200716 When getting through the door is not enough: Clinicians' perceptions around assessing adolescent minorities with eating disorders

Monday, November 9, 2009: 11:00 AM

Jackie A. Yanofsky, MSW , School of Social Work, San Jose State University, San Jose, CA
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.

Learning Objectives:
1. Attendees will be able to identify two barriers ethnic minority adolescents are faced with when seeking public mental health treatment for eating disorders. 2. Attendees will better understand challenges clinicians are faced with when assessing an adolescent in a public mental health setting. 3. Attendees will know three most important screening questions to ask an adolescent during an initial mental health assessment. 4. Attendees will list four symptoms that both ethnic minority and non-minority adolescents exhibit, as an indication that they may be struggling with an eating disorder.

Keywords: Assessments, Minority Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a graduate student at San Jose State University, School of Social Work where my research focus is around access to appropriate care for adolescents with eating disorders. I work at Lucile Packard Children's Hospital at Stanford as a Health Educator on their inpatient adolescent eating disorder unit, which has given me the opportunity to be apart of research and practice. I also work for a public outpatient mental health clinic where I provide therapy to children, adolescents, and families.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.