It's Not at the Forefront for Me: Examining Perspectives on White Identity and ACT Team Leadership

Background: Recent calls to action highlight the need to address structural racism within mental healthcare settings. Such actions have required dialogue among providers on racial disparities and inequities in services and outcomes. However, dialogues on race and racial inequalities are complex, in part owing to the history of mental health care and the demographics of mental health professionals. While many efforts are working to diversify the mental health workforce, mental health care settings are often staffed primarily with, and led by, White mental health providers. Despite the growing recognition and reckoning with structural racism and its impacts on people with marginalized racial identities, there is a gap in understanding how White mental health professionals think about their identity /social location and its relationship with their leadership. In this context, this study’s purpose was to examine Assertive Community Treatment (ACT) team leaders’ perspectives on their identity and how their identity influenced their supervision and leadership of ACT teams.

Methods: We conducted in-depth qualitative interviews (N=25) ranging from 60-100 minutes over zoom in April, 2022. Out of N=25, majority (96%) of the participants identified as White and female (84%). The interview data was transcribed and managed in NVivo. Strategies for rigor in qualitative analysis included memoing, peer debriefing, and consensus-building among coders. Each transcript was independently co-coded by two team members and finalized through a consensus discussion. More focused thematic analysis identified commonality and inter-relationship within primary codes such as formational life experiences, identity, and leading with a broader eye to the world that were extracted.

Results: For the question on identity and social location, a salient theme was “not at the forefront for me”. This theme described the participants emotions of not thinking of their White identity in the forefront. Rather, a common norm among the participants was to think of their identity in relation to their vulnerabilities and formational life experiences. The question on the relationship between identity and leadership generated two significant themes. First, embodied experiences-female leaders experienced gendered stereotypes and pushback in their position, embodying these experiences, leaders developed practices for the well-being of their staff members. Second, awareness as a leadership practice. In this theme, participants reflected on a spectrum of White privileges as team leaders; however, this awareness didn’t translate to their recognition of structural racism. Team leaders used a culturalist lens for racial inequalities, signaling that these inequalities were subjected to an individual client’s lack of resources.

Conclusion: These findings contribute to the broader scholarship of race and gender, allowing us to understand how people from dominant community in leadership positions make sense of structural inequalities. Second, as mental health practitioners, these findings help us understand how White leaders’ perspectives of identity in their work and leadership, so that policy and interventions could be appropriately developed and calibrated to meet their needs.