Teacher Tea
Mental Healthcare's Disability Divide: Themes of Ableism and Exclusion
People with disabilities often face significant barriers in accessing mental healthcare, despite being more likely to experience mental health challenges and seek support for them. In a small study done in 2022, involving 20 U.S. adults with diverse disabilities, six key themes emerged.
Many participants reported misplaced assumptions, with therapists and other mental health providers either overly focusing on their disabilities or ignoring them entirely. Instances of medical neglect and gaslighting were also common, as participants reported feeling dismissed or invalidated when advocating for their needs; interpersonal ableism often manifested in subtle expressions of condescension, such as providers addressing family members instead of speaking directly to the disabled individual. Adding to these problems was an evident and prevalent lack of disability knowledge amongst providers, with many showing limited understanding of disability-related issues and little interest in learning more. Participants in the study also reported basic accessibility challenges, including transportation difficulties, inaccessible office layouts, and a lack of accessibility features on telehealth platforms. The conclusion from this study suggests that systemic ableism within mental health institutions has perpetuated exclusionary practices, especially for individuals with complex, marginalized identities.
What the participants in that study requested was quite simple: improved accessibility, greater attention to patients, and trust in the participants’ own expertise with regard to their lived experiences. Addressing these issues requires both interpersonal changes, like avoiding stereotypical assumptions, and systemic reforms, including better disability competency training. Those of us with disabilities who are seeking mental healthcare might consider finding therapists who have specialized training, or experience in disabilities, in order to ensure more effective care.
This is a serious issue with potential ramifications for our student population. Students with disabilities often encounter significant barriers in accessing quality mental healthcare. While systemic issues undoubtedly play a role, students and their advocates must ultimately acknowledge the responsibility that they bear in navigating the healthcare system. This includes advocating for their unique needs, which can involve researching and selecting qualified professionals, and building supportive networks within the disability community.
Can the free market play a vital role in addressing these challenges? Increased competition among healthcare providers could incentivize better quality of care, in theory. Reducing unnecessary barriers and regulations that hinder the entry of new therapists, along with the development of innovative healthcare solutions, might also provide greater resources to this demographic. This could include streamlining licensing requirements for qualified mental health professionals, making them less expensive and more accessible to those who wish to join the profession, and expanding the use of technology to improve access to care. Disabled Americans often bear financial burdens that their able-bodied counterparts do not, which could account for a lack of therapists with disabilities, due to the expenses associated with licensure and accreditations.
Ultimately, a multi-pronged approach is needed, combining individual advocacy and market-driven accessibility in order to ensure that individuals with disabilities have access to the mental healthcare that they deserve.
You can read more about this particular study in “Ableism Is a Major Barrier to Mental Healthcare,” by Professor of Psychology Kathleen R. Bogart, for Psychology Today. Many students with disabilities will encounter challenges similar to the ones outlined in the study. If we want all of our students feel included, we need to understand their experiences. As teachers, we are often the first to notice that a particular student is struggling, so we have an important part in establishing access to mental health support. We also play a very unique role in our ability to normalize diversity and dissolve the various stigmas and stereotypes around disabilities.
How are mental health services integrated with other services in our schools, like academic support and special education? And how are the effectiveness of school-based mental health services being evaluated? These are the initial questions to consider when evaluating the effectiveness of our mental health services for all students.