Upon being asked to curate and edit this series for Psycom Pro, we were encouraged to look forward to the future. We were reminded that while volumes could be filled in exploration of the darkest chapters of psychiatric medicine, our hopeful vision should be directed north, toward the light at the end of the tunnel. We were encouraged to be visionary, to look for solutions, to find answers to difficult questions. We hope that the articles herein reach even a small part of that goal.

However, one cannot separate social conditions and history from the practice of psychiatry any more than we can separate the mind and body. That’s not how humanity works, as described by Dr. Glasgow in her piece on Black LGBTQ+ and mental health. That’s not even how clinical practice works. Everything is intertwined, inextricable, and impactful all at the same time, and analysis of the practice of psychiatry necessitates our flexibility and understanding.

We have looked forward to working as guest editors for this series because there is a message that mental health clinicians in this country need to hear. There are voices and issues that have been silenced and diminished for generations. Letters of solidarity and social media posts have little value if one is unable to interrogate the systems that we practice in, and attempt to understand the lived experiences of marginalized people. Systemic racism is etched and sewn into every aspect of life in America and medicine and psychiatry are not exceptions, but complicit.

We cannot merely accept and dole out apologies without the acknowledgement that this is historic, pervasive, and current. Racism is not the past, it is now.  The impact of racism on the mental health of marginalized people is real.

The topics in this collection were therefore chosen not just to raise cognizance of BIPOC Mental Health Awareness Month (Bebe Moore Campbell National Minority Mental Health Month) but because these are experiences and voices that have been forgotten, overlooked, and minimized. We hope readers will understand that saying “I’m sorry for what you’re going through” is not enough. Claiming to be “colorblind” or that you do not see color means that you are ignoring part of your BIPOC patients’ and colleagues’ experiences. Instead, we urge you to start by validating experiences and acknowledging that racism, discrimination, and biases exist. When a patient, student, or trainee is telling you that something is happening, listen. Become comfortable with being uncomfortable.

As providers – no matter the ethnicity or race, we should be interested not only in avoiding re-enactment of our mistakes but similarly, we should be uninterested in shielding ourselves from the lashings and lessons gained by confronting ignorance and correcting course. The personal is political, and absent analysis and consideration of patients’ identities, medical care can be unavoidably harmful. Physicians are trained with the idea of a standard human, with a presenting patient whose illness indicates a deviation from that norm. Yet we know that the variation of life is consistently generated by nature and by experience. Ignoring the nuances necessary to provide intentional care can only generate misunderstanding, and at worst, danger.

The perspectives contained in this series highlight the margins – from the disabled to the traumatized, because the margins lead us to question and challenge our understanding of the norm. Further, more often than not, there is an axis of marginalization present in many of the populations we serve, if only we look for them. There cannot be movement toward a more equitable future without active correction of the errors of the past.  This transformation involves education, restructuring, and expansive imagination of the possibility of a better world, and it is our hope that this series does that – makes the reader uncomfortable, hopeful, excited, and intentional, which is the only way forward.

Back to the full collection.

 

Last Updated: Aug 16, 2021