Institutional Racism Still Has Major Impact on African-American Mental Health

At the APA Institute on Psychiatric Services in October, a presidential symposium commemorated the 50th anniversary of the Civil Rights Act of 1964 and featured a discussion on the history and current state of African-American mental health.

“Today we gather to discuss things that have a spiritual root and are very important as they relate to the optimal functioning of the mind, on an emotional and psychological level, for many APA members and the general public,” said symposium moderator Altha Stewart, M.D., executive director of Just Care Family Network in Memphis. “There are issues related to race, ethnicity, and identity that still need to be addressed 50 years after the passing and signing of the Civil Rights Act … [and] psychiatry definitely has a role” in addressing these issues, she emphasized.

“This topic is unique to American history,” said APA President Paul Summergrad, M.D., in welcoming participants. “This is a chance for us to renew a very important dialogue, not end a dialogue.” Summergrad stated that psychiatrists must create more opportunities in which people can feel comfortable to talk about all forms of discrimination, which has plagued and continues to plague people of diverse backgrounds in the United States.

The symposium, “Civil Rights Movement and African-American Mental Health,” featured several speakers including psychiatrist Sandra Walker, M.D., an associate clinical professor at the University of Washington. Walker gave an overview of growing up black in Alabama in the 1960s and discussed losing a childhood friend in the 16th Street Baptist Church bombing in 1963 in Birmingham, in which four African-American school girls were killed in an act of racial hatred.

Walker also recalled the time when her parents were finally allowed to vote after they “passed”—following several attempts—the Alabama Voter Literacy Test, a once-legal suppression tool that kept many blacks from voting. “Until the FBI came to Macon County, Alabama, to evaluate every voter registration application, my parents could not pass the test … [though] my father was the chair of the English Department at Tuskegee Institute and my mother had a master’s degree in English and was working on a Ph.D.,” Walker said.

Donald Williams, M.D., a professor emeritus of psychiatry at Michigan State University, told the audience that “the civil rights movement was not just a movement for African Americans, it was a movement for Catholics, Jewish people, Italians, … and a number of European groups that were considered outsiders to some degree. All passive resistance involved multiethnic and multicultural people,” he said.

Williams emphasized that the fight against racial inequality continues as more minority men are being incarcerated and racially profiled—in some situations legally—by police. “Our neighborhoods have become systems where police can feel free to frisk all black males, and these young men can do nothing about it.” Williams stressed that for psychiatrists to provide culturally competent services to specific ethnic and racial groups, it is crucial for them to understand how institutional racism can have a negative impact on the mental health of minority populations.

Orlando Lightfoot, M.D., vice chair of community psychiatry at Boston University, stated that as it relates to racism, “there is no perfect solution for such a complex issue.” He said that banishing racial discrimination is a process that may be resolved—or at least come close to being resolved—over an extended period, adding that history has shown that there is no quick fix.

Lightfoot suggested that one way to improve race relations in the United States is be open to life experiences from people of other racial, ethnic, or cultural backgrounds and continue to modify legislative systems and policies that overtly or covertly oppress a particular group of people. He stressed that it will take a concerted effort of all racial groups to achieve this goal, and if it is successful, it has the potential to serve as a blueprint to rid the country of homophobia, sexism, classism, and other prejudices. ■