Blog

By: Patricia Napolitano, MSW, LISW-S

Understanding the Intersection of Oppression and Pathology

Mental health diagnostic intakes are a crucial step in assessing and addressing an individual’s psychological well-being. However, these assessments can sometimes inadvertently reinforce themes of oppression and pathology, especially when they do not account for the broader social context. Social workers and other mental health professionals play a critical role in mitigating these effects by employing an equity-focused approach and the least restrictive diagnosis philosophy.

Themes of Oppression in Diagnostic Assessments

1. Cultural Bias and Misdiagnosis: Diagnostic criteria can sometimes reflect cultural biases, leading to misdiagnosis of individuals from diverse backgrounds. For example, symptoms that may be culturally normative or influenced by social stressors can be pathologized when viewed through a narrow, Eurocentric lens. This can result in inappropriate or stigmatizing diagnoses that overlook the influence of cultural and systemic factors.
2. Socioeconomic Factors: Socioeconomic status can significantly impact mental health and access to care. Diagnoses that fail to consider the impact of poverty, marginalization, and systemic inequality may pathologize behaviors that are responses to external stressors rather than indicative of mental illness.
3. Stigmatization of Marginalized Groups: Certain diagnoses may carry stigmatizing labels that disproportionately affect marginalized groups. For instance, diagnoses related to psychosis or substance use disorders can be stigmatizing and may further entrench systemic inequities if not handled with cultural sensitivity and an understanding of the broader context.

Equity and Psychoeducation in Diagnosis

1. Equity-Focused Assessment: Social workers and mental health professionals committed to equity work to ensure that diagnostic assessments are sensitive to the individual’s social and cultural context. This means recognizing the ways in which oppression and discrimination can impact mental health and adjusting diagnostic criteria and interventions accordingly. Equity-focused assessments strive to prevent misdiagnosis by considering factors such as cultural background, socio-economic status, and experiences of systemic oppression.
2. Psychoeducation: Providing psychoeducation is a key component of an equity-focused approach. This involves educating clients about mental health and the diagnostic process, helping them understand how their experiences and symptoms are being interpreted. Psychoeducation empowers clients to engage more effectively in their treatment and to challenge any potentially stigmatizing or oppressive aspects of the diagnostic process.
3. Least Restrictive Diagnosis Philosophy: The least restrictive diagnosis philosophy emphasizes choosing the diagnosis that least limits a person’s rights and freedoms while still addressing their mental health needs. This approach prioritizes diagnoses that are least likely to impose unnecessary restrictions or stigmatization on individuals. It encourages mental health professionals to consider how different diagnoses might affect a person’s opportunities, relationships, and overall well-being.  A person may have symptoms of a disorder without having a disorder at all; many symptoms fall within expected emotional and behavioral responses to stress or biopsychosocial determinants of health. 

The Role of Social Workers and Diagnosing Professionals

1. Advocacy and Sensitivity: Social workers and diagnosing professionals are often at the forefront of advocating for clients’ rights and well-being. They work to ensure that diagnostic practices do not perpetuate oppression and that clients are treated with respect and dignity. This involves being aware of and addressing personal and systemic biases that might influence diagnostic decisions.
2. Holistic Understanding: Professionals committed to an equitable and least restrictive approach consider the whole person, including their social, economic, and cultural context. They strive to provide a comprehensive assessment that accounts for external factors influencing mental health, rather than solely focusing on symptoms.
3. Collaborative Approach: Engaging clients in a collaborative and transparent diagnostic process is essential. Social workers and diagnosing professionals seek to involve clients in discussions about their symptoms, experiences, and concerns, ensuring that the diagnostic process is a partnership rather than a top-down assessment.

In Conclusion

Patients often approach mental health providers with a healthy dose of suspicion, particularly now with so much information available that continues to support Culturally Stigmatizing beliefs about Mental Health. Navigating themes of oppression and pathology in mental health diagnostics requires a thoughtful and equitable approach. By employing an equity-focused perspective and adhering to the least restrictive diagnosis philosophy, social workers and mental health professionals can better address the complexities of mental health while minimizing the risks of reinforcing systemic inequities. This approach not only enhances the accuracy and fairness of diagnoses but also supports more compassionate and effective mental health care. If you are in need of mental health counseling, please reach out to our associates at Behavioral Health Services of Greater Cleveland at one of our two locations: Rocky River and Medina. Family, individual, and couples counseling are available. Please call (866) 466-9591 ext. 0 for an intake.