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Do Our Facilities and Policies Create an Environment for Mental Freedom?

June 22, 2020

By H. Steven Moffic, MD
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The opinions expressed by Psychiatry & Behavioral Health Learning Network bloggers and those providing comments are theirs alone and are not meant to reflect the opinions of the publication.

Last Friday marked Juneteenth, an annual celebration of the last announcement of the freedom of slaves that took place in Galveston, Texas. History, however, tells us that even the road to political and legal freedom was a rocky one with detours along the way.

We in mental healthcare can help to produce a different kind of freedom that we should always strive for, freedom from mental constraints. Our early history for doing so fell way short, such as the so-called “father of psychiatry,” Benjamin Rush, MD, around 1800 establishing a diagnosis of “negritude,” a form of leprosy that could only cured by becoming white.

While we always address that mental freedom in terms of treating mental disorders, we can also try to free minds from racism. Here are 10 of the ways how:

  • Reduce institutional racism by examining our facilities for any signs or symbols of racism, including artwork on the walls of common spaces and offices
  • Make our facilities inviting for patients of all racial backgrounds by community outreach, especially to Black churches
  • Strive for staff and leadership representation of racial groups consistent with—or exceeding—the representation of those groups in the community
  • Avoid the still all-too-common misdiagnosis of Black males as having schizophrenia, especially paranoid schizophrenia, rather than, say, bipolar disorder
  • Provide more psychotherapy to Black patients rather than overlying on medication
  • Conduct outcome studies that compare patients of different racial and ethnic backgrounds
  • Develop more ties with the police in our area and try to infuse mental health into policing
  • Have continuing education of racism in your system
  • Have all staff and administrators examine themselves for implicit bias; a variety of free implicit bias tests are available online
  • Celebrate Juneteenth Day in the future

We will have another holiday coming up where these racial disparities can be examined. That is July 4th, our country’s day celebrating our independence. However, here, it wasn’t independence for all, and certainly not for Black slaves or Native Americans. That is still a goal in progress that we can help meet.

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