Tuesday, May 25, 2021

How to Incorporate Anti-Racism Into Psychiatric Practice

The murder of George Floyd by a police officer one year ago today “forced overdue conversations about the structural racism in the very roots of our nation. It also caused many to examine what was once considered business as usual,” APA wrote in a statement released today. “The American Psychiatric Association and psychiatry were forced to confront our own past [as well as] to examine how racism had entwined itself into our current operations and how racism was impacting our patients on a daily basis.”

“We recommit as an organization and a field to staying vigilant to injustices that impact our patients and taking action to achieve mental health equity for all,” the statement concluded.

What actions can individual psychiatrists take to achieve mental health equity for all?

In an article appearing in the June issue of Psychiatric News, psychiatrists shared suggestions on how to adopt anti-racist practices within and outside of clinical practice. “To eradicate racism, in all its forms, everyone must embrace the concept of anti-racism,” said Rahn Bailey, M.D., APA’s minority/underrepresented trustee and chief medical officer of the Kedren Community Health Systems in Los Angeles. “Anti-racism is proactive and assertive,” he said. “It is taking an active stance against racism in every facet of your life and career.”

Acknowledge that racism exists everywhere: The first step to centering racial equity is starting the process of self-reflection and self-education, Lucy Ogbu-Nwobodo, M.D., M.S., an APA/APAF SAMHSA Minority Fellow and PGY-3 psychiatry resident at the Harvard Massachusetts General Hospital/McLean Psychiatry Program, told Psychiatric News. “It’s being willing to take an honest inventory of yourself, your role, and who you are in society.” Jessica Isom, M.D., M.P.H., a psychiatrist at Codman Square Health Center and a voluntary faculty member at Yale School of Medicine, emphasized that building awareness of racism is a skill that individuals must hone over time by committing themselves to doing so. Acknowledging racism’s role both individually and within the field of psychiatry can lead to better outcomes for patients.

Incorporate anti-racist values into your practice: There are many ways to bring anti-racist values into psychiatric practice, said Michael Mensah, M.D., M.P.H., APA’s immediate past resident-fellow member trustee and a PGY-4 psychiatry resident and co-chief of the residency program at the Semel Institute of Neuroscience of the University of California, Los Angeles. “Ask yourself: What does it look like for you to center anti-racism? Does it mean introducing a sliding scale to help patients who can’t pay? Does it mean taking more Medicare and Medicaid patients than before? Does it mean taking a more active role in your local residency program to advocate for a more diverse residency class?” Ayala Danzig, M.D., M.S.W., a fourth-year resident in the Yale University Department of Psychiatry, chair of the Assembly Committee of Resident-Fellow Members, and the Assembly’s Area 1 resident-fellow member representative, described how she regularly audits her own panel of patients, for example, to see if she is disproportionally diagnosing her Black patients with psychotic illnesses or if she’s prescribing more controlled substances to her White patients.

Ask for guidance: Mensah noted there are multiple resources about how psychiatrists can incorporate anti-racism into clinical practice. APA staff can direct psychiatrists to anti-racism advocacy opportunities, and district branches may be able to help identify local anti-racism experts who can offer valuable insights. He encouraged psychiatrists to reach out to other experts to ask for guidance.

“In medicine, we sometimes think that racial equity is not in our lane or our issue to tackle,” Ogbu-Nwobodo said. “But unless we all think of it as our duty as physicians to address these issues, they’re never going to be tackled. We all need to roll up our sleeves and get into the discomfort of this work.”

For more information, see the Psychiatric Services article “Racism and Mental Health Equity: History Repeating Itself,” the APA resource document “How Psychiatrists Can Talk With Patients and Their Families About Race and Racism,” and APA’s structural racism task force hub.

(Image: iStock/FatCamera)

Serve Your Association and Make a Difference

Members of the Board of Trustees make the important decisions that ultimately steer the organization and have a real-life impact on patients. To reflect APA’s diversity, members of minority or underrepresented groups are especially encouraged to run for office. Nominate yourself or a colleague for the following national offices for 2022: president-elect, treasurer, trustee-at-large, Area 3 and 6 trustees, and resident-fellow member trustee-elect. The deadline for nominations is Wednesday, September 1.


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