Mitigating Biased Actions

00:00 Another strategy we can use is mitigating our biased actions.

00:11 And it all goes back to self-analysis, self-awareness because if we don’t analyze we can't become aware.

00:18 Remember, none of us are perfect.

00:19 And it's not to induce guilt, it's so that we can move forward because in a previous segment I talked about how, in any form of therapy or rehabilitation, the first step is acknowledging.

00:31 The second would be a willingness to want to change.

00:34 So, to mitigate those biased actions, I can use that cognitive behavior theory.

00:39 Remember it talks about how you see a person or expose to a certain situation and then you have these automatic involuntary thoughts, which are based on our lived experience and perspective and upbringing.

00:53 And then mindfulness.

00:55 We have to be able to be in a space where we can own those things that we think about we can own our biases and we understand that certain things are triggering those biases.

01:07 Well, just as we are able to the third part of that cognitive behavior theories, those reactions we have that are emotional, physical or physiological.

01:19 And so that they can happen in isolation those different feelings we have or they can happen altogether.

01:25 And because you become aware of what happens when you're exposed to a certain person, group of people, or certain issue, situation, whatever it is, when you feel that happening, when you're exposed to whatever that is, that's the way we can control it.

01:41 But we have to be able to be mindful as we talked about in a previous segment.

01:46 And if you're over texted, overworked, you don't get enough rest or if you have a lot of distractions, then it's difficult to be mindful.

01:55 So this is work is my point of all these. This is not something we fix overnight and it does take time and effort.

02:02 So it didn't happen overnight, it won't change overnight, and it doesn't mean that you're always going to get it right because we're always going to be human first so that's we're showing grace and those situation comes into play.

02:15 However, as a great colleague of mine likes to say "Grace has an expiration date." So consistency is key. If we consistently practice the right behaviors, then that's a positive.

02:26 But if we consistently continue to allow biases to get in the way of our interactions in a negative space, then that is also hard to believe and develop trust because again that is so important, the concept of trust in this.

02:40 And if you keep making the same mistake, then it goes away from being a mistake and becomes a habit.

02:47 And it communicates to people that maybe you're not so interested in the change.

02:52 So, it is work, constant work. Then you have to have a commitment to equity.

02:57 And I've driven the point home about the humanitarian and ethos and principles a lot because that's how important it is.

03:06 If you're committed to humanitarianism, then it's a little bit easier to commit to equity.

03:13 A healthcare specific application would be the Barriers to Access to Care Evaluation scale, which you can kind of do some research and look that up.

03:23 And then another one is structural competency.

03:26 And it impact obstruct is rather on health.

03:31 Structural competency is a framework that teaches clinicians and approach to communication, diagnosis, and treatment and it takes into account culturally specific sources of stigma.

03:42 That kind of already mentioned it so mental health diagnosis in certain cultures is taboo or unacceptable.

03:49 And I'm going to go back again in my culture with blacks, African Americans, and that's in general.

03:56 We told to pray about it, we try to pray everything off.

03:59 Now for me, prayer does work but I also realized when physiological changes happen I also may need medication, may or may not and I may or may not need therapy or I may need a combination of both depending on the level of severity of it.

04:15 So just respecting. If someone tells you that we don't believe in taking medicine, we don't believe in therapy in my culture.

04:22 We do have to respect it but we also want to educate at the same time.

04:26 So, you may not get people to do it the first time around, but you do want to continue to have those conversations and we do have to realize especially as healthcare providers it's our responsibility to partner with patients and families and persons depending in which term we want to use, not to tell people what they have to do.

04:46 We can tell them what we know from a scientific perspective what might work best, but that's part of being culturally inclusive as well and not making people feel stigmatized because of their cultural beliefs and traditions.

05:01 Structural competency reviews existing approaches to stigma and health inequities, and then it takes into account 5 core competencies which include recognizing structures that guide clinical interactions.

05:15 So, historically, we were thought certain things and how to approach specific assessments, diagnosis, and treatments. Right? And we wanted to follow that to a T but with the structural competency we include culture in all of that.

05:32 So, we have a more holistic approach to care.

05:37 And then developing extra clinical language related to structure, meaning nonclinical.

05:42 Outside of just the clinical arena, how do we talk about treatment, diagnosis, and assessment from a structural perspective which takes culture into account again and remembering how some stigma that we have about certain people.

06:01 I'm going to use vaccine hesitancy as an example.

06:04 Oftentimes people tend to judge, but you're not thinking about the stigma and structure that may have facilitated some of that vaccine hesitancy.

06:14 And so we label and stereotype people.

06:17 We might think people don't care about health or they don't believe in signs.

06:21 We call people all kinds of stuff.

06:23 If we're going to be honest, I've heard lots of different things and honesty and transparency is so important in this work.

06:29 We've all been around those conversations and have participated in some of those conversations.

06:35 But again, going back to what Dr. Maya Angelou says "When we know better, we do better." And that's part of why we're promoting and engaging in this diversity equity inclusion and belonging work and taking culture into account and prioritizing culture and difference.

06:52 Then reframing cultural interpretations based on structural terms.

06:56 So each one of these is much more in-depth than what I'm talking about, but how do we reframe the way we think about culture.

07:05 I kind of alluded to that in some of the previous bullets.

07:08 Well, we do have to be cognizant of it and make an effort to reframe how we think about culture and how we move more toward the stopping stigma, destigmatizing different cultural practices and beliefs.

07:22 Then observing and imagining structural interventions. So not only do we want to see it happen, but we want to start to think about innovative ways, imagining those interventions that we can do and I mentioned in a previous segment, "If it's not causing harm, why would we not try to integrate some of those cultural preferences into our plans of care and then developing structural humility." So again, that's acknowledging that these things exist, being sensitive to those things, and being humble and open to the fact that there are different ways of being in different norms.