When getting through the door is not enough: Clinicians' perceptions around assessing adolescent minorities with eating disorders

Objective: Eating disorders are still perceived as an illness affecting mainly White affluent females despite epidemiological evidence that they are prevalent in all ethnic and socioeconomic groups. Ethnic minorities are less likely to be diagnosed and referred to a specialist for their eating disorder, though the level of symptomatology does not differ between a minority and a non-minority individual. The purpose of this study was to investigate clinicians' perceptions around assessing adolescents, and whether diagnostic patterns are similar when comparing clinicians in public and private clinics. Method: Qualitative, semi-structured interviews were conducted through a snowball sample of nine clinicians from three public mental health clinics and three private practice eating disorder specialists. Results: Current gaps exist in public versus private settings because of the limitations in assessment tools and the misconceptions clinicians have about eating disorders. Public clinicians did not classify themselves as experts on treating an eating disorder, nor did they refer their clients to a specialist because of perceived financial and insurance barriers for clients. Comparing the narratives of the private clinicians and public clinicians, adolescents were more likely to be diagnosed by a private clinician who seemed better able to associate symptoms with a primary eating disorder diagnosis. Conclusion: Ongoing training and identified specialists are needed in public clinics where ethnic minority clients will be accessing services. Relevant assessment tools need to be implemented in order to accurately diagnose eating disorders, thereby improving access to appropriate care.