In a recent study that examined physician perspectives related to people with disabilities (Iezzoni et al., 2021), results indicated that 80% of physicians believe that people with significant disabilities have a worse quality of life than those without disabilities. Furthermore, only about 18% of physicians believe that the medical field is unfair towards those with disabilities.
I am currently training to be a pediatric psychologist and have the privilege to work with children with disabilities and their families to address behavioral health concerns that may arise when coping with a medical condition. In this role, I work closely with physician and medical teams. I was, like many medical and adjacent professionals (along with the entirety of the Twitterverse), frustrated by the results of this study – understandably so. Nevertheless, these results are not new, but merely a snapshot of the current situation. Ableism has been deeply engrained in the medical field for years. For the disability community, the results of this study confirmed many painful lived experiences. For medical professionals, it was a reflection of the many ways we have failed to address ableism in our own ranks.
There are many questions that have been raised as a result of Iezzoni’s study – how did this happen? Who is responsible? How to we stop a culture of ableism in the medical field? As a graduate student, I reflected on my own experiences and the ways that ableism has been implicitly (or explicitly) engrained in my own psychology training. There have been very few instances of engagement with disability issues in the classroom, lack of relevant training or collaboration experiences with those with disabilities, and limited exposure to disability self-advocacy. There is a huge lack of representation of those with disabilities within psychology leadership and in the student population. Majority of psychology students are dissatisfied with disability-related training experiences (Green et al., 2009). I became interested in the question of who is responsible for preventing ableism in the medical and mental health field. Specifically, I am most curious about how we teach future mental health professionals to care about and utilize multicultural and social justice approaches in their work. Said another way, how do we teach students to be anti-racist, anti-ableist, anti-sexist, anti-xenophobic, anti-homophobic, anti-transphobic, etc.?
I think one of the most important aspects in teaching future medical and mental health professionals is through the training environment, specifically, the social justice training environment. Graduate training is an incredibly formative time for future healthcare professionals. During this time, student attitudes, beliefs, and behaviors are highly influenced, especially related to multiculturalism and social justice. There are a few ways that graduate and medical programs can invest in anti-ableist education and training opportunities for their students (adapted from McConnell et al., 2021):
Multicultural and social justice orientation infused throughout the training environment. This includes through teaching, education, relationships, modeling, etc., at every level of engagement.
Inclusivity. There should be diverse representation throughout all levels – faculty, students, administration, leadership, etc. This means hiring diverse educators, recruiting students with intersectional identities – AND creating and fostering a culture that supports retention of these individuals.
Identity. Encourage all persons to develop a multicultural-social justice identity. This should also include awareness of own intersectional identity, as well as engagement with personally meaningful reflection of power, privilege, and oppression in identity development (Caldwell & Vera, 2010).
Opportunities. There should be practical and applied learning opportunities to engage in multicultural and social justice informed work.
Collaboration. Healthcare services do not occur in a vacuum. Encourage students to collaborate with community organization to engage with anti-ableism efforts beyond the classroom (Viecili et al., 2010).
These five examples provide only a starting place for programs to engage multiculturalism and social justice in the formation of their students. The good news is that there are so many great approaches and resources available! I hope that the results of Dr. Iezzoni’s study is a wake-up call for medical and mental health training programs to better engage anti-ableist perspectives and practices.
A picture containing books, shelves, library; male student appears blurry in the background, wearing a backpack.
References:
Disability Visibility: First Person Stories from the 21st Century. Edited by Alice Wong. https://disabilityvisibilityproject.com/book/
Green, D., Callands, T. A., Radcliffe, A. M., Luebbe, A. M., & Klonoff, E. A. (2009). Clinical psychology students’ perceptions of diversity training: a study of exposure and satisfaction. Journal of Clinical Psychology, 65(10), 1056–1070. https://doi-org.ezproxy.wheaton.edu/10.1002/jclp.2060
Iezzoni, L.I., Rao, S.R., Ressalam, J., Bolcic-Jankovic, D., Agaronnik, N.D., Donelan, K., Lagu, T., & Campbell, E.G. (2021). Physicians’ Perceptions of People with Disability And Their Health Care. Health Affairs, 40(2), 297-306.
McConnell, J.M., Liu, T., Brown, E.M., Fort, C.J., Azcuna, D.R., Tabiolo, C.A.M., Kibble, C.D.M., & Winslow, A.B. (2021). The multicultural peace and justice collaborative: Critical peace education in a research training environment. Peace and Conflict: Journal of Peace Psychology,
Viecili, M., MacMullin, J., Weiss, J., & Lunsky, Y. (2010). Predictors of Psychology Graduate Student Interest in the Field of Developmental Disabilities. Journal of Mental Health Research in Intellectual Disabilities, 3(4), 190–201. https://doi-org.ezproxy.wheaton.edu/10.1080/19315864.2010.524725
