Developing a Structural Intervention for Outpatient Mental Health Care: Mapping Vulnerability and Privilege

Abstract

The Mapping Vulnerability and Privilege (MVP) exercise is a clinical intervention based on a structural competency framework that emphasizes societal structures-social determinants of health and of biology, behavior, and culture-and their impact on health outcomes. The exercise comprises the MVP Tool, Visual Guide, and Processing Guide. It was created with the goals of helping clinicians to develop structural humility and introducing a structural lens for viewing the therapeutic milieu and the structural barriers that affect both intrapsychic experiences and interactions with the health care system, while encouraging patients and clinicians to take action to address the systemic and structural issues that affect patients' well-being. This article provides an overview of the development of the MVP exercise as an educational and clinical intervention.

Keywords: Community integration; Outpatient; Psychotherapy; Social determinants of health; Structural competency.