What is diversity and what is inclusion? What does it mean to be an inclusive class? What kinds of inclusive spaces do you want to be able to create in your OT practice? Why is it important for OTs to think about diversity and inclusion issues?
I read somewhere an explanation - diversity is the mix (of race, gender, sexual orientation, ability, culture, education, income etc), inclusion is getting a mix to work well together (through respect, support, openness).
When I first thought about diversity and inclusion in OT school, I immediately thought about how I really didn’t have many Jewish friends before the program started but now I’ve been to Passover dinner! But diversity and inclusion is a lot more than making friends with people of a different culture. The story I think illustrates it more is this: one of our first group projects, I challenged a presentation about an intervention with older adults. I was adamant it wouldn’t work with certain cultures, as the occupation chosen was not inherently meaningful. I think the occupation was setting the table before a meal, so it could feel more homey. In all fairness it was a tough criticism to take in front of the whole class. My classmate responded that people who didn’t speak english would have their own nursing home. It was a very awkward interaction in front of the whole class … But here’s the thing. We got through it because our class was inclusive — meaning we were open to each other’s ideas, able to accept ours and others strengths and weaknesses, and honestly and genuinely respected one another.
OTs have a unique responsibility when it comes to diversity and inclusion. The obvious one would be for physical or mental disabilities - to be understanding and create safe spaces for our clients. As for OT students in particular, one thing we don’t consider is each other’s life experiences and academic backgrounds. Everyone has something of value to offer to the class, and it would serve you well to remember that as you go through school together.
But to be honest, looking at diversity and culture in our clients is different from looking at diversity and inclusion among OT students, and all that is different from diversity in OT. Broadly speaking, our profession has diversity issues. The gender dichotomy is obvious, AOTA (https://www.aota.org/AboutAOTA/Get-Involved/BOD/OTD-FAQs.aspx) put out the information that 82% of practicing american OTs are white, and there a few articles describing the challenges that people with disabilities have working or getting into the profession (http://www.ncbi.nlm.nih.gov/pubmed/10732180). Not to mention the certain socioeconomic privileges afforded to those of us who make it to grad school. These are not inherently problematic, but we should talk about why these diversity issues exist, and how it affects the care we provide.
I guess this would be a good time to explain what I do. I work as an OT case manager on an intensive case management team. We work with individuals who are homeless with mental health and addictions issues and connect them to community resources (including housing) and support recovery. As a team, we’ve undergone trauma training together, suicide prevention, and anti racism/anti oppression. Working with a marginalized population that experiences multiple forms of oppression, it is extremely important we are sensitive to how these past experiences affect what and how they engage in occupations. A lot of my clients have a history of trauma, have experienced racism, stigma for mental health, and stigma of poverty. And these experiences affect everything they do. I work with a male nurse, for example, and poor guy has been fired by several of his clients, more often than not, because he’s a guy, and women with a history of rape are more comfortable with female workers. We accommodate when we can but it’s not always possible. It’s a pretty simple example of diversity and inclusion in our practice, but one that unfortunately comes up a lot.
Here in this metropolitan city, you can’t get away from meeting people of diverse walks of life. Race, sexual orientation, socioeconomic status, physical/mental disability, culture, gender…these all affect health and how occupations are performed and perceived. A quick example of this is race: i love the title of this article. RACISM NOT ALWAYS BY RACISTS. http://www.psychologytoday.com/blog/between-the-lines/201204/studies-unconscious-bias-racism-not-always-racists
"minorities are less likely to be given appropriate cardiac medications or to undergo bypass surgery, and are less likely to receive kidney dialysis or transplants. after a broken leg, they’re less likely to get pain medication". Ask the treating physician specifically if they think they’re racist, they’ll probably say no…The problem according to this research is unconscious discrimination. Research shows that when people hold a negative stereotype about a group and meet someone from that group, they often treat that person differently and honestly don’t even realize it. Unless we intentionally go out of our way to learn about and become aware of our own bias, it is likely to spill out at the most inopportune time. We have to learn to become aware and be willing to acknowledge our own biases and then consciously override them. Denial and professed racial color-blindness only makes things worse.
The expectation for you as a healthcare professional isn’t to know about all the issues that exist for every diverse population.
I would argue that a reasonable expectation would be for you to know your own privileges and how they might relate to your client, but to also be humble and open and respectful and willing to hear the lived experiences of the people we work with.
Hmm i’m going to have to edit this… lol