In our specific corner of the world at Flourish, we care sincerely about the well-being of our clients. We hope for our practice to be a true safe place for women and issues related to diversity and varied cultural considerations play a huge role in the work that we do. As we strive to create equity and advocate for our clients, we must look at the rates of mental health issues among disenfranchised groups and then take steps to understand how we can utilize interventions, such as diagnosis, to create opportunities for us to improve as professionals.
Below is a breakdown by demographic of rates of mental illness in the US, according to the National Alliance on Mental Illness:
As mental health professionals, we are acutely aware of the disparities in care for these often oppressed and overlooked communities. We know there are multiple barriers to access to help, including mistrust in helper/clinician roles, and misconceptions to help overall. It is also a well-known fact that communities of color weren’t looked at or studied in the advent of counseling. Diagnoses, interventions, modalities, note-taking, and assessment of these groups were thus created with bias and exclusion.
Consideration about the whole picture of our client’s life, what is involved in what we hear, and how we conceptualize presenting problems should be part of our ongoing advocacy work as counselors. Building the therapeutic relationship to dive deeper into presenting issues can allow us, as clinicians, to get more to the core of needed care. Defining thoughts or feelings around life events with mindful techniques can further identify our client’s presenting problems, and sometimes, a diagnosis isn’t leading these cognitions for clients of color.
We must remember that a diagnosis can carry from counselor to counselor and can cause our clients more harm than good with limited touch points, communication, and can hinder the positive progression of the client’s work. Therefore, with advocacy work, it’s important to ask questions like: how does a diagnosis change the client’s point-of-view once they overcome the societal and cultural pressures of committing to therapy? A diagnosis should be explored thoroughly and be in line with the factors of the client’s life, thinking through moments of systemic injustice they may face throughout their lifetime.
Equity and transparency hold such an important place in my work as a counselor. These pillars are necessary to build rapport, trust, and safety in the therapeutic relationship. I take this into consideration in every session, especially when it comes to diagnosis and cultural considerations.