Mental health professionals working in U.S. schools—the setting where youth are most likely to access mental health services—associate distinct negative traits with Black and Latinx students, suggests a report in Psychiatric Services. School mental health professionals also showed pro-White, anti-Black, and anti-Latinx biases toward school-age youth on implicit bias tests.
“Clinician bias includes prejudice (both positive and negative evaluations) and stereotyping (traits associated with a given social group),” wrote Freda F. Liu, Ph.D., of the University of Washington School of Medicine and colleagues. To understand the role of stereotypes and bias by mental health professionals in U.S. schools, Liu and colleagues conducted two separate studies.
The first study involved an online survey of 42 U.S. school-based clinicians. According to the authors, the participants were “geographically diverse,” predominantly White (81%), and female (95%). The participants were asked to reflect on conversations they have had or overheard of their colleagues and identify “behaviors or characteristics [they] think school mental health professionals most commonly associate with” Black youth. They were given the same prompt and asked to identify the behaviors and characteristics that school mental health professionals commonly associated with Latinx youth. For each group, the participants were encouraged to fill in their own responses and then to select the top three from a list of 14 characteristics.
Most (81%) of the school-based clinicians surveyed identified academic failure as the characteristic most frequently associated with Black and Latinx youth; 76% identified anger and aggression as a stereotype for Black youth and 29% identified this stereotype for Latinx youth; 62% described Latinx youth as unmotivated and 45% described Black youth this way.
Liu and colleagues next developed four distinct Implicit Association Tests (IATs) to assess school-based mental health clinicians’ implicit prejudice and stereotyping of Black and Latinx youth relative to non-Hispanic White youth. The IAT is a computer categorization task that measures the relative strength of associations by examining the speed with which people assign images and words to categories (for example, people who have stronger pro-White or anti-Black biases would be faster at pairing White people with positive words and Black people with negative words than the reverse), the authors noted.
A new sample of 58 U.S. school-based mental health clinicians (74% White and 90% female) completed the IATs, as well as the Bias Awareness Scale, a four-item questionnaire that measures awareness of and concern for one’s own implicit bias.
All four IATs generated average IAT difference scores that indicated implicit prejudice or stereotypes favoring White over Black and Latinx youths, the authors reported. The IATs negatively correlated with participants’ self-reported awareness of their own implicit bias (for example, those who demonstrated greater implicit bias reported less personal awareness and concern for implicit bias).
“The small samples in both studies limit the generalizability of findings, such that replication is needed before firm conclusions can be drawn,” Liu and colleagues wrote. However, the studies “provide important foundational knowledge and research tools (new IATs) to better understand how clinician bias contributes to biased care and disparate outcomes in youth mental health.”
For related information, see the Psychiatric News article “Psychiatrists Unveil Anti-Racism Tool.”
(Image: iStock/Phynart Studio)
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