Recently we have been thinking a lot about the things that prevent people with an eating disorder or mental health condition from getting well. These barriers are complex.
- There are some conditions that can’t be cured, and for which treatment is an ongoing part of life.
- There are some folks that are in treatment plans that prioritize getting better, but stop short of seeking “wellness.”
- There are those who experience treatment trauma which limits their ability to heal.
In this blog, we want to focus our attention on an aspect of mental healthcare that doesn’t get enough attention–the relationship between a person’s cultural and ethnic background and their mental health treatment.
July is “National Minority Mental Health Awareness Month” according to the US Department of Health and Human Services. The month is designated to “bring awareness to the unique struggles that racial and ethnic minority communities face regarding mental illness in the United States.” This initiative is one that we applaud and embrace at Galen Hope. And it’s an idea that has us thinking about the issue in a variety of ways.
Historically Excluded Populations
We wonder if the term “minority” is the most useful term in this instance. It seems to imply that this is an issue that is smaller than it is; “minority” is, by design, a diminutive term. If we take all “minority” cultures and ethnicities in the United States as a monolithic whole, as the term seems to want us to do, non-”white” Americans account for 40% of the population. So, a minority, yes, but not by much.
But the grouping of these diverse populations into a monolith called “minority” is problematic. The category is comprised of many ethnic and cultural groups, even as recognized by the Department Of Health and Human Services. HHS’ website provides statistical data on
- African Americans and Mental Health
- American Indians/Alaska Natives and Mental Health
- Asian Americans and Mental Health
- Hispanics/Latinos and Mental Health
- Pacific Islanders/Native Hawaiians and Mental Health
Each of these populations have different needs, and different relationships to mental healthcare in terms of access, stigmas, and attitudes.
One vital thing that these groups have in common is that they are historically excluded from primary research in many meaningful ways. Mental health statistics have all-too-often excluded granular demographics that may help better serve diverse populations. And as a result, practitioners are often unprepared to treat these populations in ways that are at once meaningful and culturally sensitive.
The American Psychological Association says, “Racial/ethnic, gender, and sexual minorities often suffer from poor mental health outcomes due to multiple factors including inaccessibility of high-quality mental health care services, cultural stigma surrounding mental health care, discrimination, and overall lack of awareness about mental health.”
In terms of exclusion from meaningful research studies, a recent systematic review published in Frontiers in Public Health found that “Although some literature reviews have summarized barriers and facilitators for mental health service use among children and adolescents, none of them focused on racial/ethnic minority adolescents in the U.S. Given the unique social and cultural contexts that minority adolescents navigate in the U.S., it is important to understand their experiences when seeking mental health services.”
When it comes to eating disorder research, the scenario is equally dire–if not worse. So much so that Frontiers in Psychiatry published an article literally entitled “A Plea for Diversity in Eating Disorders Research.” In the article, the authors propose that:
Future ED research would need to focus on addressing the role of diversity in treatment experiences and disparities in outcomes, which may require adjusting recruitment, assessment, and reporting practices in clinical trials. Moreover, anticipating future developments that could pose diversity challenges and incorporating diversity-related issues systematically in ED-related clinical training are asked for, though tackling these issues may require considerable effort to extend theoretical conceptualizations of diversity and develop interventional approaches.
It is for this reason that we have chosen to frame these populations not as “minorities” but as historically excluded.
How can we better serve historically excluded populations?
There are a few steps that practitioners can take now to better serve the mental health and eating disorder treatment needs of these excluded populations.
Develop a sense of cultural humility
A good first step is for practitioners and clinicians to recognize their own cultural subject positions. Understand that clients may have a remarkably different background, and a disparate set of assumptions about everything from treatment efficacy to mental illness itself.
Understand, too, that the research and foundations that many practitioners receive in school does likely not reflect the cultural specificity of all clients. As mentioned above, these populations are not adequately reflected in the research.
Become diversity-affirming
In their practices, providers should celebrate and promote diversity. Taking a pluralist approach that values the uniqueness of every client and their individual background can help to ensure that needs are being met in ways that are sensitive to cultural and ethnic backgrounds.
Promote diverse hiring
If programs are deliberate and thoughtful with their hiring, seeking to promote diverse voices and perspectives amongst the staff, clients will feel more supported in terms of their own cultural uniqueness.
At Galen Hope, we are proud of our diverse team. Amongst our staff, we can support clients in at least 5 languages. We are thoughtful about how we relate to our clients, and mindful of their cultural needs. We are committed to understanding the gaps in mental health and eating disorder research, and support our team in their contributions to this research.
THE ROAD TO WELLNESS STARTS BY SEEKING HELP. TODAY.
Built on the principles of assertive community treatment, Galen Hope is an eating disorder and mental health treatment center offering individualized treatment options that include Intensive Outpatient (IOP) and Partial Hospitalization Programs (PHP). As a “Community of Integrated Wellness,” we pride ourselves in fostering a thoughtful and meaningful care experience that can guide our clients on their road to recovery and increased quality of life, regardless of diagnosis. Galen Hope currently offers separate, age-specific programming for female and transfeminine adolescents ages 12-17 and adults 18 and up, as well as gender-specific programming for males and transmasculine individuals with eating disorders and primary mental health diagnoses.
To learn more, or to join our community for integrated wellness, please contact us today.
Belong. Heal. Grow.