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Berger-Sweeney J. Diversity in Neuroscience: How This Moment Is Different. J Neurosci 2023; 43:7724-7726. [PMID: 37968122 PMCID: PMC10648502 DOI: 10.1523/jneurosci.1897-23.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 10/08/2023] [Indexed: 11/17/2023] Open
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Plummer N, Guardado R, Ngassa Y, Montalvo C, Kotoujian PJ, Siddiqi K, Senst T, Simon K, Acevedo A, Wurcel AG. Racial Differences in Self-Report of Mental Illness and Mental Illness Treatment in the Community: An Analysis of Jail Intake Data. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023; 50:966-975. [PMID: 37733128 PMCID: PMC10543583 DOI: 10.1007/s10488-023-01297-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2023] [Indexed: 09/22/2023]
Abstract
Jails and prisons in the United States house people with elevated rates of mental health and substance use disorders. The goal of this cross-sectional study was to evaluate the frequency of racial/ethnic differences in the self-report of mental illness and psychiatric medication use at jail entry. Our sample included individuals who had been incarcerated between 2016 and 2020 at the Middlesex Jail & House of Correction, located in Billerica, MA. We used data from the "Offender Management System," the administrative database used by the jail containing data on people who are incarcerated, and COREMR, the electronic medical record (EMR) used in the Middlesex Jail & House of Correction. We evaluated two primary outcomes (1) self-reported mental illness history and (2) self-reported use of psychiatric medication, with the primary indicator of interest as race/ethnicity. At intake, over half (57%) of the sample self-reported history of mental illness and 20% reported the use of psychiatric medications. Among people who self-reported a history of mental illness, Hispanic (AOR: 0.73, 95% CI: 0.60-0.90), Black (AOR: 0.52, 95% CI: 0.43-0.64), Asian/Pacific Islander (Non-Hispanic) people (AOR: 0.31, 95% CI: 0.13-0.74), and people from other racial/ethnic groups (AOR: 0.33, 95% CI: 0.11-0.93) all had decreased odds of reporting psychiatric medications. Mental illness was reported in about one-half of people who entered jail, but only 20% reported receiving medications in the community prior to incarceration. Our findings build on the existing literature on jail-based mental illness and show racial disparities in self-report of psychiatric medications in people who self-reported mental illness. The timing, frequency, and equity of mental health services in both the community and the jail setting deserves further research, investment, and improvement.
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Affiliation(s)
- Narcissa Plummer
- Department of Population Health, Northeastern University, Boston, MA USA
| | - Rubeen Guardado
- Division of Geographic Medicine and Infectious Diseases, Department of Medicine, Tufts Medical Center, Boston, MA USA
| | - Yvane Ngassa
- Division of Geographic Medicine and Infectious Diseases, Department of Medicine, Tufts Medical Center, Boston, MA USA
| | - Cristina Montalvo
- Department of Psychiatry, Tufts Medical Center, Boston, MA USA
- Tufts University School of Medicine, Boston, MA USA
| | | | | | | | - Kevin Simon
- Harvard Medical School, Boston, MA USA
- Children’s Hospital, Boston, MA USA
| | - Andrea Acevedo
- Department of Community Health, Tufts University, Medford, MA USA
| | - Alysse G. Wurcel
- Division of Geographic Medicine and Infectious Diseases, Department of Medicine, Tufts Medical Center, Boston, MA USA
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McGINTY BETH. The Future of Public Mental Health: Challenges and Opportunities. Milbank Q 2023; 101:532-551. [PMID: 37096616 PMCID: PMC10126977 DOI: 10.1111/1468-0009.12622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 09/30/2022] [Accepted: 01/06/2023] [Indexed: 04/26/2023] Open
Abstract
Policy Points Social policies such as policies advancing universal childcare to expand Medicaid coverage of home- and community-based care for seniors and people with disabilities and for universal preschool are the types of policies needed to address social determinants of poor mental health. Population-based global budgeting approaches like accountable care and total cost of care models have the potential to improve population mental health by incentivizing health systems to control costs while simultaneously improving outcomes for the populations they serve. Policies expanding reimbursement for services delivered by peer support specialists are needed. People with lived experience of mental illness are uniquely well suited to helping their peers navigate treatment and other support services.
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Abstract
Black people are disproportionately affected by mental illness, including depression. While the prevalence of depression is paradoxically lower among the Black population, the impact of depression on Black people results in greater severity of illness and higher chronicity. The main factors through which Black people experience worse mental health outcomes includes delayed treatment seeking, and poor access to mental health services. Mental illness stigma contributes to the delay in treatment seeking behavior. Stigma refers to negative attitudes, beliefs or behaviors about a particular characteristic of an individual such as their health status. Both patients and mental health professionals experience stigma that impacts health engagement, limits access to effective depression treatments, and compromises positive patient-clinician communication. A commitment to lifelong learning about the role of culture, history, and the psychosocial context of our patients is critical to closing public health gaps in the field of mental health.
