Minority mental health patients face many health inequities and inequalities that may stem from implicit bias and a lack of cultural awareness from their healthcare providers. I analyzed the current literature evaluating implicit bias among healthcare providers and culturally specific life traumas that Latinos and African Americans face that can impact their mental health. Additionally, I researched a current mental health assessments tool, the Child and Adolescent Trauma Survey (CATS), and evaluated it for the use on Latino and African American patients. Face-to-face interviews with two healthcare providers were also used to analyze the CATS for its’ applicability to Latino and African American patients. Results showed that these assessments were not sufficient in capturing culturally specific life traumas of minority patients. Based on the literature review and analysis of the interviews with healthcare providers, a novel assessment tool, the Culturally Traumatic Events Questionnaire (CTEQ), was created to address the gaps that currently make up other mental health assessment tools used on minority patients.

Given the growing reports of toxic gymnastics culture and evidence of mental health issues in gymnasts, this study aims to fill in the gaps surrounding the causes of poor mental health and wellbeing of gymnasts as a result of negative gymnastics culture focusing on the idea of mental toughness. Current college gymnasts (n=7) completed a questionnaire and in-person interview to discuss their ideas around mental toughness, their experience with gymnastics culture and the coaching behaviors that create it, and their understanding of their own mental health. 7 participants completed all materials. Results showed that all participants had a mental toughness score falling in the “average” or “good” range with a mean score of 85 out of 140. Mental toughness was mentioned in a negative context 95 times overall and a in positive context 41 times overall during interviews. 6 participants rated their overall experience of gymnastics culture as average and 1 rated it as good, but when reflecting on their most negative experiences of gymnastics culture 4 participants rated their experience as average and 3 rated their experiences as bad. All participants expressed having experienced symptoms of poor mental health in the past 4 months and witnessed symptoms of poor mental health in teammates. 6 participants were unlikely to communicate their symptoms and 4 were unlikely to seek professional help, yet the number of participants likely to offer direct support or encourage teammates to communicate symptoms with a coach/trainer was 5 and 4 respectively. Negative mentions of mental health overall (118) was three times higher than positive mentions of mental health (43) during interviews. As a whole, gymnasts who experienced negative gymnastics culture struggled to recognize poor mental health/wellbeing and viewed mental toughness as synonymous with enduring mental and physical pain. Starting gymnastics at a young age and development in the sport and ideas becoming internalized as part of self, as well as negative coaching behaviors and abuse were referenced as potential reasons for poor understanding of mental health in gymnasts. Recommendations for improvement of gymnastics culture to prevent the negative consequences on gymnasts understand of their mental health include (1) acknowledgement and awareness by coaches of the impact their behaviors can have on gymnasts, (2) building strong personal connections with gymnasts, (3) increasing coaches and support staffs understanding of mental health symptoms so they can recognize them in gymnasts, and (4) promoting and encouraging meaningful conversations around mental health to remove stigma and fear of retaliation for gymnast.