8 Ways to Create a More Inclusive Workplace: A Guide for Providers

A traditional definition of inclusion is giving everybody a seat at the table. But today, in the field of mental health in particular, that definition is evolving rapidly. “To me, true inclusion means starting a new table, one that is co-constructed in a way that elevates the perspectives and needs of those who have not been centered before,” says Sand Chang, PhD (they/them/theirs), a nonbinary psychologist and equity consultant. “This includes people who have lived experiences as BIPOC (Black, Indigenous or people of color), trans, queer, disabled, neurodivergent, fat, poor and other marginalized identities.”

Creating an Inclusive Workplace

By integrating inclusion, diversity and belonging within their practices, providers can build safer spaces for patients and families. When they fail to do so, they run the risk of exacerbating mental health disparities. For example, research shows that -

• Providers are significantly less likely to ask BIPOC people about eating disorder symptoms than they are white people.[1]
• Trans individuals are four times more likely to experience a mental health condition than cisgender individuals.[2]
• Doctors spend less time with people in larger bodies and fail to refer them for diagnostic tests.[3]

Crafting an intentional space for your practice can go a long way toward closing these critical care gaps and developing more meaningful connections with patients.

“When I walk into a practice as someone in a larger body,” says Meredith Nisbet, MS, LMFT, CEDS-S (she/her/hers), national clinical response manager at Eating Recovery Center and Pathlight Mood & Anxiety Center (ERC Pathlight), “I need to see myself in that room—that it has a chair I fit into and a staff member who looks like me. That signals this is a place that has thought about my needs.”

The eight steps outlined below can help providers develop a more inclusive practice.

1. Assess your own biases.

Start by examining your own implicit biases. These are the biases that are inherent in each of us.

“Increasing self-awareness about our implicit biases can help prevent us from unintentionally saying or doing something that our clients consider to be culturally inappropriate or offensive,” says Charlynn Small, PhD, CEDS-S (she/her/hers), assistant director of health promotion at Counseling and Psychological Services, University of Richmond.

Harvard University offers an online tool called an Implicit Association Test that providers can use to examine their implicit bias. Providers can then challenge those biases by asking themselves open-ended questions, such as: Why do I feel this is true? What evidence do I have to support that? How can I respond as if I didn’t believe that?

“Implicit bias isn’t something to be ashamed about—we all have it,” Nisbet says. “The key is to get curious about it instead of defensive.”

2. Perform an audit of your workplace.

Look at your physical spaces, including waiting areas or exam rooms. Nisbet recommends considering the following:

• Is the artwork on the walls inclusive?
• Does your staff include people from marginalized identities?
• Can your office chairs accommodate people of all sizes and abilities?

If you’re not sure what to prioritize, you can hire a paid consultant with lived experience in a marginalized identity. “Rely on their expertise to help you create more inclusive programs and offerings,” says Dr. Chang.

3. Embrace cultural humility.

“This approach emphasizes seeking answers instead of making assumptions and is helpful to break down the power dynamic of the provider-client relationship,” Dr. Small says. Cultural humility also means owning your own mistakes, demonstrating respect for different viewpoints and changing your behavior to foster repair.

4. Build an environment of psychological safety.

“Create a space for a person to be their authentic self without judgment,” says Selina Griswold, MSM, MA (she/her/hers), director of diversity, equity, inclusion, accessibility and belonging (DEIAB) at ERC Pathlight. This starts with understanding that different lived experiences exist so you can build trust and alliance with patients.

5. Ensure linguistic competency.

The words you and your team use within your practice are just as important as your actions. “Use inclusive language, introduce proper pronoun usage into your practice and make sure you’re not using words that hurt,” Griswold says.

6. Seek different perspectives.

“No one can position themselves as an expert on groups to which they don’t belong,” Dr. Chang says. But providers can reduce this barrier by engaging in the communities of the patients they serve. Join support groups that might identify with a different identity to enhance your learning. Reach out to groups that provide training, awareness and continuing education opportunities in DEIAB.

7. Understand impact over intent.

Your words and actions might have a different impact on people with marginalized identities than you intend for a variety of sociocultural reasons. What is most important is addressing that impact rather than defending your intent.

8. Commit to lifelong discovery.

“Being inclusive requires a commitment to learn about others,” Griswold says. As you navigate your own personal journey toward inclusiveness, be kind to yourself. “Understand that inclusivity is a systemic concern, but that you have a personal responsibility to be part of the solution and not part of the problem,” Nisbet says.

Committing to Diverse and Inclusive Workplaces

Griswold launched a strategic roadmap to create a process and structure around ERC Pathlight’s DEIAB strategy. “DEIAB is a journey, not a destination,” Griswold says. “As part of our commitment to fostering a culture that reflects DEIAB, we will continually evolve our strategy to meet the current and future needs of our patients and teammates.”

Diversity, Equity, Inclusivity, Accessibility and Belonging CE Events

Browse ERC Pathlight CE courses and events focused on DEIAB here.

Expand Your Knowledge On Inclusivity

• https://mhanational.org/racismand-mental-health - Resources and stats on racism and mental health from Mental Health America
• https://membershare.iaedp.com/ - Culturally Competent Conversations, held the third Tuesday of each month, from the International Association of Eating Disorders Professionals
• www.inclusivetherapists.com – A community dedicated to providing equitable access to affirming and culturally responsive mental health care
• www.apa.org – Inclusive language guidelines from the American Psychological Association
• www.hrc.org – Healthcare Equality Index benchmarking tool

Partner Spotlight: Fighting Eating Disorders in Underrepresented Populations (FEDUP)

FEDUP is a collective of trans+, intersex and gender-diverse people who believe eating disorders in marginalized communities are social justice issues. Its mission is to make visible, interrupt and undermine the disproportionately high incidence of eating disorders in trans and gender-diverse individuals. To access FEDUP workshops that will help you create more gender-literate practices, visit www.fedupcollective.org/training.

Sources

1. Coffino, J.A., Udo, T., & Grilo, C.M. (2019). Rates of help-seeking in US adults with lifetime DSM-5 eating disorders: Prevalence across diagnoses and differences by sex and ethnicity/race. Mayo Clinic Proceedings, 94(8), 1415-1426

2. The Trevor Project. (2022). National Survey on LGBTQ Youth Mental Health 3. Phelan, S.M., Burgess, D.J., Yeazel, M.W., Hellerstedt, W.L., Griffin, J.M., & van Ryn, M. (2015). Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Obesity Reviews, 16(4), 319–326

3. Phelan, S.M., Burgess, D.J., Yeazel, M.W., Hellerstedt, W.L., Griffin, J.M., & van Ryn, M. (2015). Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Obesity Reviews, 16(4), 319–326