Consider Intersectionality: Caring for Latinx and LGBTQ+ Individuals

Check out this lecture I did for the University of Toledo College of Medicine's Language of Diversity Series. Other lectures as part of the series can be found here. 

Stigma Within Professionals

Let's face-it, there is some major stigma within the social work field in regards to seeking mental health therapy/treatment services. We do not have parity between physical health and mental health. Parity is the state or condition of being equal and we do not view these types of health as equal. 

Recently, I challenged my co-workers to think differently about their responses they gave to changing our Employee Assistance Program (EAP). The current EAP provider was ending their contract with us and need to find a new provider. A co-worker asked about a provider she had seen some flyers for in the building (we share our building with another organization). It was shared that the EAP provider on the flyer was a subsidy of a local community mental health center that we contract with. The co-worker wasn't advocating for them, but pointing this EAP provider out as a potential option. The question was proposed, could this be an option?

Several staff members had strong opinions about using this particular EAP as a provider. Staff had the same feelings that stop many people from getting services:

• I may have gone to school with some of them.
• What if someone I know sees me?
• How do I know my information will be kept confidential?

While I am not saying these feelings are invalid (because all feelings are valid), I would challenge people to stop and think about those feelings and if they relate to stigma. If this was a medical procedure would these be the same thoughts and feelings? These immediate reactions staff shared really relate to the internalize stigma we, even as leaders in behavioral health, have towards seeking help for mental health concerns. We don't trust people to keep our information confidential and we are afraid people who we know may see us getting help. 

I challenged the staff to think about internalized stigma. I am not advocating to contract with this particular EAP provider. I do think we need to examine our thoughts and reactions when mental health treatment "hits close to home". Sure it's easy to think that people should get help when they need it and that people should believe that licensed professionals would keep their information confidential, but is it that easy when it comes to the professional needing help. 

Parity comes when we see mental health and physical in the same light. When our thoughts and reactions to someone (or ourselves) needing psychiatric medications or to talk to someone are the same as getting prescribed something for blood pressure or diabetes. Parity occurs when we take the same prevention measures for mental health and as we do for physical health (hint: a lot of it is the same). Parity is when we understand that physical and mental health are interdependent and they effect each other. 

Stigma is a major roadblock to parity. If we are going to #EndStigma we need to start evaluating our own thoughts and beliefs. 

I'm Sorry

I've come to the realization that I have to apologize to myself. For far too long, I have allowed my employers to make me feel that I am "lucky" to have a job or that I am "fortunate" to be working for them. I have allowed myself to internalize these feels and have convinced myself to think that I am worth less that my current circumstance. I have allowed myself to reinforce these beliefs with denied opportunities and have questioned by own competencies and qualifications. I regularly defer any type of group recognition to the group for success while also taking sole responsibilities for failures and shortcomings. I feel the need to be overqualified to even compete with those who are barely qualified. 

So, I am sorry. I am sorry I allowed other's devaluation of my skill and competence to question my own worth. I am sorry I allow myself to settle for less because I have internalized messages that I am lucky to work for an organization. More importantly, I am sorry for questioning what I know about myself and not having the internal strength to fight against socialized norms that don't always fit me. 

I am quite and introverted. I reflect and think. I believe my words should be heard so I refrain from just creating noise. I am not the person to introduce myself to everyone in the room, but I am the person to develop deep connections with others. What I lack in charisma I make up for in wisdom. What I lack in knowledge and skill I make up for in an eagerness to learn and humility. 

As I think about where I am in life and where I want to go, I know that my perspectives have to change. A true apology requires a change in behavior. 

Challenge for Transformation

In her book, I'm Still Here, author Austin Channing Brown described the act of challenge for transformation. In context, people may say something racist (or offensive) and recognize the err and apologize for it. In many cases it becomes more of a social courtesy rather than having any real intent to change. In chapter 4 or 5, the author discusses the discord around race and how it is centered around whiteness. The act of apologizing often so the offender feels better; not for the individual who was wronged. Not accepting the apology would be a social misstep, even if the apology was meaningless. 

Instead of accepting the apology and moving on, Austin Channing Brown will challenge for transformation. She will ask the individual what are you going to do differently now? This is a great question to get people to think about their behavior and how to change it. Apologizes don't automatically lend themselves to transformation. It is important for individuals to think about their actions and how to change those in the future. When people are genuinely sorry, they will want to change behavior. Asking them directly will give them a chance to think about it. If they are not interested in changing their behavior they may get upset, but that is ok. Their apology needs not be accepted because they are not interested in doing things differently, they are just interested in saving face. 

An apology without change is empty. Challenge for transformation. 

Stop acting with yesterday's logic

 

Doing the right things

Belonging

In the work of Diversity, Equity, and Inclusion, we can see the growing importance of the concept of belonging. The Society for Human Resource Management (2020) states that research has shown the need to belong at work is second to the need to belong at home. I am not an expert on the topic of belonging, but it is intriguing to me. It has been brought up in some of the spaces I am in, especially at work where our Director of Health Equity has started to bring it up a lot. 

I know from my own experience I do not feel like I belong at work. I don't feel a part of what's going on. I feel like if I left no one would care or notice. I feel like the work I do isn't valued so whether I take on extra responsibility or do the bare minimum it doesn't matter. 

I asked the group I provide training supervision for "what does it feel like when you belong?". I wanted to get from their perspective what does belonging look and feel like because belonging is a feeling. The best intentioned supervisor or administrator can do a lot of things to try to make employees feel involved, but that may not get that feeling of belonging. 

Here are the responses from the group when asked about feeling like they belong. 

• Protecting the group
• Receiving and giving positive reinforcement
• Getting something out of the relationship
• Authentic relationships that allow for correction
• Accountability
• Knowing the culture
• Feeling safe

I think that last point is very salient. Feeling safe at work is a necessary first step to belonging. How do you belong without feeling safe? Maybe belonging is a long term process, so organizations should focus on helping people feel safe before they feel like they belong.