Dismantling Structural Racism in Psychiatry: A Path to Mental Health Equity

2021 ◽  
Vol 178 (7) ◽  
pp. 592-598
Author(s):  
Ruth S. Shim
Keyword(s):  
Mental Health ◽  
Health Equity ◽  
Structural Racism

scholarly journals Application of an antiracism lens in the field of implementation science (IS): Recommendations for reframing implementation research with a focus on justice and racial equity

2021 ◽  
Vol 2 ◽  
pp. 263348952110494
Author(s):  
Rachel C. Shelton ◽  
Prajakta Adsul ◽  
April Oh ◽  
Nathalie Moise ◽  
Derek M. Griffith
Keyword(s):  
Implementation Science ◽  
Health Equity ◽  
Implementation Research ◽  
Implementation Strategies ◽  
Health Inequities ◽  
Evidence Based ◽  
Racial Equity ◽  
Structural Racism ◽  
Core Elements ◽  
Evaluation Approaches

Background Despite the promise of implementation science (IS) to reduce health inequities, critical gaps and opportunities remain in the field to promote health equity. Prioritizing racial equity and antiracism approaches is critical in these efforts, so that IS does not inadvertently exacerbate disparities based on the selection of frameworks, methods, interventions, and strategies that do not reflect consideration of structural racism and its impacts. Methods Grounded in extant research on structural racism and antiracism, we discuss the importance of advancing understanding of how structural racism as a system shapes racial health inequities and inequitable implementation of evidence-based interventions among racially and ethnically diverse communities. We outline recommendations for explicitly applying an antiracism lens to address structural racism and its manifests through IS. An anti-racism lens provides a framework to guide efforts to confront, address, and eradicate racism and racial privilege by helping people identify racism as a root cause of health inequities and critically examine how it is embedded in policies, structures, and systems that differentially affect racially and ethnically diverse populations. Results We provide guidance for the application of an antiracism lens in the field of IS, focusing on select core elements in implementation research, including: (1) stakeholder engagement; (2) conceptual frameworks and models; (3) development, selection, adaptation of EBIs; (4) evaluation approaches; and (5) implementation strategies. We highlight the need for foundational grounding in antiracism frameworks among implementation scientists to facilitate ongoing self-reflection, accountability, and attention to racial equity, and provide questions to guide such reflection and consideration. Conclusion We conclude with a reflection on how this is a critical time for IS to prioritize focus on justice, racial equity, and real-world equitable impact. Moving IS towards making consideration of health equity and an antiracism lens foundational is central to strengthening the field and enhancing its impact. Plain language abstract There are important gaps and opportunities that exist in promoting health equity through implementation science. Historically, the commonly used frameworks, measures, interventions, strategies, and approaches in the field have not been explicitly focused on equity, nor do they consider the role of structural racism in shaping health and inequitable delivery of evidence-based practices/programs. This work seeks to build off of the long history of research on structural racism and health, and seeks to provide guidance on how to apply an antiracism lens to select core elements of implementation research. We highlight important opportunities for the field to reflect and consider applying an antiracism approach in: 1) stakeholder/community engagement; 2) use of conceptual frameworks; 3) development, selection and adaptation of evidence-based interventions; 4) evaluation approaches; 5) implementation strategies (e.g., how to deliver evidence-based practices, programs, policies); and 6) how researchers conduct their research, with a focus on racial equity. This is an important time for the field of implementation science to prioritize a foundational focus on justice, equity, and real-world impact through the application of an anti-racism lens in their work.

Achieving Health Equity Through Eradicating Structural Racism in the United States: A Call to Action for Nursing Leadership

2020 ◽  
Vol 52 (6) ◽  
pp. 696-704
Author(s):  
Deena Nardi ◽  
Roberta Waite ◽  
Marian Nowak ◽  
Barbara Hatcher ◽  
Vicki Hines‐Martin ◽  
...  
Keyword(s):  
United States ◽  
Health Equity ◽  
The United States ◽  
Nursing Leadership ◽  
Structural Racism ◽  
Call To Action

Achieving Mental Health Equity

2020 ◽  
Vol 43 (3) ◽  
pp. 471-485
Author(s):  
Toi Blakley Harris ◽  
Sade C. Udoetuk ◽  
Sala Webb ◽  
Andria Tatem ◽  
Lauren M. Nutile ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Equity

