In our roles as Editors of The American Journal of Psychiatry, we are committed to stand against racism, social injustice, and health care inequities. Recent events of racism, the outpouring of voices of protest, and our own strong antiracist sentiments motivated discussions among us that have been focused on our need to address the role of structural racism in psychiatry and the notable lack of attention to this issue in scientific publications. Racism has greatly contributed to the mental and physical suffering of Black individuals and has served to undermine their health care. In relation to psychiatry and mental health services, there are enormous health care disparities that need to be remedied. Biases and misaligned priorities have resulted in a lack of resources, and combined with other barriers, these issues have contributed to poor access to clinical care that is disproportionately experienced by Black individuals. These factors also help to explain the paucity of research focused on understanding factors that will specifically aid in the treatment of stress-related and psychiatric disorders in Black individuals.
As described by APA President Jeffrey Geller in a recent historical review (
1), American psychiatry’s early years were marked by engagement in blatant systemic racism, the consequences of which remain evident today (
2). We note that in 1970, a series of papers was published in the
Journal (
3–
9) that spoke to how psychiatry should address racism; unfortunately, little progress has been made, and the
Journal’s efforts fell short.
As Editors of the Journal, we are determined to use the Journal as effectively as possible to present scientific and clinical information that will combat racism and its devastating effects on psychiatric care and mental well-being. The ultimate role of the Journal is to bring the latest scientific and clinical developments to our readership to directly improve care, reduce suffering, and build resilience in our patients. In this regard, the Black community will be a priority.
In addition to self-examining our own unintentional behaviors that may contribute to racism, the additional action steps that we are taking include the following:
1.
Commitment to further enhance inclusiveness and diversity in the Journal in relation to the Editorial Board, authorship, and reviewers.
2.
Prioritization of high-quality papers focused on the history of racism, systemic racism issues, health care inequities, mechanisms underlying illness, and new treatment development that are relevant and specific to the mental health of Black individuals.
3.
Highlight publications and other initiatives that promote strategies to attract and train Black physicians to become clinical psychiatrists, educators, and researchers.
4.
Development of a special section of the Journal website to update progress in these areas and to allow for the rapid posting of highly relevant, impactful new manuscripts. This will underscore the importance of these topics and will provide a means to rapidly alert our readership and the public to new publications aimed at racism, health care inequities, and social injustice as they pertain to mental health.
5.
Work in concert with APA’s Presidential Task Force to Address Structural Racism Throughout Psychiatry in its charge to develop achievable and actionable recommendations for change to eliminate structural racism.