Giving Voice to the Underserved: An Interview with Dr. Kevin Nadal

The professor, psychologist and activist discusses the importance of diversifying mental health care

By Lauren O'Shaughnessy

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There is no one-size-fits-all approach to mental health. Our upbringings, cultural identities and lifestyles greatly impact the way we experience and present symptoms, and the success we find with certain styles of treatment.

Race, gender, sexual orientation and socioeconomic status are crucial components of a sufferer’s life, and should be top-of-mind when administering care. What works for someone from one culture or community, may not for someone with a different set of norms and experiences.

However, for most of history, psychology has progressed around a wealthy, white, male understanding of the mind. In effect, the needs and experiences of minority populations have gone unaddressed.

This lack of cross-cultural understanding presents tremendous barriers within modern healthcare systems. Disadvantaged communities with the greatest need for mental health services, are not only being denied them, but are often misdiagnosed or mistreated when they are reached.

Some people - like Dr. Kevin Nadal - are looking to change that. We spoke with the professor, psychologist, writer and activist about the importance of diversifying modern psychology.

Tell us about yourself — who are you, where do you live, what do you do?

I’m a tenured Full Professor of Psychology at the City University of New York. I teach undergraduate and graduate classes at both John Jay College of Criminal Justice and the Graduate Center. I also do research and write on various topics like microaggressions, intersectional identities, and mental health.

Why did you decide to become a psychologist?

I decided to become a psychologist towards the end of my undergraduate career at UC Irvine, when my mentor Dr. Jeanett Castellanos encouraged me to apply to graduate school. I did not know any psychologists personally, and I especially did not know of any Filipino American psychologists or queer psychologists of color. As a student, I saw so many gaps in the academic literature, which meant that there were so many gaps in training mental health practitioners to become culturally competent in working with historically marginalized communities. So, I ambitiously thought that if I entered the field of psychology, I could somehow give voice to the communities that were important to me.

Much of your work is LGBTQ+ centric. What barriers do queer individuals, particularly those of color, face when it comes to mental health?

One of the issues in psychology and most other academic fields is that its foundations are built and centered on White, heterosexual, cisgender male narratives. That means that everyone else (queer, trans, women of color) are supposed to somehow assimilate or fit into these dominant narratives, or become viewed as pathological or deficient.

In general, psychology also fails to consider or normalize intersectional approaches, or the ways that multiple marginalized identities negatively impact people’s mental health. Queer and trans people of color have to essentially navigate the harmful message they learn about racism, sexism, homophobia, transphobia, and the intersection of them all. They have to deal with homophobia and sexism within their communities of color, while dealing with racism in the “mainstream” (read: White) LGBTQ+ communities. And they have to deal with multiple forms of systemic oppression in general society.

As a result of that, there are many mental health issues they may experience. When they don’t feel acceptance in their family and aren’t able to live as their authentic selves in their communities, they may develop depression and other mood disorders. When they don’t feel desired or valued among LGBTQ+ communities, they may develop social anxiety or low self-esteem.

How can modern healthcare systems better service the LGBTQ+ community?

One of the most important first steps for any aspect of the LGBTQ+ community is to name and acknowledge that there is no singular LGBTQ+ community. There are many communities of people who identify as LGBTQ+, but there is no (and should not be) a centric group that all LGBTQ+ people should norm themselves after.

When White cisgender people (who are mostly upper class or uppermiddle class men) try to claim a singular, united LGBTQ+ community, they end up erasing, negating, or pathologizing the experiences of trans and queer people of color, especially those from lower socioeconomic statuses, those living with disabilities, or those with any issues that mainstream group does not acknowledge. In being able to identify the true diversity of LGBTQ communities, health care providers can make better and more informed decisions about an array of healthcare issues, including direct services, outreach, advocacy, and policy work

Further, in simply asking LGBTQ+ communities of the issues that negatively impact them and attempting to provide (re)solutions to those issues, healthcare workers can uplift various LGBTQ+ people in ways that they need most.

What role does the internet play in the mental health movement? How do you see it changing the ways people discuss their conditions and find care?

One of the major roles of the internet today is that it provides people of historically marginalized groups to see the possibilities of what is out there; it gives people the opportunity to feel like they are not alone in their experiences and to give people the opportunity to connect. When I was a teenager, there were so few online resources for me, so I engaged in a lot of risky, self-hating behaviors, because that was all that I thought was possible for me.

At the same time, it is important to make sure that people are intentional in putting out quality content to help people in their mental health journeys. Ensure that stories represent a broad spectrum of experiences, and that cultural obstacles are addressed. Take care in ensuring that stories do not center the experiences of the privileged or those with access. Make certain that appropriate resources are provided, while also not overworking the people who are on the front lines.

What recommendations do you have for people who want to help, but don’t know where to start?

People who want to help can start by taking initiative and relieving people who are always doing the work. So often, people of color (especially LGBTQ+ people of color, Black women, and other women of color) are tasked with doing all the work. As researchers, they are expected to do all studies; as clinicians, they are expected to see all of the clients who feel “othered”. If you see this, step up and make yourself available. And even if people still continue to turn to those to LGBTQ+ people of color, validate them by acknowledging that they are usually expected to do this extra work.

A second recommendation is to reflect upon how you can be an psychologist-activist/ practitioner-activist in every aspect of your life. If you do some work on all levels, you are helping to instill change, whether you recognize it or not. Talk to kids of all ages about gender roles and systemic racism and how it negatively affects all of us. Point out inequitable dynamics and privileges in your various workplaces or school settings. Initiate conversations about complicity and ask people about their implicit biases. Review all institutional and organizational policies and reflect upon how each and every one may have negative impacts for people of historically marginalized groups. You must be intentional. You must be open to critique. You must reflect on your own privilege and roles, and you must emotionally connect to that. And once you do that, maybe you will fight for social change in a meaningful way.

What closing remarks/advice would you give to someone reading this?

Being socially aware and “woke” doesn’t mean that you don’t get to enjoy life. It means that you are doing everything you can to fight for justice and equity - which hopefully means that you are making the world a better and easier place for people to live. And because of that peace and purpose, you might be able to enjoy life a little more.

Kevin Nadal, Ph.D., is a Filipino-American professor at the City University of New York and is considered one of the leading scholars on microaggressions, Filipino American identity, and LGBTQ issues in the US. You can keep up with him on www.kevinnadal.com.

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