The Importance of Representation within Mental Health Care
Jessica Chang MHC-LP
The mental health field has historically centered whiteness. From the very beginning, leaders in psychology were almost exclusively white, heterosexual men. The impacts of this narrow viewpoint are seen and felt in the racist, sexist, homophobic foundations of psychological concepts, theories, and diagnoses (e.g. hysteria, conversion therapy, etc.). Devastatingly, diversity in mental healthcare continues to be largely lacking. A striking example includes as recently as in 2021, the American Psychological Association acknowledged that the organization “ignored the opportunity to take a formidable stand to address poverty, racism, and social concerns affecting African Americans, despite the strong advocacy of our members, some of whom consequently left the organization.” Although the mental health field is moving towards addressing long-standing health and wellness disparities and embodying the importance of tending to diverse identities and experiences, lack of representation of marginalized identities within the mental health field continues. This lack of representation includes but is not limited to race and ethnicity, gender, sexual orientation, socioeconomic status, and abilities, along with the intersection of multiple marginalized identities.
Representation within the mental health field is deeply impactful, meaningful, and necessary in many ways:
1. Acceptance and belonging. Representation communicates what is socially acceptable and valuable. Strong mental health stigmas remain within many non-dominant cultures, attaching shame and guilt to working with a mental health professional and upholding therapy as being for affluent white folk or those who are “crazy” or “damaged”. These stigmas are largely informed by colonizer narratives of what is considered acceptable and a long history of trauma for BIPOC communities experiencing and witnessing attempts at trusting Western people/practitioners, lack of accessibility, and maltreatment of marginalized groups. These stigmas are further enforced through pre-existing representation of mental health care as WASP-y clients receiving treatment from WASP-y therapists.
By seeing mental health professionals who share your identities, these stigmas are challenged and the message is communicated that you are not alone, you belong, and you do not need to feel shame for who you are or for seeking help. Marginalized folk are often left out of the mental health discourse and are less likely to seek and receive mental health care than their white counterparts. We are only as strong as our most vulnerable, and seeing more representation within the mental health field can increase the visibility, accessibility, and possibility for vulnerable populations to receive the care they deserve. It is only then that we can all reach our fullest potential.
2. Empathy, understanding, curiosity, confidence, and community. When working with a therapist with shared or similar identities, one may feel a greater sense of empathy from their therapist, which is an essential part of effective therapy. It is common for marginalized individuals to feel a sense of shame regarding their minority status. With clear and unwavering representation, clients may feel that there is more room for their experiences and perspective to be heard and not judged. Further curiosity and growth may be facilitated by a therapist who shares various identities and experiences. Empathy allows clients to feel understood without having to explain every detail of their experience and attuned to such that they feel seen without having to justify and defend themself from ignorant biases. Representation thus helps historically marginalized folk feel more confident and in community with all of their identities.
3. Protection against harm. While therapy can save lives, it can also cause and perpetuate deep-rooted harm. Therapy is relational work. It requires a sense of safety and trust in order to be useful, and that sense of safety and trust can be broken. Representation can help minimize being questioned and judged in a demeaning way, often experienced as microaggressions or blatant, outright discrimination. Underrepresented communities seeking mental health care are already up against various barriers in the current health care system, as well as barriers of mistrust from the past in which the medical industrial complex has created a sense of danger regarding itself when it comes to treating marginalized communities. This is seen through well-documented mental health disparities including BIPOC individuals disproportionately receiving diagnoses of greater severity and less appropriate care than white individuals. Representation can help to address the very real fear that marginalized communities have in regards to seeking help and receiving mental health care.
Conclusion
As it often goes, representation is extremely important and impactful within mental health care. Not only can representation facilitate greater feelings of belonging and acceptance, but it can be a key factor in marginalized communities seeking out and receiving the appropriate care we all deserve. Representation in itself is often an act of intersectional, multicultural, trauma-informed, decolonial, anti-oppressive care. It is imperative to continue to push for diverse narratives, multi-faceted humans, to be heard and embraced within the mental health field. We will thrive when we all thrive.
Sources:
Chamlou, N. (2024). Diversity in the Mental Healthcare Profession: Then and Now. Psychology.org.
Huang, C. Y., & Zane, N. (2016). Cultural influences in mental health treatment. Current opinion in psychology, 8, 131–136. https://doi.org/10.1016/j.copsyc.2015.10.009
Van Sickle, H. (2024). Why Representation Matters in Mental Health: Students and Alumni Reflect on The Impact of Their Mentors. William James College.