Mental Illness Discrimination in Mental Health Treatment Programs: Intersections of Race, Ethnicity, and Sexual Orientation

Abstract

People with mental illnesses (PWMI) who are of color and/or lesbian, gay, or bisexual (LGB) experience mental health disparities, including within mental health treatment programs (MHTPs). Informed by a critical framework with attention to intersectionality and microaggressions, this qualitative study asked 20 PWMI and family members who also are of color and/or LGB whether they had experienced mental illness discrimination in MHTPs, a possible factor in disparities. We also asked participants about aspects of MHTPs that supported recovery. Participants reported that they were ignored/not listened to, not viewed as complex individuals, experienced condescension/lack of respect and violations of privacy or other rights, and were presumed to lack intelligence. In addition, identifying mental illness discrimination was complex due to intersections of identities. Despite these perceptions of discrimination, participants described supportive aspects of MHTPs. Implications for practice and research are offered.

State of the art in U.S. multicultural social work practice: Client expectations and provider challenges

“…Often, providers did not adequately address the needs of minority communities (e.g., Ahn, Miller, Wang, & Laszloffy, 2014;Barrio, et al, 2008;Holley, Tavassoli, & Stromwall, 2016).…”

“…Racial and ethnic minority clients reported having experienced marginalization, discrimination, bias, and microaggressions from social workers and other professionals in healthcare services (Black, 2012;Hicks, Tovar, Orav, & Johnson, 2008), mental health services (Constantine, 2007;Holley et al, 2016;Huang, Appel, & Ai, 2011;Lorenzo-Blanco & Delva, 2012), and substance abuse services (Jones, Hopson, Warner, Hardiman, & James, 2015). Constantine (2007) found 12 different types of microaggressions that African American college students experienced while receiving college counseling services.…”

“…Providers accused the clients of hypersensitivity regarding racial or cultural issues, denied racial-cultural differences through colorblind statements, and denied their personal racism. Holley, et al (2016) found that minority clients felt disregarded in mental health services. They reported often having their identities simplified and rights disrespected and being perceived as lacking intelligence.…”

Stigma of mental illness and multicultural counseling self-efficacy : investigating the implications of the multicultural training environment, mental health literacy, and empathy.

“…Research indicating that the stigma of mental illness has an effect on mental health outcomes has led to increased study of stigmatizing attitudes among mental health providers, both of individuals providing service Woollaston, & Hixenbaugh, 2008) and of mental health care program settings (Flanagan, Miller, & Davidson, 2009;Holley, Tavassoli, & Stromwall, 2016). Researchers have already called upon medical professionals, such as physicians and nurses, to become more aware of the stigmatizing attitudes that have negatively impacted the medical care of their patients with mental illnesses (Clarke et al, 2007;Freidrich et al, 2013;Sadow et al, 2002).…”

“…Additional recent literature suggests that such awareness will become expected of a wide range of mental healthcare providers, including non-medical mental health care providers, such as professional counselors (Holley et al, 2016;Kennedy et al, 2014;Nemec et al, 2015;Stuber, Rocha, Christian, & Link, 2014).…”