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Affiliation(s)
- Aderonke Bamgbose Pederson
- Depression Clinical and Research Program, Massachusetts General Hospital, One Bowdoin Square, Boston, MA, 02114, USA
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
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Glass DJ, Young YM, Tran TK, Clarkin P, Korinek K. Weathering within war: Somatic health complaints among Vietnamese older adults exposed to bombing and violence as adolescents in the American war. J Psychosom Res 2023; 165:111080. [PMID: 36680917 PMCID: PMC9902178 DOI: 10.1016/j.jpsychores.2022.111080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 11/03/2022] [Accepted: 11/06/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE People living in war may experience deteriorating health via weathering (wear and tear) from long-term exposures to psychosocial and environmental stressors. Weathering embodied in somatic health complaints may illuminate the effects of war on health. METHODS We investigate whether wartime stress exposures occurring during adolescence and early adulthood affect weathering in late adulthood via linear regression with data from the Vietnamese Health and Aging Study (VHAS). VHAS is a cross-sectional study wherein investigators surveyed 2447 adults aged 60+ in four districts of northern and central Vietnam in 2018. These same individuals ranged in age from seven to 52 in 1965, with most having been in adolescence or early adulthood at the peak of the American war in Vietnam (1965-1975). The sample used for this study (n = 2254) were participants in the first VHAS wave in 2018. RESULTS We find older Vietnamese adults exposed to higher-intensity provincial bombing suffer more numerous somatic health complaints (unstandardized β = 0.005, SE = 0.001, p = 0.001). Additionally, greater health complaints emerge among older adults whose most intense bombing exposures were at younger ages of adolescence (< age 15) as compared to those whose peak exposures were in older ages (19-25) (unstandardized β = 0.62 95%, SE = 0.19, p = 0.01). CONCLUSION Our findings suggest that age of exposure to armed conflict is a critical determinant of weathering across the life course.
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Affiliation(s)
- Delaney J Glass
- University of Washington Seattle, Department of Anthropology, United States of America.
| | - Yvette M Young
- University of Utah, Department of Sociology, United States of America.
| | - Toan Khanh Tran
- Hanoi Medical University, Family Medicine Department, Viet Nam
| | - Patrick Clarkin
- University of Massachusetts Boston, Department of Anthropology, United States of America.
| | - Kim Korinek
- University of Utah, Department of Sociology, United States of America.
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Malinowska JK, Żuradzki T. Towards the multileveled and processual conceptualisation of racialised individuals in biomedical research. SYNTHESE 2022; 201:11. [PMID: 36591336 PMCID: PMC9795162 DOI: 10.1007/s11229-022-04004-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
In this paper, we discuss the processes of racialisation on the example of biomedical research. We argue that applying the concept of racialisation in biomedical research can be much more precise, informative and suitable than currently used categories, such as race and ethnicity. For this purpose, we construct a model of the different processes affecting and co-shaping the racialisation of an individual, and consider these in relation to biomedical research, particularly to studies on hypertension. We finish with a discussion on the potential application of our proposition to institutional guidelines on the use of racial categories in biomedical research.
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Affiliation(s)
| | - Tomasz Żuradzki
- Institute of Philosophy & Interdisciplinary Centre for Ethics, Jagiellonian University, ul. Grodzka 52, 31-044 Kraków, Poland
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Grasser LR, Jovanovic T. Neural Impacts of Stigma, Racism, and Discrimination. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:1225-1234. [PMID: 35811064 DOI: 10.1016/j.bpsc.2022.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/28/2022] [Accepted: 06/28/2022] [Indexed: 12/13/2022]
Abstract
Racism is a chronic stressor fueled by stigma that can result in significant distress and dysfunction as well as negatively affect emotions, behavior, quality of life, and brain health. The effects of stigma and discrimination emerge early in life and have long-term consequences. In this review, we sought to use neuroscience research to describe how stigma, racism, and discrimination can impact brain and mental health. Societal stigmas may be encoded by associative fear learning and pattern completion networks, and experiences of racial discrimination may similarly affect threat-responsive regions and circuits. Race-related differences in brain function and structure supporting threat circuitry are largely attenuated when negative life experiences and discrimination are taken into account. Downstream, chronic activation of the hypothalamic-pituitary-adrenal axis and the sympathetic-adrenal-medullary axis in the context of discrimination and stigma can contribute to physical health disparities in minoritized and marginalized groups. Finally, we discuss models that provide a framework for interventions and societal-level strategies across ecologic systems to build resilience and foster posttraumatic growth.
