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Trinh NHT, Talukder F, Nagendra A, Ali AM, Emmerich A, Chow L, Jenkins JH, Okereke OI. From Diversity, Equity, and Inclusion to an Antiracism Strategic Plan: An Academic Department of Psychiatry's Journey. Psychiatr Serv 2024; 75:391-394. [PMID: 38347815 DOI: 10.1176/appi.ps.20230024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
The efforts of an academic psychiatry department to embark on an antiracism strategic planning process are outlined, including the establishment of an antiracism task force charged with the development of an antiracism strategic plan. The initial process of the task force is described, recommendations are summarized, and future directions are outlined.
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Affiliation(s)
- Nhi-Ha T Trinh
- Department of Psychiatry, Massachusetts General Hospital (all authors), and Harvard Medical School (Trinh, Nagendra, Emmerich, Chow, Jenkins, Okereke), Boston
| | - Farhabi Talukder
- Department of Psychiatry, Massachusetts General Hospital (all authors), and Harvard Medical School (Trinh, Nagendra, Emmerich, Chow, Jenkins, Okereke), Boston
| | - Arun Nagendra
- Department of Psychiatry, Massachusetts General Hospital (all authors), and Harvard Medical School (Trinh, Nagendra, Emmerich, Chow, Jenkins, Okereke), Boston
| | - Areeba M Ali
- Department of Psychiatry, Massachusetts General Hospital (all authors), and Harvard Medical School (Trinh, Nagendra, Emmerich, Chow, Jenkins, Okereke), Boston
| | - Anne Emmerich
- Department of Psychiatry, Massachusetts General Hospital (all authors), and Harvard Medical School (Trinh, Nagendra, Emmerich, Chow, Jenkins, Okereke), Boston
| | - Louis Chow
- Department of Psychiatry, Massachusetts General Hospital (all authors), and Harvard Medical School (Trinh, Nagendra, Emmerich, Chow, Jenkins, Okereke), Boston
| | - Jonathan H Jenkins
- Department of Psychiatry, Massachusetts General Hospital (all authors), and Harvard Medical School (Trinh, Nagendra, Emmerich, Chow, Jenkins, Okereke), Boston
| | - Olivia I Okereke
- Department of Psychiatry, Massachusetts General Hospital (all authors), and Harvard Medical School (Trinh, Nagendra, Emmerich, Chow, Jenkins, Okereke), Boston
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Mensah MO, Collison A, Dacarett-Galeano D, Stewart AJ. Profiles in Wisdom: A Survey of Leading Psychiatrists to Inform the Diversity of the Future Psychiatric Workforce. Child Adolesc Psychiatr Clin N Am 2024; 33:1-15. [PMID: 37981332 DOI: 10.1016/j.chc.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Long-standing challenges facing the mental health system require more effective strategies to furnish a workforce whose diversity matches an increasingly diverse population. Current and former system leaders can offer expert guidance informed by their experiences and perspectives. Their professional journeys to leadership in this area provide context and unique insight into issues of justice, including workforce diversity, equity, and inclusion in psychiatry. These experts agree that significant policy changes are needed to improve psychiatric workforce diversity and that implementing change will require that disparate groups together to achieve this goal. Financial considerations must be included in policy and advocacy.
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Affiliation(s)
- Michael O Mensah
- National Clinician Scholars Program, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA.
| | - Amira Collison
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Dennis Dacarett-Galeano
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Altha J Stewart
- Division of Public and Community Psychiatry and Office of Community Health Engagement, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
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Hill LD, Avenevoli S, Gordon JA. The Role of the National Institute of Mental Health in Promoting Diversity in the Psychiatric Research Workforce. Child Adolesc Psychiatr Clin N Am 2024; 33:77-86. [PMID: 37981339 DOI: 10.1016/j.chc.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
The mission of the National Institute of Mental Health (NIMH) is to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery, and cure. This mission can only be realized if full participation in the research enterprise is open to all. Nevertheless, systemic racism and other barriers remain significant obstacles to achieving a diverse workforce. To address these barriers, NIMH must ensure a just and equitable funding process, support diversity-focused training opportunities, and encourage research into mental health disparities and other areas of interest to a diverse array of scientists.
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Affiliation(s)
- Lauren D Hill
- Office for Disparities Research and Workforce Diversity, National Institute of Mental Health, National Institutes of Health, 31 Center Drive, MS2116, Bethesda, MD 20892-2116, USA
| | - Shelli Avenevoli
- Office of the Director, National Institute of Mental Health, National Institutes of Health, 31 Center Drive, MS2116, Bethesda, MD 20892-2116, USA
| | - Joshua A Gordon
- Office of the Director, National Institute of Mental Health, National Institutes of Health, 31 Center Drive, MS2116, Bethesda, MD 20892-2116, USA.
