions counseling (3rd ed.). New York, NY: Pearson. Gardenswartz, L. & Rowe, A. (2015). Dimensions of diversity. In J. Bennett (Ed.), The SAGE encyclopedia of intercultural competence (pp. 234-238). Thousand Oaks,, CA: SAGE Publications, Inc. doi: 10.4135/9781483346267.n84 Harmon, A. (2020). Mental health stigma. Salem Press Encyclopedia of Health. https://ezproxy.snhu.edu/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ers&AN=100259349&site=eds-live&scope=site Kessler, R., Mickelson, K., & Williams, D. (1999). The Prevalence, Distribution, and Mental Health Correlates of Perceived Discrimination in the United States. Journal of Health and Social Behavior, 40(3), 208-230. Retrieved June 11, 2020, from www.jstor.org/stable/2676349 Osborn, L. A. (2009). From Beauty to Despair: The Rise and Fall of the American State Mental Hospital. Psychiatric Quarterly, 80(4), 219–231. https://doi-org.ezproxy.snhu.edu/10.1007/s11126-009-9109-3 Parekh, R. (2018). What is mental illness? American Psychiatric Association. https://www.psychiatry.org/patients-families/what-is-mental-illness Preston, S. (2006). “Representing Reality.” Stage of the Art, 17(3), 10. Stock photos retrieved from https://www.pexels.com/ and are available for use by the public domain.