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APA President Jeffrey Geller, M.D., M.P.H., began with a discussion of racism dating back nearly to the inception of American psychiatry. He described two alleged diseases theorized by nonpsychiatrist and Mississippi physician Samuel Cartwright in the mid-1800s: drapetomania, the desire to flee from servitude, and dysaesthesia aethiopica, a lack of work ethic.
“Cartwright’s theories were embraced in the slave states and mocked in the free states, including in medical journals,” Geller said. “The APA was silent, and that is our shame. They were silent then, and we have been silent for 176 years.”
Danielle Hairston, M.D., president of the APA Caucus of Black Psychiatrists and the psychiatry residency training director at Howard University College of Medicine, answered a question posed by a member who registered for the town hall, “How can we support Black residents and students?”
“You can start by validating that racism exists and validating their experiences. When a student or trainee is telling you that something [racist] is happening, listen,” she said. “When there are no black residents in your program, … do something to prioritize diversity, discuss sponsorship and mentorship, and invest in diversity as part of your recruitment.”
Walter E. Wilson Jr., M.D., M.H.A., a member of APA’s Council of Minority Mental Health and Health Disparities and a second-year fellow in child and adolescent psychiatry at Vanderbilt University, spoke about the term “all lives matter” as a response to the Black Lives Matter movement. He described an analogy he had seen online.
“If you distill American society into one neighborhood, and each house represents a different racial or ethnic group, oftentimes African Americans end up asking for help throughout the community for emergencies associated with their house, and others respond with, ‘Well, all houses matter,’” he explained. “The problem with that is that the African American house is on fire. It has been on fire for 400 years. We were forced to live in a house that was smaller than the other houses, we were forced to be firefighters, and then we were blamed for the fire.”
Ayana Jordan, M.D., Ph.D., ECP trustee-at-large on the APA Board of Trustees, directed many of her comments toward white psychiatrists, emphasizing that racism is something white people must actively address. She called for open, authentic dialogue and active change in dismantling racism in psychiatry.
“I am asking that we as a member-led organization enter into a liberated space together. No, it’s not safe. Yes, you may get your feelings hurt,” she said. “But as psychiatrists we understand that in conflict, often therein lies the work which can indeed yield growth. … At some point, you must wrestle with the truth that is deeply embedded in the foundation and roots of this organization and inherent in the practice of psychiatry: that of anti-Black racism.”
Thea L. James, M.D., an associate professor of emergency medicine at Boston Medical Center/Boston University School of Medicine, discussed disparities in health care and how they are rooted in disparities in other areas of life.
“Perpetual cycles of hospital admissions, ER visits, and poor health outcomes persist because they are just downstream consequences of root causes upstream like lack of income, unstable housing, and lack of access to healthy, affordable foods,” she said.
Geller announced that he had established a presidential task force to address structural racism throughout psychiatry. The task force consists of 10 members, five of whom are members of the Board of Trustees.
“The goal of this group is to create actions, not position statements, not white papers, but actions,” Geller said.