Lessons We Can Learn From the March on Washington

On August 28, our nation commemorated the 50th anniversary of the March on Washington for Jobs and Freedom. The civil-rights organizations leading this demonstration viewed it as an “outpouring of the deep feeling of millions of white and colored American citizens that the time has come for the government of the United States…to grant and guarantee complete equality in citizenship of the Negro minority of our population.”

In the preceding decades, African Americans faced formidable obstacles to living the promises made in the Emancipation Proclamation. Nowhere was this challenge greater than in the Jim Crow South. There, African Americans were cast in a second-class social order governed by diabolical laws. Despite local governments’ efforts to stymie justice with intimidation, imprisonment, and brutality, members of the civil-rights movement chose nonviolent resistance—a mindset of peace with the hope that it would lead to freedom.

Conceptualized by A. Phillip Randolph, a civil-rights pioneer who held many administrations (from Franklin Roosevelt through Lyndon Johnson) to the task of equality, the march tested our collective conscience. Leading up to it, mounting fear and uncertainty about the threat of violence loomed, even among White House officials.

Now, we fondly look back on the day’s unity and harmony, highlighted by the more than 200,000 white and black faces present and enhanced by Rev. Dr. Martin Luther King Jr., who presented America with a moral question—Would our country guarantee civil-rights protection to all Americans regardless of race or religion, culture or creed, and gender or socioeconomic status? King noted in his speech that 1963 was “not an end but a beginning.” As resilient as civil-rights groups had been prior to the march, afterward they remained firm despite a repeat wave of local governments’ retaliation. Through much tribulation, the following years would see passage of the Civil Rights Act and the Voting Rights Act.

As we remember the March on Washington for Jobs and Freedom, 2013 marks another anniversary—the 40th year of the Minority Fellowship Program.

Much of the fellowship program evolved from the context of the civil-rights movement. (Two books, Black Psychiatrists and American Psychiatry edited by Jeanne Spurlock, M.D., and Mental Health, Racism, and Sexism edited by Charles Willie, Patricia Rieker, Bernard Kramer, and Bertram Brown, provide important historical background regarding this era and challenges to diversity in psychiatry.) African-American psychiatrists, sociologists, psychologists, social workers, nurses, and other leaders in the health field recognized that racism permeated American culture. Many were a part of the movement and noticed a traumatized nation, particularly its traumatized minority populations. African-American psychiatrists led this charge and prompted the National Institute of Mental Health (NIMH) to review its policies and systemic prejudices. Nationally, racism began to be recognized as a major public-health problem with extreme psychosocial ramifications.

Under government pressure, NIMH evaluated its decisions and hiring practices and developed the Center for Minority Group Mental Health Programs. Dr. James Ralph oversaw this center, which evaluated the impact of racial inequity and advocated for minority and disenfranchised groups to assist communities in developing adequate mental health services. Rising to the challenge and acknowledging the importance of both research and clinical training, NIMH created the Minority Fellowship Program (MFP) in 1973. This program was to be aligned with professional organizations in the fields of psychiatry, psychology, nursing, and social work. Two decades later, oversight and implementation of the MFP was transferred to the Substance Abuse and Mental Health Services Administration. More recently, MFP training expanded to include marriage and family therapists and professional counselors.

The APA Office of Minority and National Affairs coordinates the APA MFP. To date, more than 600 fellowships offering specialized training in cultural competence, mental health advocacy, and leadership have been awarded. The continued success of APA’s MFP spans multiple levels. It offers a direct benefit at the most critical point in a psychiatrist’s professional life—during training. Decisions early in one’s professional development enrich later career choices. Additionally, the MFP is extra-organizational; it extends from the purview of organized psychiatry within APA to directly influence the local community while emphasizing leadership skills.

As was the case with psychiatrists who confronted NIMH and the civil-rights leaders who challenged Congress, meaningful and long-lasting change occurs when institutional policies are addressed. The APA MFP views its commitment to minorities and underserved groups as the professional responsibility of all members, regardless of whether they are a member-in-training or a distinguished life fellow.

The country’s increasingly diverse population and the stubborn persistence of racial disparities highlight the importance of examining our past to shed light on the present. Mental health in America has come a long way, yet the means to effectively coordinate and improve outcomes for all of our patients continues to feel like a ceaseless beginning. ■