Confronting Ageism, Ableism and Mentalism Biases: A Narrative Review of Literature Supporting Lifespan Inclusive Model of Clinical Training and Practice

Research Objectives: Though clinical training programs incorporate approaches to serve a variety of individuals, most practice areas are markedly segregated according to age, diagnosis or category of need, aligned with a social model of disability. Socially responsive professions can more intentionally examine how systemic policies and existing biases( implicit or explicit, consensus or unconscious) may contribute to perpetuating oppression beliefs and attitudes , such as mentalism, ageism, ableism and other bias-masking ‘isms’. The purpose of this review is to synthesize available literature pertaining to segmented clinical approaches alongside integrated, inclusive delivery of services, as a means of designing a ‘Lifespan Inclusive Model of Clinical Training and Practice’.

Design: Studies included in this narrative review were discovered via Cochrane Library, Ebsco, Proquest and Google Scholar, to include English language articles from 2017 through March 2023. Combined terms using the Boolean operators “AND” and “OR” included “ageism”, “ableism”, “mentalism”, “intergenerational”, “lifespan”, “disabilities”, “mental health”, “older adults” and “aging”.

Setting: N/A

Participants: N/A

Interventions: N/A

Main Outcome Measures: N/A

Results: Careful review of literature revealed varied approaches aimed to address biases pertaining to ageism, ableism and mentalism in clinical training programs, though efforts to combat these biases in real-life practice settings were limited. Approaches generally were divided into two modalities: (1) education to improve understanding of individuals via a strengths-based lens and (2) specific program-embedded exposure to a variety of individuals to gain experiential knowledge and familiarity. Most studies outlined an approach combating just one form of segmented practice (ableism, ageism or mentalism), rather than a universally inclusive approach.

Conclusions: While literature outlines specific programs to address isolated forms of segmented practice, approaches that systematically and universally prevent all forms of segmented practice are crucial to equitable and inclusive healthcare and educational systems. Findings of this narrative review highlight the ethical responsibility to create inclusive practice settings, while informing design of a ‘Lifespan Inclusive Model of Clinical Training and Practice’.

Author(s) Disclosures: N/A