Putting the mind at ease: How mental health professionals can be more inclusive for people with disabilities
By Jesse Berlin
Even if a person doesn’t have a physical injury or illness, they can still be in pain. To support those who may be suffering internally, health care providers should ensure that anyone who’s looking to talk to someone or get prescribed medication for mental health purposes can do so safely and comfortably. However, people with disabilities often face greater obstacles in getting the care and treatment they need because of health care facilities overlooking accessibility gaps and health care providers failing to properly communicate with and understand patients [1].
To remove these barriers, improvements to the physical space and structural environment and changes to the systematic procedures through which health care providers conduct their business can help make sure anyone, regardless of their disability status, is accounted for [1].
Update facilities with features such as automatic doors and accessible parking spots, according to the National Center on Health, Physical Activity and Disability, so patients can enter, exit and navigate the space without difficulty [1]. Put up signs and displays that anyone can read, says the Society for the Advancement of Psychotherapy, and add in movable furniture and adjustable lighting to waiting rooms and appointment spaces [2]. Have alternative formats such as braille, large print or plain language for any paperwork or documentation someone receives to not only make it easier for the patient but for the provider to streamline the intake process [1] [2] [3]. It might also be a good idea to have qualified interpreters and assistive technology on standby [1].
Having electronic versions of the documents at your disposal can be beneficial, according to an article on alternate formats by the state government of Maine, because it’ll allow the patient to adjust the text size or use a screen reader to process the information at their own pace [3]. In that same vein, health care providers can offer online scheduling for appointments to take advantage of the electronic format and have ways to receive or send out requests remotely [1].
Once the appointment starts, health care providers, particularly those who specialize in or are knowledgeable about mental health, can change the way they talk to and interact with patients with disabilities as they can have misconceptions or preconceived biases that can negatively affect not only their relationship with the patient but their ability to provide adequate care [5].
One of the main areas that could cause contention, according to an article on disability inclusion by John Hopkins University’s Bloomberg School of Public Health, is that the health care provider believes that they know best and thus their assessment of the situation, subsequent diagnosis and recommended treatment plan are correct, regardless of how the patient may feel [4]. It’s understandable that a provider would think this, but if they reach these conclusions based on their lack of knowledge or understanding of their patient’s lived experience, it can be harmful.
Health care providers should consider that disability isn’t something that makes someone broken, damaged or less than and thus they need to be fixed or cured [5]. It can obviously be acknowledged, but it doesn’t define someone as a person and encapsulate everything about their life nor does it have to influence how an individual thinks and feels in the moment [5]. Don’t assume there’s automatically a link or connection between someone’s mental health concern and the disability, says the National Alliance on Mental Health [6]. It’s possible there is, but what’s important is that the provider gives the patient the space and opportunity to say that or not say that themselves while focusing on laying out options based on the patient’s own input and answering any questions they may have as they come to their own decisions [1] [4].
Someone could be dealing with a rough period of their life or dealing with loss, trauma or tragedy, just as anyone could, or has a diagnosed or undiagnosed mental health disorder, all of which can be unrelated to disability, and that’s why they came in. However, if a patient explains to you themselves that a disability they have could be a contributing factor in how they feel at this particular moment in time, it’s important for the health care provider to understand that an individual’s relationship with their disability can be the result of how society at large views and treats people with disabilities and that they could internalize these societal perceptions to shape their own, likely negative, view of themselves [5]. Presenting to a patient self-compassion and resiliency, as many mental health professionals might do with any patient, can help shift their mindset or mentality and behavior and create a more positive outlook on their life [5].
It’s okay to not have all the answers either. Pointing patients in the direction of other resources and areas of support can also be beneficial, according to an article on behavioral health care for patients with disabilities by the Healthy Minds Policy Initiative, especially if a person feels alone or like they don’t have anyone else they can reach out to [7]. Whether it’s groups that bring people dealing with or experiencing similar sets of circumstances together, community-based events and initiatives that are welcoming to all, including people with disabilities, or publicly-available programs that teach valuable and applicable skills, they give patients a chance to hopefully make meaningful connections and find themselves in a happier, more fulfilling place and state of mind [7]. Knowing about these opportunities takes initiative on your part but they can help reinforce in patients a sense of empowerment and a more hopeful attitude [1] [7].
Anyone who works in health care should feel an obligation to support people’s health and well-being as best as they can and that goes beyond treating the physical. People may still not be okay even if they’re physically okay, and by taking bigger steps towards inclusivity and an expansion of their knowledge base to consider people with disabilities, health care providers can help make sure no patient that’s seeking treatment is overlooked, mistreated or left behind.
[1] n.a. (n.d.). Tips for Promoting Disability Inclusion in Your Mental Health Care Practice. The National Center for Health, Physical Activity and Disability. https://www.nchpad.org/resources/tips-for-promoting-inclusion-in-your-mental-health-care-practice/.
[2] Balva, D. & Tapia-Fuselier Jr., J.L. (2020, March 8). Working with Clients With Disabilities. Society for the Advancement of Psychotherapy. https://societyforpsychotherapy.org/working-with-clients-with-disabilities/.
[3] n.a. (n.d.). Alternate Formats. Accessibility Resources. https://www.maine.gov/accessibility/accessibility-guide/documents/alternate-formats.
[4] Rogers, L.S. (2023, July 19). From Individual to Industry: How We Can All Improve Disability Inclusion. John Hopkins Bloomberg School of Public Health. https://publichealth.jhu.edu/2023/disability-inclusion-through-advocacy-accessibility-and-appreciation.
[5] Stuntzner, S. & Hartley, M.T. (2014). Disability and the Counseling Relationship: What Counselors Need to Know. American Counseling Association. https://manifold.counseling.org/read/disability-and-the-counseling-relationship-what-counselors-need-to-know.
[6] n.a. (n.d.). People with Disabilities. National Alliance on Mental Illness. https://www.nami.org/community-and-culture/people-with-disabilities/.
[7] n.a. (2024, July 17). Improving access to behavioral health care for people with intellectual and developmental disabilities. Healthy Minds Policy Initiative. https://www.healthymindspolicy.org/research/improving-access-to-behavioral-health-care-for-people-with-intellectual-and-developmental-disabilities.
