Managing Oppression in the Resumption of Face to Face

Dr. David G. Zelaya (he/him/él) is currently a Postdoctoral Research Associate at Brown University School of Public Health within the Center for Alcohol and Addiction Studies. He is also a research fellow at Harvard Medical School. He received his Ph.D. from Georgia State University in counseling psychology and completed his residency at Harvard Medical School's Cambridge Hospital part of the Latinx Mental Health Program, the Gender and Sexuality Clinic, and the Psychiatric Emergency Service. His research program focuses on examining health disparities, from an intersectionality and minority stress lens, among Black, Indigenous, and People of Color and sexual and gender minority communities.

Q: Dr. Zelaya, you are an expert in the area of minorities and mental health. Can you tell us about some of the main reasons why you have decided to focus on this population?

Q: Can you explain to us who a minority is and give us an idea of persons who would be classified as a minority?

I have a passion for serving the underserved through practice and research. Through conducting research with the underserved population, I am able to inform practice on how to adequately and efficiently address the needs of this population. I believe in centering the needs of individuals living at the margins of society who are often the most vulnerable to multiple health risks.

This is a subgroup of a population with “social, religious, racial, sexual orientation, gender identity or other characteristics” that are different from the majority of the population.

Minorities may include: Blacks, Indigenous Peoples, People of Color, Persons with Disabilities, and Sexual and Gender Minority Communities. In short, a minority is an individual who is

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impacted by multiple forms of oppression, also known as the four I's of oppression: ideological oppression (e.g., the idea that one group is better than another), institutional oppression (e.g., policies and laws that control the rights of others such as women and the ability to get an abortion and enter into a gay marriage), interpersonal oppression (e.g., racist jokes, stereotypes), internalized oppression (e.g., where one begins to believe that they are inferior due to societal messages).

Q: Dr. Zelaya, based on your recent work and research in the area, are minorities at a greater risk for mental health challenges when compared to the majority group? If so, what are some of the challenges that they face?

In short, yes. Based on my research and clinical work, minorities are indeed at higher risk for worse mental and physical health outcomes compared to their majority counterparts. Many of the challenges can be attributed to broader systems of oppression. I think it’s important to note that being a minority does not confer risk (e.g., being a woman, being a sexual minority, or being transgender), but rather it’s the structural systems in place that impact health such as racism, sexism, heterosexism, cis-sexism, and classism. These systems of oppression are upheld by institutional, ideological, individual, and internalized structures which in turn impact access to mental health and lead to stigma related to mental health. For example, broadly speaking, individuals with socially marginalized identities are at higher risk for mood disorders, trauma, and physical health challenges (e.g., hypertension). Additionally, many of the behavioral health interventions we have created are developed and normed with majority populations and often do not take into consideration the contextual factors relevant to minority populations. In turn, this creates a disparity for minority individuals seeking treatment. Finally, another important factor to address is bias within the medical field that may also impact the mental and physical health of minority individuals thus presenting another barrier that further exacerbates their presenting concern. All these systems synergistically impact the health and well-being of minority individuals.

Q: What are some of the ways in which minorities can overcome these challenges?

Minorities can overcome these challenges in several ways- actively seeking social support, engaging in self-care and activities that bring joy, seeking providers from minority backgrounds, and searching for interventions that have been created by and for groups from marginalized backgrounds (Please refer to Black Life Meditation at https://www.drcandicenicole.com/post/201607-black-lives-matter-meditation). Yet, at the end of the day, it's important to change these systems of oppression and one way to do so is through collective action, getting involved, and actively working to dismantle them.

Q: Now that we are resuming face-to-face learning, are there any helpful tips on how minorities can reintegrate into the academic setting?

As we return to in-person and face-to-face learning, I think now, more than ever it will be important to engage in self-care. I think the move to virtual teaching helped to decrease day-to-day microaggressions we may experience in the hallway, the classroom, queuing to get lunch, etc. Therefore, it may be triggering or activating as we return to non-structured interactions with other people in person. I direct the reader to this helpful article by Harvard Business Review to help cope with microaggressions (https://hbr.org/2020/07/when-and-how-to-respond-tomicroaggressions). Additionally, I think striving for work-life balance and setting boundaries will also be important. The move to a virtual world blurred the boundaries between work and personal life therefore, this will be a good exercise to try to reestablish a more distinct separation between the two. Finally, we know that mental health concerns have been on the rise since the pandemic started and minorities have been drastically impacted. Therefore, seeking support, connecting with others, and asking for help when needed are important to ensuring that we can put our best foot forward as we reintegrate into the academic setting.