Magazine article Clinical Psychiatry News

Damming the Rivers of Racism

Magazine article Clinical Psychiatry News

Damming the Rivers of Racism

Article excerpt

"No, we are not satisfied, and we will not be satisfied until justice
rolls down like waters and righteousness like a mighty stream."
--Rev. Martin Luther King Jr., August 1963

Black History Month has come and gone. As usual, we celebrated the many achievements of black Americans. Adding special luster this year was the announcement of his presidential candidacy by Sen. Barack Obama in Springfield, Ill., where Abraham Lincoln started his political career. President Lincoln, of course, likely prevented the country from drowning in the rivers of racism.

Unfortunately, racial bias continues to flow, a fact that is not ignored during Black History Month. As another civil rights leader, Dorothy Height, has said, "The inequality is more subtle now." Significant racism, sexism, homophobia, and economic inequality still exist.

"As physicians, our greatest obligation is to the patients least able to
advocate for themselves: the poor, the imprisoned, immigrants, members
of minority groups."
--Dr. Nada L. Stotland, president-elect, American Psychiatric
Association, 2007

Given the ripple effect of racism into most areas of our society, the American Psychiatric Association has been involved in addressing the problem. Dr. Annelle B. Primm, director of the APA Office of Minority and National Affairs, points to advances in our specialty, such as the elimination of diagnoses like "drapetomania"--flight-from-home madness--from any diagnostic manual. On the other hand, Dr. Primm notes that we still have disparities in accuracy of diagnosis, access to service, and quality of care among patient populations. Though frequently worst for African Americans, these inequalities extend to other disadvantaged groups.

Disparities remain despite reports from presidential commissions and reports from surgeons general over the past 30 years. Just last year, in response to Hurricane Katrina, the Board of Trustees of the APA felt the need to adopt the Resolution Against Racism and Racial Discrimination and Their Adverse Impacts on Mental Health ('APA Takes Stand Against Racism," CLINICAL PSYCHIATRY NEWS, December 2006, p. 15)

The APA's current president is of Hispanic background, and the next two presidents will be white women. An African American has not run as a candidate since 1980.

"Our religious traditions--and if we're not religious, the secular
analogs of those traditions--inform everything we do and, in fact, have
to."
--Dr. Farr Curlin, 2007

In the article, "Belief in Medicine," published recently in the University of Chicago Magazine, Dr. Curlin, an internist and medical ethicist, recommends "... an ethic of candor and respect, where we are more self-conscious, more candid about why we practice as we do."

As a teacher of cultural psychiatry, it is always important to me to start a new class by discussing our subjective and perceived cultural identities. In such a setting, I usually identify myself as a Jewish American. In situations in which I might want to emphasize my Judaism, I say an American Jew. Because there are no obvious clues to my cultural identity in my appearance or name, people--students, colleagues, patients, and readers--frequently perceive me at first as "white."

In living according to the Jewish value of Tikkun Olam, repairing the world, I have tried to devote the major part of my career to serving the underserved of the under-served in medicine, i.e., poor minorities in psychiatry. This goal also meets the Abra-hamic tradition in the Torah of treating the stranger well, because, as the Passover holiday celebrates, our Jewish ancestors were strangers and slaves in Egypt.

"... so we must think anew, and act anew."
--Abraham Lincoln, annual message to Congress, 1862

Those of us who treat underserved populations are frequently frustrated by the limited progress toward what could be termed the mental rights of civil rights. …

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