Structural Racism in Psychiatric Research Careers: Eradicating Barriers to a More Diverse Workforce
Publication: American Journal of Psychiatry
Abstract
Investigators from minoritized backgrounds are underrepresented in psychiatric research. That underrepresentation contributes to disparities in outcomes of access to mental health care. Drawing on lived experience, scholarly qualitative reports, and empirical data, the authors review how the underrepresentation of minoritized researchers arises from interlocking, self-reinforcing effects of structural biases in our research training and funding institutions. Minoritized researchers experience diminished early access to advanced training and opportunities, stereotype threats and microaggressions, isolation due to lack of peers and senior mentors, decreased access to early funding, and unique community and personal financial pressures. These represent structural racism—a system of institutional assumptions and practices that perpetuates race-based disparities, in spite of those institutions’ efforts to increase diversity and in contradiction to the values that academic leaders outwardly espouse. The authors further review potential approaches to reversing these structural biases, including undergraduate-focused research experiences, financial support for faculty who lead training/mentoring programs, targeted mentoring through scholarly societies, better use of federal diversity supplement funding, support for scientific reentry, cohort building, diversity efforts targeting senior leadership, and rigorous examination of hiring, compensation, and promotion practices. Several of these approaches have empirically proven best practices and models for dissemination. If implemented alongside outcome measurement, they have the potential to reverse decades of structural bias in psychiatry and psychiatric research.
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History
Received: 7 August 2022
Revision received: 6 December 2022
Revision received: 4 February 2023
Accepted: 22 February 2023
Published online: 19 April 2023
Published in print: September 01, 2023
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Competing Interests
Dr. Jordan has received funding from NIAAA, Yale University, and the private foundation FORE. Dr. Alpert has received research support from NIMH, honoraria from Belvoir Publishing and MGH Psychiatry Academy, and royalties from Cambridge University Press. Dr. Carpenter has clinical trial contracts (with Butler Hospital) with Affect Neuro, Janssen, Neuronetics, and Neurolief; she has received research equipment loans from Magstim, Neuronetics, and Nexstim; and she has served as a consultant for Affect Neuro, Janssen, Magnus Medical, Neuronetics, Neurolief, Otsuka, Sage Therapeutics, and Sunovion. Dr. Krystal has served as a consultant for Aptinyx, Biogen Idec MA, Bionomics, Boehringer Ingelheim, Epiodyne, EpiVario, Janssen Research and Development, Jazz Pharmaceuticals, Otsuka, Spring Care, and Sunovion; he has served on scientific advisory boards for Biohaven Pharmaceuticals, BioXcel Therapeutics, Cerevel Therapeutics, Delix Therapeutics, Eisai, EpiVario, Jazz Pharmaceuticals, Neumora Therapeutics, Neurocrine Biosciences, Novartis, PsychoGenics, Takeda, Tempero Bio, and Terran Biosciences; he is co-founder of Freedom Biosciences; he is a stockholder in Biohaven Pharmaceuticals, Freedom Biosciences, and Spring Health and holds stock options in Biohaven Pharmaceuticals Medical Sciences, Cartego Therapeutics, Damona Pharmaceuticals, Delix Therapeutics, EpiVario, Neumora Therapeutics, Rest Therapeutics, Tempero Bio, Terran Biosciences, and Tetricus; he serves as editor of Biological Psychiatry; he is involved in research studies for which medications are provided by AstraZeneca, Cerevel, and Novartis; and he is named on patents related to psychiatric treatment. Dr. Nemeroff has received research support from NIH; he has served as a consultant for AbbVie, ANeuroTech (division of Anima BV), BioXcel Therapeutics, Clexio, EMA Wellness, EmbarkNeuro, Engrail Therapeutics, Intra-Cellular Therapies, GoodCap Pharmaceuticals, Magstim, Ninnion Therapeutics, Pasithea Therapeutics, Sage, Senseye, Signant Health, Silo Pharma, SynapseBio, and Relmada Therapeutics; he has served on scientific advisory boards for ANeuroTech, the Anxiety and Depression Association of America (ADAA), the Brain and Behavior Research Foundation, Heading Health, the Laureate Institute for Brain Research, Pasithea Therapeutics, Sage, Signant Health, and Skyland Trail and on the boards of directors for ADAA, Gratitude America, and Lucy Scientific Discovery; he is a stockholder in Antares, Corcept Therapeutics, EMA Wellness, Naki Health, Relmada Therapeutics, and Seattle Genetics; and he is named on patents related to psychiatric treatment. The other authors report no financial relationships with commercial interests.
Funding Information
Dr. Widge and Dr. Wilson acknowledge financial support from the Minnesota’s Discovery, Research, and InnoVation Economy (MnDRIVE) initiative. Dr. Wilson acknowledges support from the NIH National Center for Advancing Translational Sciences (grant UL1TR002494).The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of NIH or any other funding body. The original article was prepared by an APA Component and approved by the Board of Trustees, and has been modified only as required by peer review.
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