LGBTQ+ Latino/a Young People’s Interpretations of Stigma and Mental Health: An Intersectional Minority Stress Perspective

2019 ◽  
Vol 10 (2) ◽  
pp. 163-179 ◽  
Author(s):  
Rachel M. Schmitz ◽  
Brandon Andrew Robinson ◽  
Jennifer Tabler ◽  
Brett Welch ◽  
Sidra Rafaqut
Keyword(s):  
Mental Health ◽  
Young Adults ◽  
Young People ◽  
Health Inequalities ◽  
Minority Stress ◽  
People Of Color ◽  
Structural Racism ◽  
Gender Policing ◽  
Prejudice And Discrimination ◽  
Social Prejudice

Lesbian, gay, bisexual, transgender, and/or queer (LGBTQ+) young people of color encounter interlocking systems of social prejudice and discrimination. However, little is understood about how subjective meanings of perceived structural stigma associated with multiple marginalized social statuses influence mental health. We document how perceived stigma can shape mental health inequalities among multiply marginalized individuals if they also encounter stigmatizing societal frameworks. Data come from in-depth interviews with 41 LGBTQ+ Latino/a young adults in the Rio Grande Valley collected from 2016 to 2017. Utilizing an intersectional minority stress framework, we qualitatively examine how young people conceptualize structural stigma, their multiple social locations (e.g., sexuality, gender, race/ethnicity, age), and their mental health. Findings highlight how LGBTQ+ Latino/a young adults experience structural racism, gender policing, and anti-LGBTQ+ religious messages in relation to their mental health. This study showcases the importance of an intersectional minority stress framework for documenting processes that can shape mental health inequalities.

scholarly journals Health Equity Rounds: An Interdisciplinary Case Conference to Address Implicit Bias and Structural Racism for Faculty and Trainees

MedEdPORTAL ◽  
2019 ◽  
Vol 15 (1) ◽  
pp. 10858 ◽  
Author(s):  
Joanna Perdomo ◽  
Destiny Tolliver ◽  
Heather Hsu ◽  
Yuan He ◽  
Katherine A. Nash ◽  
...  
Keyword(s):  
Health Equity ◽  
Implicit Bias ◽  
Case Conference ◽  
Structural Racism

The Business Case for Mental Health Equity

2020 ◽  
Vol 43 (3) ◽  
pp. 429-438
Author(s):  
James Corbett ◽  
Temi Olafunmiloye ◽  
Joseph R. Betancourt
Keyword(s):  
Mental Health ◽  
Health Equity ◽  
Business Case

State Policy and Mental Health Outcomes under COVID-19

2021 ◽  
Author(s):  
Michael W. Sances ◽  
Andrea Louise Campbell
Keyword(s):  
Mental Health ◽  
Race And Ethnicity ◽  
State Policy ◽  
State Level ◽  
Safety Net ◽  
Census Bureau ◽  
Economic Security ◽  
Unemployment Benefit ◽  
Structural Racism ◽  
Indirect Measures

Abstract Context: The COVID-19 pandemic has caused enormous damage to physiological health and economic security, especially among racial and ethnic minorities. We examine downstream effects on mental health, how effects vary by race and ethnicity, and the role of existing state-level social policies in softening the pandemic’s impact. Methods: We analyze an online, multi-wave Census Bureau survey fielded to nearly a million respondents between late April and July 2020. The survey includes questions measuring psychological distress as well as indirect measures of experience with the pandemic. We combine these data with state-level measures of COVID cases, lock-down orders, unemployment filings, and safety net policy. Findings: We find significant mental stress among all respondents and a sizeable gap between non-white and white respondents. Adjusting for pandemic experiences eliminates this gap. The effect of losing work due to the pandemic is slightly offset by state policies such as unemployment benefit size and Medicaid expansion. The magnitude of these offsetting effects is similar across racial/ethnic groups. Conclusions: The racialized impacts of the pandemic are exacerbated by inequalities in state policy exemplifying structural racism. If the least generous states matched the policies of the most generous, inequalities caused by the pandemic would be diminished.

Sign in / Sign up

Export Citation Format

Share Document