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Affiliation(s)
- Lana Ruvolo Grasser
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan.
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Smith DT, Faber SC, Buchanan NT, Foster D, Green L. The Need for Psychedelic-Assisted Therapy in the Black Community and the Burdens of Its Provision. Front Psychiatry 2022; 12:774736. [PMID: 35126196 PMCID: PMC8811257 DOI: 10.3389/fpsyt.2021.774736] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 12/14/2021] [Indexed: 11/26/2022] Open
Abstract
Psychedelic medicine is an emerging field that examines entheogens, psychoactive substances that produce non-ordinary states of consciousness (NOSC). 3,4-methylenedioxymethamphetamine (MDMA) is currently in phase-3 FDA clinical trials in the United States (US) and Canada to treat the symptoms of posttraumatic stress disorder (PTSD). MDMA is used in conjunction with manualized therapy, because of its effectiveness in reducing fear-driven stimuli that contribute to trauma and anxiety symptoms. In 2017, the FDA designated MDMA as a "breakthrough therapy," signaling that it has advantages in safety, efficacy, and compliance over available medication for the treatment of trauma-, stress-, and anxiety-related disorders such as PTSD. In the US and Canada, historical and contemporary racial mistreatment is frequently experienced by Black people via a variety of macro and micro insults. Such experiences trigger physiological responses of anxiety and fear, which are associated with chronically elevated stress hormone levels (e.g., cortisol and epinephrine), similar to levels documented among those diagnosed with an anxiety disorder. This paper will explore the benefits of entheogens within psychedelic assisted-therapy and their potential benefits in addressing the sequelae of pervasive and frequent negative race-based experiences and promoting healing and thriving among Black, Indigenous and other People of Color (BIPOC). The author(s) discuss the ethical responsibility for providing psychedelic-assisted therapy within a culturally competent provider framework and the importance of psychedelic researchers to recruit and retain BIPOC populations in research and clinical training.
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Affiliation(s)
- Darron T. Smith
- Department of Sociology, The University of Memphis, Memphis, TN, United States
| | | | - NiCole T. Buchanan
- Department of Psychology, Michigan State University, East Lansing, MI, United States
| | | | - Lilith Green
- Department of Sociology, The University of Memphis, Memphis, TN, United States
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Lunsford L, Arthur ML, Porter CM. African and Native American foodways and resilience: From 1619 to COVID-19. JOURNAL OF AGRICULTURE, FOOD SYSTEMS, AND COMMUNITY DEVELOPMENT 2021; 10:241-265. [PMID: 34824878 PMCID: PMC8612693 DOI: 10.5304/jafscd.2021.104.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
The COVID-19 pandemic is flooding and splitting "efficiency" fault lines in today's industrialized food system. It also exploits centuries of historical traumas, White supremacy, and systemic racism to kill non-White people at triple the rates of Whites. In 1619, an English ship landed on the shores of the Powhatan confederacy, or, as the English called it, Point Comfort, Virginia. The ship delivered stolen people onto stolen land. This was a first step in founding today's U.S. food system. Until that time, the people of North America and West Africa had lived off the land for millennia, foraging, hunting, and cultivating food. But 400 years ago, the twin European colonial influences of invasion and enslavement entwined the lives and, to some extent, the foodways of Native Americans and West Africans in what is now the U.S. Yet, these communities are still resilient. This paper offers re-stories about how African American and Native American communities have adapted and maintained foodways to survive, thrive and renew, from 1619 to COVID-19. Methods include historical and literature reviews, interviews, and brief auto-ethnography. Even in the face of a pandemic, Native American and African American communities still leverage their foodways to survive and thrive. Some of these food system strategies also illustrate shifts that could be made in the United States food system to help everyone thrive.
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Affiliation(s)
- Lindsey Lunsford
- College of Agriculture Environment and Nutrition Sciences, Tuskegee University; 205 Morrison Mayberry Hall; Tuskegee Institute, AL 36088 USA
| | - Melvin L. Arthur
- Department of Kinesiology and Health, University of Wyoming; 1000 East University Avenue, Department 3196; Laramie, WY 82071 USA
| | - Christine M. Porter
- Professor and Wyoming Excellence Chair of Community and Public Health; Growing Resilience Principal Investigator; Division of Kinesiology & Health, College of Health Sciences, University of Wyoming; 1000 East University Avenue, Department 3196; Laramie, WY 82071 USA
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