Positioning Towards Change: The Role of Positionality in Creating Systemic Transformation

By: Grace Cruse, BA (she/they)



As science has progressed, our understanding of what contributes to mental health conditions has grown. It is widely accepted that mental health conditions are the result of a myriad of interacting factors, including biological, psychological, and social contexts that influence well-being. Some mental health conditions have biological correlates, such as changes in serotonin in depression. Although this connection may certainly be truthful, what can be said about the impact of social conditions in creating mental distress?  


According to Alegría et al. (2018), cross-cultural studies have found that lower income is associated with poorer mental health. Longitudinal studies have also identified that persistent exposure to poor quality housing, such as inadequate heating and overcrowding, food insecurity, and poor diet quality are linked to poorer mental health. Additionally, “discrimination, whether related to race/ethnicity, immigrant status, sexual orientation, and/or occupational status, has repeatedly been associated with negative mental health outcomes in the United States and Canada (Alegría et al., 2018).” 


The evidence that mental health is impacted by our social conditions is clear. These social conditions are a result of our institutions. However, when considering systemic influences of mental distress, how can we, as individuals, even begin to tackle issues so large? 


Every individual action, combined with other individual actions, creates a ripple effect. Enough ripples can create a wave. Although social change is only possible when many individuals come together, we can play our part in starting the movement. How do we begin? 


One first step towards tackling systemic inequity is practicing positionality. Positionality refers to the social positions we hold in our society that influence how we interact with the world. Social positions, such as race, ethnicity, class, gender, socioeconomic status, political affiliation, educational attainment, (dis)ability, nationality, and sexual orientation, hold meaning in our society because of cultural and historical contexts that have attached certain advantages and disadvantages to these characteristics. Positions, however, are different from identity. Positions are socially constructed by the world around us and may not always reflect our true identities. For example, even if we are disabled, the world may perceive us as able-bodied.  


Positionality influences our perceptions of the world, how we engage with others, and how others interact with us, regardless of whether we identify with our positions. Understanding positionality requires a critical reflection of our positions and how or why these characteristics afford us certain privileges, power, or disadvantages. Reflection on positionality is meant to be an iterative, constant process. Our positions change over time, as does our context, so we must continuously reflect on our positions and how they interact with our environment. Beyond the practice of continual reflection and re-examination of our positions, biases, and limitations, what we learn about ourselves must be translated into action. Positionality without action is simply reflection.  


We can make our society more just by embracing differences and using our privileges to enact social change, such as creating inclusive environments. Positionality can allow us to uplift those with lived experience to inform policy and program development. Positionality provides us an opportunity to consider whose voices we need to be listening to and what we can learn from their experiences. Practicing positionality is a first step towards dismantling unjust systems that harm mental health. Positionality allows us to consider what roles we can play in advocating for equity, diversity, and inclusion. 


Do you want to learn more about positionality and mental health? Check out the Positionality Project by the South Southwest Mental Health Technology Transfer Center. 



Alegría, M., NeMoyer, A., Falgàs Bagué, I., Wang, Y., & Alvarez, K. (2018). Social Determinants of Mental Health: Where we are and where we need to go. Current Psychiatry Reports, 20(11). https://doi.org/10.1007/s11920-018-0969-9  


About the Author 


Grace Cruse (she/they) graduated from Southwestern University with a Bachelor of Arts in Psychology and a minor in Anthropology. She is passionate about social justice and how community interventions can support the mental health of individuals, promote equity, empower communities, and enact social change. They have experience in psychological research and graphic design. While they are not working, you can find her gardening, exploring local coffee shops, and spoiling her cat, Luna. Grace is currently pursuing a Master of Arts in Community Psychology at the University of Brighton in Brighton, England.

Positionality Statement: I am a white, pansexual woman with living experiences of mental health conditions. My lived experiences have inspired my passion for mental health awareness and advocacy. I believe that positionality in mental health is important because we can use it as a tool to center lived experiences in care and research and advocate for better representation and equity in mental health spheres.


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