Most likely, every mental health professional has served a client with a visible or invisible disability. But not every clinician is prepared to receive someone with a disability.
The physical barriers that may prevent a client from feeling comfortable and safe to pursue counseling need to be addressed in businesses and organizations. Accessibility begins with the website a potential client visits to learn more about the practice. It continues with parking, access to public transportation, entrance ways, seating arrangements and paperwork. Ableism, a negative attitude toward people with disabilities, also blocks a person with disabilities from receiving services. Talila A. Lewis, an abolitionist community lawyer, uses this working definition for ableism: “(It is) a system of assigning value to people’s bodies and minds based on societally constructed ideas of normality, productivity, desirability, intelligence, excellence and fitness.”Integrating inclusive practices within mental health services will attract more clients who seek help. “Disability is part of every community and identity,” says Ryan Easterly, executive director of WITH Foundation, a California-based nonprofit working to promote comprehensive health care for adults with developmental disabilities. “Mental health professionals can help serve and support clients with disabilities by being mindful of any accessibility barriers their office and practice may have. “In addition to considering if a client with disabilities can physically access the space, professionals should be mindful that disability is natural and may be part of a client’s identities.”Putting a plan into action Alexis Duggan, a disability services professional, educator and licensed professional counselor associate in Dallas, Texas, facilitates one- to three-hour in-person and virtual training sessions for professionals who want to learn about disability barriers, etiquette and terminology.
Labels such as “lazy” or “working the system” attached to people with disabilities create barriers to receiving services. Ableism could be the reason accommodations aren’t provided. “Ableism is nondisabled people putting their expectations on disabled people,” Duggan says. “They don’t understand disability and they don’t want to.”Duggan suggests these guidelines when working with people with disabilities:
Include people with disabilities in decisions about programs, training and planning. “When I’m making decisions with people with disabilities, not for people with disabilities,” Duggan explains. “I need to bring that person to the table. What questions do you have? What are you hoping?”
Be inclusive from the start. Most accessibility issues are addressed after a complaint is made. “When we’re planning events, looking at spaces, looking at programs, it may sound good, but is it accessible?” Duggan says. “That question needs to be on the front end.”
Ask the person with disabilities what they need. Assuming what someone requires can lead to uncomfortable situations. “Folks with disabilities are the best judge of what they can and what they cannot do,” she says.
Avoid touching a person with disabilities’ personal items without permission. Canes, service animals and wheelchairs are an extension of their body.
Be familiar with the ADA guidelines about service animals. “According to ADA (Americans With Disabilities Act), you can only ask these two questions: Is this an animal for a person with a disability? And What task has this animal been trained to do?” says Duggan. “You may not ask about the disability.
‘Proud wheelchair user’In 2005, Charlotte, North Carolina, resident Melanie Dunston reinvented herself after she was diagnosed with pseudotumor cerebri, or intercranial pressure in her brain. She retired from her administrative job at a nursing home and, by 2008, she was using a wheelchair to get around due to severe osteoporosis.“I am a very proud wheelchair user,” Dunston says. “Without my wheelchair, I don’t know what I would do.”Dunston serves in several volunteer capacities throughout Charlotte, advocating for people with disabilities through board positions in organizations and as a court mediator for the county. She’s attended academies through the local FBI, the Federal Emergency Management Agency, police department and the sheriff’s office and trained in Crisis Intervention Partners. Despite Dunston’s experience and credentials, she’s faced ableism. “People assume I need help, that I need assistance, that I’m fragile,” she says. “When you’re in a wheelchair, they wonder what you can do.”When Dunston is out in the community, she wants to be independent. She’s been successful in advocating for stores to purchase scooters with baskets to make the shopping experience more accessible. “When I go someplace, I ask myself, ‘Am I comfortable? Do I think everyone is being treated the same way?’” Dunston says. “People don’t see wheelchair users or those who use mobility devices as an important thing when they have a business. If you invite me somewhere, keep me in my mind that I am a wheelchair user.”Dunston started Charlotte Wellness Group on Facebook in 2015 to share free and inexpensive resources for programs about health and wellness, and the 2,000 members also get to know her, a strong and creative Black woman with disabilities. Her posts include information about topics ranging from financial well-being to where to find free counseling. “The more you get to see us (people with disabilities), the more you get to know us,” Dunston says. “We’re not as scary,”
First published in Black Mental Health Today, Summer 2023 (Vol. 8).