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Calhoun AJ, Martin A, Adigun A, Alleyne SD, Aneni K, Thompson-Felix T, Asnes A, de Carvalho-Filho MA, Benoit L, Genao I. Anti-Black racism in clinical supervision: asynchronous simulated encounters facilitate reflective practice. MEDEDPUBLISH 2023; 13:4. [PMID: 37123251 PMCID: PMC10140654 DOI: 10.12688/mep.19487.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2023] [Indexed: 05/02/2023] Open
Abstract
Background Racist interactions in clinical practice remain a pervasive reality for Black healthcare providers. We sought to develop a framework to inform supervisors' actions when confronting racism in clinical practice and protecting trainees under their oversight. Methods We conducted a qualitative study in which experienced supervisors responded to seven short, videotaped interactions between: 1) Black trainees and a simulated patient (SP) in a racist role; 2) the trainees and their respective supervisors; and 3) the trainees and their supervisors together with the SP. The clinical exchanges exemplified different types of racist (entrenching) or antiracist (uprooting) behaviors by the supervisors. After viewing each clip, participants wrote their reflections confidentially; they later joined a structured debriefing together. We used thematic analysis to identify supervisors' behavioral patterns when confronting racist interactions. Results Based on the input of 52 participants recruited into five two-hour-long sessions, we categorized the behaviors of supervisors facing anti-Black racial injuries involving learners under their oversight. We organized supervisor behaviors into five interlocking domains, each with a range of possible themes: 1) Joining: from conciliatory to confrontational in communicating with the aggressor; 2) Explicitness: from avoiding to naming racism; 3) Ownership: from individual to shared responsibility of the event and the response to it; 4) Involving: from excusing to including the aggrieved party when confronting the aggressor; and 5) Stance: from protective to paternalistic in supporting the learner's autonomy. Conclusions Our qualitative findings can provide a framework for facilitated discussion toward reflective practice among healthcare providers who may have experienced, witnessed, or intervened in anti-Black racist interactions. They can also help medical educators to inform faculty development to fight anti-Black racism in clinical practice. The video materials we developed are available for viewing and download and can be used or adapted as springboards for reflective discussion or faculty development activities.
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Affiliation(s)
- Amanda J. Calhoun
- Child Study Center, Yale School of Medicine, New Haven, CT, 06520, USA
| | - Andrés Martin
- Child Study Center, Yale School of Medicine, New Haven, CT, 06520, USA
| | - Ayodola Adigun
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, 10032, USA
| | - Shirley D. Alleyne
- Division of Child Psychiatry, Lakeland Regional Health Medical Center, Lakeland, FL, 33805, USA
| | - Kammarauche Aneni
- Child Study Center, Yale School of Medicine, New Haven, CT, 06520, USA
| | | | - Andrea Asnes
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, 06520, USA
| | | | - Laelia Benoit
- Child Study Center, Yale School of Medicine, New Haven, CT, 06520, USA
| | - Inginia Genao
- Office of Equity, Inclusion and Belonging, Penn State College of Medicine, State College, PA, 17033, USA
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Calhoun AJ, Martin A, Adigun A, Alleyne SD, Aneni K, Thompson-Felix T, Asnes A, de Carvalho-Filho MA, Benoit L, Genao I. Anti-Black racism in clinical supervision: asynchronous simulated encounters facilitate reflective practice. MEDEDPUBLISH 2023. [DOI: 10.12688/mep.19487.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background Racist interactions in clinical practice remain a pervasive reality for Black healthcare providers. We sought to develop a framework to inform supervisors’ actions when confronting racism in clinical practice and protecting trainees under their oversight. Methods We conducted a prospective study in which experienced supervisors responded to seven short, videotaped interactions between: 1) Black trainees and a simulated patient (SP) in a racist role; 2) the trainees and their respective supervisors; and 3) the trainees and their supervisors together with the SP. The clinical exchanges exemplified different types of racist (entrenching) or antiracist (uprooting) behaviors by the supervisors. After viewing each clip, participants wrote their reflections confidentially; they later joined a structured debriefing together. We used thematic analysis to identify supervisors’ behavioral patterns when confronting racist interactions. Results Based on the input of 52 participants recruited into five two-hour-long sessions, we categorized the behaviors of supervisors facing anti-Black racial injuries involving learners under their oversight. We organized supervisor behaviors into five interlocking domains, each with a range of possible themes: 1) Joining: from conciliatory to confrontational in communicating with the aggressor; 2) Explicitness: from avoiding to naming racism; 3) Ownership: from individual to shared responsibility of the event and the response to it; 4) Involving: from excusing to including the aggrieved party when confronting the aggressor; and 5) Stance: from protective to paternalistic in supporting the learner’s autonomy. Conclusions Our qualitative findings can provide a framework for facilitated discussion toward reflective practice among healthcare providers who may have experienced, witnessed, or intervened in anti-Black racist interactions. They can also help medical educators to inform faculty development to fight anti-Black racism in clinical practice. The video materials we developed are available for viewing and download and can be used or adapted as springboards for reflective discussion or faculty development activities.
