Four Psychiatrists Pen Open Letter to Former First Lady Michelle Obama

When four Black women psychiatrists got together to affirm Michelle Obama’s podcast in early August about the burdens borne by Black women during the COVID-19 pandemic and the racial reckoning that is now taking place, it took about 72 hours to formulate what amounts to a manifesto that would in time be signed by more than 200 other Black women.

In an open letter to the former first lady, the four original authors—an intergenerational group of leaders in cultural psychiatry and organized medicine, including past APA President Altha Stewart, M.D.—applauded Obama’s message and issued a call to action.

“As psychiatrists, many of us care for Black women in our communities. We bear witness to the pain experienced by Black women, though it is systematically unrecognized by traditional health care systems. Our current systems overpathologize Black women’s experience of pain and trauma, rather than affirming and acknowledging our experience as valid. Black women’s mental health should be a national priority.” (For the full text of the open letter, see box).

In addition to Stewart, the authors were Aderonke B. Pederson, M.D., an instructor in the Department of Psychiatry and Behavioral Sciences at the Northwestern University Feinberg School of Medicine; Brandi Jackson, M.D., co-founding director of the Institute for Antiracism in Medicine, the director of Integrative Behavioral Health at Howard Brown Health, and an adjunct professor of psychiatry at Rush University Medical Center; and Crystal Clark, M.D., MSc., co-director of the Women’s and Perinatal Mental Health Fellowship at the Northwestern University Feinberg School of Medicine and president of Marcé of North America. (The International Marcé Society for Perinatal Mental Health is an international, interdisciplinary organization dedicated to supporting research on prenatal and postpartum mental health for mothers, fathers, and their babies.)

In a conversation with Psychiatric News, the authors described how the small seed of a good idea grew—through contacts with influential leaders who are “in the know” and know how to spread the word, including the adept use of social media—into something larger than its original intention: Though addressed to Michelle Obama, the audience for the open letter is really the universe of Black women in America, organized medicine, and the public.

Several weeks later, Pederson and Jackson wrote an editorial in the Washington Post that amplified their message.

It was Pederson who initiated the idea after hearing Obama’s podcast in which the former first lady testified to experiencing low-grade depression, sleeplessness, and anxiety during a period of remarkable upheaval. Obama also referenced the disproportionate burden of COVID-19 carried by the Black community and the anger and heartache resulting from the death of George Floyd and other Black men and women at the hands of police.

“As Black women, we have all watched this iconic figure who is so important to all of us and has been a voice for us in a public space,” Pederson said. “She articulated what so many of us are feeling—as clinicians but also as Black women ourselves—about the disproportionate deaths of Black people from COVID-19 and all that has happened with regard to police brutality.”

Pederson wanted to affirm Obama’s message, and she began to put out feelers and make cold calls to colleagues and other Black women physicians, including Clark and Jackson. What would they think of writing a letter to the former first lady?

One of those email messages also went to Stewart, whom Pederson had never met. She posed her message to the former APA president warily—a teaser—just enough information to pique her interest.

It worked because Stewart, who has no shortage of emails to look at, jumped on this one. “I was in the car in the parking lot of the grocery store when I saw this message, and I was immediately excited,” she said.

She recalled that a theme of her presidential year was engaging young psychiatrists to be leaders. “Right away I knew this was something I wanted to be a part of,” she said.

That was a Saturday. The next morning the four women held a Zoom meeting and not long after had a letter composed.

Stewart was able to connect the small group and its letter to the Black Psychiatrists of America and other relevant groups and prominent psychiatrists. In addition, Clark, who has an international reputation and connections in women’s perinatal health and mental health, also had something very useful to making a message go viral—an Instagram account.

Her handle is @DrCrystalListens. “My Instagram account was created during the pandemic in response to my ongoing passion and goal to increase awareness about mental health issues, particularly those that uniquely impact women,” Clark said. “In addition to raising awareness, my goal is to amplify and empower women through education.”

Within 24 hours, the letter had more than 200 signatures of Black women psychiatrists—and the support of many white women psychiatrists nationwide. On August 17, the open letter was picked up by Chicago Tribune columnist Heidi Stevens and reprinted in its entirety.

What had started as a personal letter to the former first lady was now a kind of declaration and a living document testifying to the needs of Black women in troubled times and to their power and resilience.

On September 4, the Washington Post published an opinion piece by Pederson and Jackson that echoed and amplified the message in the open letter, with a special emphasis on the work of women psychiatrists. (Both women were fellows in the Public Voices program at the University of Illinois, a signature component of which is the OpEd Project connecting fellows with journalist mentors.)

“As Black female psychiatrists, we recognize the feeling of being overwhelmed,” they wrote. “There aren’t many of us: Roughly 2% of practicing physicians in the United States identify as Black women. Of those, only a small number choose psychiatry as their specialty. … Even if we all saw patients 24/7, we Black female psychiatrists could never meet the mental health needs of Black women. … On the rare occasion that we meet, we speak freely about the anguish we feel. … We admit that we have no answers, and at times feel hopeless.

“And then we get up again, and we do our jobs.”

The former APA president downplayed her role in the unfolding story. “These are brilliant young women clinicians and researchers, and they are why I am hopeful about the future of psychiatry,” Stewart said. “They have created a message for other Black women psychiatrists and for Black women everywhere: We hear you, we see you, we are you.”

The Chicago Tribune article is posted here.

The Washington Post editorial is posted here.

Information about The Public Voices Fellowship and OpEd Project is posted here.