5 Tips to Increase Disability Inclusion in Eating Disorder Recovery Spaces
Breaking down barriers to eating disorder treatment can take many forms. Providing financially accessible treatment options, advocating for systemic and healthcare reform, de-stigmatizing mental health care, and even providing educational resources to communities about when/how to seek out help. Another form of barrier breaking is creating recovery environments that are accessible and inclusive for the disabled community.
People with disabilities make up 28.7% of the US population (TW: stigmatizing language) and the disabled community intersects with all other marginalized communities. Therefore, increasing access to eating disorder treatment for people with disabilities is critical. As an accessibility professional, I have come to learn that when we break down barriers for the disabled community, we actually end up creating environments, processes, and procedures that work better for everyone. As a person who has gone through eating disorder recovery myself, I can attest to the need for this type of work.
The idea of increasing accessibility often conjures images of expensive renovations to treatment facilities or costly new technology. In reality, addressing accessibility gaps in treatment spaces can take many forms and everyone – including those in recovery, advocates, family members, healthcare providers, and administrators – can contribute to creating more inclusive experiences for all patients, including but not limited to those with disabilities.
Let’s explore five opportunities to address accessibility gaps in recovery.
1. Remember that Disability is Not a Bad Word
The first step to increasing accessibility is recognizing that disability is a normal part of the human experience and is multidimensional. Acknowledging and addressing disability is critical for enhancing inclusion because it enables patients to have honest conversations with their treatment teams about what they need to heal from their eating disorder.
Within their practices, healthcare professionals can normalize conversations about the intersection of disability and eating disorders, talking to patients who have disclosed their disabilities about how those disabilities inform their identity and their approach to eating disorder recovery. Creating a disability-affirming culture within recovery spaces ensures that everyone feels safe to bring their whole selves to the recovery process.
Not sure how and when to talk about disability? That’s totally normal. When in doubt, follow the disabled person’s lead, don’t change your demeanor, speech patterns, or assume anything about anyone’s capacity based on their physical appearance or apparent disability. Don’t stray away from the word disability and recognize that disabilities are core parts of many people’s identities.
Additionally, a mindset shift can be a great place to start if you are looking to break down barriers to accessible eating disorder spaces. Much of the healthcare field operates under the medical model of disability, viewing disability as an innate characteristic of a person that needs to be fixed. Shifting toward a social model of disability, we can see how in reality, environmental, systemic, and structural barriers are disabling and that there is nothing that needs to be fixed within any individual. Our environment simply has not been designed to work equitably for everyone. This can actually be an empowering perspective as it helps us realize that we have agency to re-imagine and redesign our environments and make them more accessible and inclusive!
2. Examine Your Physical Space
While disability is not only a physical experience, physical barriers to care are real for many people within our community. An office on a second floor with no elevator, tables in a lunchroom too low to roll a wheelchair under, exam rooms with high contrast lighting that make it hard to read paperwork, group treatment spaces with a lot of ambient noise — these are just a few examples.
While it isn’t possible to break down, or even identify, all of these barriers immediately, a great start is to examine your space. Look at your space from the parking lot, the approach to the entrance, moving into treatment rooms and other spaces where patients may visit, and so on. Observe where patients are getting stuck or having trouble navigating. When you begin to do this, you may observe patterns indicative of physical barriers. Or, even better than this observation technique, work with folks from the disabled community to identify physical barriers and opportunities to break them down. There are many organizations that provide this type of support and even resources you can use on your own.
3. Consider the Sensory Experience
Some disabilities cause sensory sensitivities. This can include sensitivity to light, sound, smell, and more. Avoiding harsh smells, loud noises, and bright lights in physical treatment spaces can make it more approachable and tolerable.
Consider creating a “quiet space” in your waiting room that is tucked away, shields out noise, and maybe even has noise cancelling headphones inside. This will allow people to avoid some of the ambient sound that’s typical in these larger common areas and can be overstimulating.
Use light switches with dimmers where possible and ask patients what lighting will work best for them. Set up task lighting in areas where people might be filling out paperwork or looking at something closely (for example: a lamp over a desk where people fill out intake forms).
Try to use fragrance-free, hypoallergenic products where possible when cleaning and in bathrooms.
4. Provide Flexibility Where Possible
In the field of disability inclusion, we often use the principles of universal design to create spaces and experiences that work better for everyone. This isn’t specialized design for people with disabilities, it’s design that is intuitive and flexible so that people with and without disabilities can do what they want and need to effectively.
We can incorporate flexibility into eating disorder treatment spaces in many ways, for example:
Offer resources in a variety of forms. Provide information in writing (including large print), in audio formats with captioning, using videos/images, and in Braille. This empowers people to choose how to engage with the materials on any given day.
Have a variety of furniture and equipment options in physical office spaces. For example, check in desks with multiple heights, a variety of seating options like benches, chairs with and without arms, and adjustable height beds/exam tables. These enable people to select what works best for them. They can roll up to a lower check in desk, transfer safely to a couch for a treatment session, or adjust a treatment table to be lower to the ground on a day they aren’t able to transfer onto a higher surface.
Where possible and safe, provide people with options for remote care. If someone has trouble physically accessing a treatment space or lives in a place with poor paratransit systems, offering care that is virtual can be the difference between getting care and not.
5. Nothing About Us Without Us
A common adage in disability inclusion spaces is nothing about us without us. Meaning, when you are pursuing accessibility in any space, it is incredibly important to center diverse disabled voices. Find local disability organizations and partner with them, seek out disability consultancies who can give feedback on how your processes and spaces can continue to improve.
Accessibility, like eating disorder recovery, is a journey, not a destination. It can’t be taken alone and it isn’t a straight line. Like healing from an eating disorder, we have to start where we are in terms of accessibility, take one tiny step at a time, and believe that change is possible.
