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LectureHop: Inequality In Mental Health Care For Black Americans

On Tuesday, September 15, Columbia Psychiatry hosted a panel titled “Unequal Care: Mental Health and Black Americans,” the first of a three-panel series in partnership with the School of Journalism titled “Justice and Mental Health: A Country on Fire.” 

In this moment when public health, systemic racism, and social justice are at the forefront of national consciousness, Columbia’s departments of Psychiatry and Journalism have joined forces to address the intersections of these issues. In the first part of a three part series on Justice and Mental Health, three panelists came together to discuss the topic of inequality and racism in mental health care and the mental health issues that weigh particularly heavily on Black communities.

The panel featured Dr. Angela Coombs and Dr. Sidney Hankerson, of the Columbia University Department of Psychiatry, and Dr. Brian D. Smedley of the American Psychological Association. Linda Rosenberg of Columbia Psychiatry moderated the event. The conversation focused on identifying and eliminating systemic racism in mental health care practices and institutions. Speakers also touched upon the toll that the COVID pandemic and the national police brutality crisis are taking on the mental health of Black individuals and communities. 

A practicing psychiatrist who specializes in patients first experiencing psychosis and student of transgenerational trauma, Dr. Coombs spoke passionately about prioritizing patients as a means to disentangle mental health care from bias and racism. She cited statistics on diagnoses given to men exhibiting psychosis symptoms. Black men are disproportionately diagnosed with schizophrenia, whereas white men with the same symptoms are more likely to be diagnosed with bipolar disorder or depression. She discussed how the criteria for a schizophrenia diagnosis was changed decades ago in order to emphasize the symptom of paranoia. Black men in distress trying to advocate for themselves in a clinical environment may be seen as paranoid rather than defending their own human dignity. 

To counteract the effects of systemic injustices in mental health such as this, Dr. Coombs advocated recentering treatment on patients. She warned that while current psychiatric practice can fixate on alleviating visible symptoms, the priority in patient care should be on improving a patient’s quality of life. Treatment in which patients define their own goals for living a meaningful life should be emphasized, in Dr. Coombs’ opinion, and professionals should use medications and therapy to support them in achieving these. 

This theme of focusing on the patient arose repeatedly throughout the panel. Dr. Hankerson, who specializes in patients with depression, emphasized the importance of focusing on patients as they are situated in their communities and cultures. Faith is of tremendous importance to Dr. Hankerson, whose father is a deacon and whose mother played piano for his church choir when he was growing up. Dr. Hankerson recognizes the importance of the church as a space of gathering and solace in many Black communities. Since many Black Christians seek emotional as well as religious support at church, he works with pastors and other faith leaders on developing programs to bolster the mental health of their communities. 

All three of the panelists noted that Black individuals may hesitate to seek professional mental health assistance, for reasons ranging from less access to health insurance to stigma surrounding therapy. While they all advocate for dismantling these barriers, they also recognize the need to meet people where they’re at. This includes Dr. Hankerson’s church initiatives and Dr. Coombs’ patient-centered care models, as well as creating mental health support in other community spaces such as barbershops and schools, working with members of communities that are being served to create programs that they actually need, and centering Black individuals in the mental health professional community.

Eliminating racism from mental health, this panel suggested, will be a process of recognizing the value and potential of every patient, every community, and every individual.

Journalism via Bwog Archives

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