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Pacheco N, Trinh NH, Jahan A, Mensah M, Felix G, Clark F, Strong S, Hairston D. Dismantling Structural Racism in Psychiatric Residency Training: Nurturing a New Generation of Black, Indigenous, and People of Color (BIPOC) Psychiatrists. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2022; 46:657-662. [PMID: 35857267 DOI: 10.1007/s40596-022-01678-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 06/24/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Nicole Pacheco
- Columbia-New York State Psychiatric Institute, New York City, NY, USA
| | - Nhi-Ha Trinh
- Massachusetts General Hospital, Boston, MA, USA.
| | - Aava Jahan
- Massachusetts General Hospital, Boston, MA, USA
| | | | | | - Frank Clark
- University of South Carolina School of Medicine-Greenville Prisma Health, Greer, SC, USA
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Mensah MO, Collison A, Dacarett-Galeano D, Stewart AJ. Profiles in Wisdom: A Survey of Leading Psychiatrists to Inform the Diversity of the Future Psychiatric Workforce. Psychiatr Clin North Am 2022; 45:227-241. [PMID: 35680239 DOI: 10.1016/j.psc.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Long-standing challenges facing the mental health system require more effective strategies to furnish a workforce whose diversity matches an increasingly diverse population. Current and former system leaders can offer expert guidance informed by their experiences and perspectives. Their professional journeys to leadership in this area provide context and unique insight into issues of justice, including workforce diversity, equity, and inclusion in psychiatry. These experts agree that significant policy changes are needed to improve psychiatric workforce diversity and that implementing change will require that disparate groups together to achieve this goal. Financial considerations must be included in policy and advocacy.
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Affiliation(s)
- Michael O Mensah
- National Clinician Scholars Program, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA.
| | - Amira Collison
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Dennis Dacarett-Galeano
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Altha J Stewart
- Division of Public and Community Psychiatry and Office of Community Health Engagement, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
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Hill LD, Avenevoli S, Gordon JA. The Role of the National Institute of Mental Health in Promoting Diversity in the Psychiatric Research Workforce. Psychiatr Clin North Am 2022; 45:303-312. [PMID: 35680246 PMCID: PMC9262310 DOI: 10.1016/j.psc.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The mission of the National Institute of Mental Health (NIMH) is to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery, and cure. This mission can only be realized if full participation in the research enterprise is open to all. Nevertheless, systemic racism and other barriers remain significant obstacles to achieving a diverse workforce. To address these barriers, NIMH must ensure a just and equitable funding process, support diversity-focused training opportunities, and encourage research into mental health disparities and other areas of interest to a diverse array of scientists.
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Affiliation(s)
| | | | - Joshua A. Gordon
- Corresponding Author: Office of the Director, NIMH, MSC2116, 31 Center Dr., Bethesda, MD. 20892-2116,
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Calhoun A, Genao I, Martin A, Windish D. Moving Beyond Implicit Bias in Antiracist Academic Medicine Initiatives. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:790-792. [PMID: 34907963 DOI: 10.1097/acm.0000000000004562] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The concept of implicit bias has arguably laid the groundwork for uncomfortable discussions surrounding race in academic medicine, but its effectiveness in changing racist behavior and systems remains unclear. Terms like implicit bias, while perhaps more palatable than other concepts to some, may result in confusion and divert time from meaningful reconceptualization and creation of effective antiracism initiatives. This Invited Commentary contends that the term implicit bias is inadequate for addressing racism because it is too broad; does not necessarily lead to a change in racist behaviors; assumes that racism is unconscious, aggressor-centered, and individual-focused; and implies that everyone suffers equally in a racist system. The authors illustrate why terms like implicit bias are inadequate in combatting racism in medicine and suggest alternate terminology to use while engaging in antiracism work in academic medicine.
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Affiliation(s)
- Amanda Calhoun
- A. Calhoun is an adult/child psychiatry resident, Yale Child Study Center, New Haven, Connecticut
| | - Inginia Genao
- I. Genao is the graduate medical education director for diversity and inclusion and associate professor of medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Andrés Martin
- A. Martin is the Riva Ariella Ritvo Professor, Yale Child Study Center, and medical director, Children's Psychiatric Inpatient Service, Yale-New Haven Children's Hospital, New Haven, Connecticut
| | - Donna Windish
- D. Windish is associate professor of medicine and program director, General Internal Medicine Medical Education Fellowship, Yale School of Medicine, New Haven, Connecticut
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Kalin NH. Improving Treatment Outcomes Includes Increasing the Diversity of the Psychiatric Workforce. Am J Psychiatry 2021; 178:207-209. [PMID: 33641378 DOI: 10.1176/appi.ajp.2020.21010043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Ned H Kalin
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison
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