Often, it is the most difficult times that lead to the bursts of energy that will lift us out of our despair, but also move us toward a more fruitful and fulfilling path. The past eighteen months have not been an exception of course. From the personal and collective anxiety and mourning the world is experiencing seemingly together, also comes the recognition that in many ways we are not truly sharing the same experience as humans. This has been increasingly evident during the pandemic. But now, there is also increased recognition that life in general is quite different even in the absence of a global catastrophe depending on one’s skin color, citizenship, primary language, employment, wealth, neighborhood, sexual preference, gender identity, and a slew of other determinants. Perhaps our lemonade or silver lining of COVID-19 is that it allowed the nation and local communities to focus on what has been present the whole time — that healthcare access and provision are not equitable, there are a lack diversity in providers and researchers, and care is not inclusive or welcoming to many within the communities we need to serve (and often say we are committed to serving).
Specifically, the spotlight on the reality that Black and Brown communities are less likely to have adequate health care access and treatment has garnered the attention from many in our healthcare and non-healthcare systems to move towards change. The increased awareness of the impact of mental health care disparities of marginalized groups of people, coupled with a desire to make meaningful change in our collective and individual paths forward, has sparked the conception of the UNC Psychiatry DEI Program in 2020 and the Mental Health Equity Program (MHEP) in 2021. The Mental Health Equity Residency Training Track is to launch in 2022.
The MHEP’s mission is to expand the UNC Psychiatry Department’s efforts towards achieving and sustaining equity in access, engagement, and provision of high quality mental and behavioral health care services to under-represented and marginalized groups. The ultimate goal is to produce meaningful systemic improvements and healthcare outcomes utilizing intentional strategies that prioritize advocacy, community engagement, multi-disciplinary collaborations, data-driven interventions, and a culturally centered focus. — But what does that mean in practice? How can we ensure that this momentum does not drift from meaningful to performative? How can we ensure that our vision of ‘quality healthcare for all’ comes to fruition? The answers of course depend on all of us.
To achieve sustainable, meaningful change in how we conduct ourselves and how we provide care to those in need of mental healthcare, we as a collective and as individuals must commit to at least the following:
- Be honest with ourselves. We must be willing to look within and acknowledge our own flaws and shortcomings. None of us are immune to intrinsic bias.
- Be willing to see things from a different perspective. We must be willing to put on someone else’s shoes and walk their path. This may be metaphorical, but there are opportunities to seek out, engage with, listen to, and walk with others who are different from us.
- Be open to learning how to do things differently, equitably, and more inclusively.
- Be able to receive and grow from constructive feedback about our ways of engaging with others. We must discard our tendency to see the issues as belonging to someone else or to be caused by someone else’s flaws or bad character.
- Be cautious of quick fixes. We must take the time to appropriately identify and understand the issues adversely impacting our care for patients. This includes taking the time to include the perspectives and lived experiences of the people we are focused on providing care for. Let them be their own voice in the conversation as we plan programs and opportunities geared to their community. This takes purposeful and intentional time.
Tyehimba “Tye” Hunt-Harrison, MD, MPH
Director of the Mental Health Equity Program
Director of the Mental Health Equity Residency Training Track
Child and Adolescent Psychiatrist
UNC Department of Psychiatry