Integrating Diversity, Equity, and Inclusion Into an Academic Department of Psychiatry and Behavioral Sciences

In 2017, the Department of Psychiatry and Behavioral Sciences at our university formed the Diversity and Inclusion Subcommittee (DISC), which includes faculty, trainees, and staff selected by the vice chairs who had previous DEI responsibilities. The committee members represent diversity related to professional degree, primary work site, age, gender, gender identity, race, ethnicity, culture, national origin, religion, sexual orientation, ability status, primary language, immigrant status, and family socioeconomic status. This committee may be expanded in the future to include other stakeholders, such as patients and community members. Spearheaded by the Vice Chair for Faculty Development with the support and input of the chair and other senior leaders of the psychiatry department, the DISC created a mission, a goals statement including values, and a logo. Its mission statement reads: “The Department . . . welcomes, respects, and embraces differences in age, sex and gender, sexual orientation, gender identity, race, ethnicity, indigenous background, culture, national origin, language, religion, spiritual orientation, ability status, social class, education, veteran status, political persuasion, professional interests, and other cultural and professional dimensions. We celebrate intersectionalities among these cultural and professional dimensions. The DISC endeavors to foster an equitable and inclusive culture in which all members of the department feel respected, valued, and recognized for their unique and collective contributions.”

In keeping with the DISC’s strategic plan, several related work groups were formed. One year after the DISC was established, to enhance the experience of and to empower diverse faculty, the Women’s Faculty Subcommittee (WFS) and the Racial, Ethnic, and Cultural Minority Faculty Subcommittee (RECM) were formed. These two cochaired subcommittees outlined their own missions and goals. The mission of the WFS is to “promote a culture that actively supports the successful professional and personal development of all women faculty in our department through education, advocacy, and mentoring.” The mission of the RECM is to “promote awareness of issues related to race, ethnicity, and culture among the faculty in our department, and provide a source of safety and support, education and other resources.” The following year, the Resident Diversity Committee, was created to advance diversity initiatives within the residency program.

To bolster the departmental DEI portfolio and obtain the personnel to implement the strategic plan, the DEI infrastructure was expanded. In 2019, two assistant Vice Chairs for Diversity and Inclusion were selected by senior leaders of the psychiatry department. They assumed leadership roles vis-à-vis key components of the diversity strategic plan, and their responsibilities evolved based on their interests and expertise and departmental needs. The Vice Chair for Faculty Development’s scope was broadened; she became Vice Chair for Faculty Development, Diversity, Equity, and Inclusion and was allotted a small annual budget. The vice chair, assistant vice chairs, and subcommittees’ cochairs formed a Diversity Leadership Council to learn from one another and to collaborate to expand their impact. Members of this council determine fiscal priorities for the diversity budget.

Despite these accomplishments, several challenges have complicated efforts to achieve subcommittee missions and infuse DEI values into departmental systems, practices, and culture. Although our aim is to foster a culture of open dialogue, some individuals have been reluctant to speak; some fear that being vulnerable could be risky and result in retribution, and others are concerned they might offend esteemed colleagues or those in power. Others do not appear to be invested in such conversations, possibly because they do not share or prioritize the DEI values enumerated above. These challenges limit the diversity of perspectives offered.

Even among people committed to advancing DEI, challenges emerge in the discourse which need to be navigated. After 2 years of working to align values, the DISC struggled to issue a statement about a hate crime that was perceived differently by individuals from diverse backgrounds. Instead of glossing over the complexities or avoiding making a statement, the subcommittee built respect and trust by acknowledging the process, seeking commonalities, and issuing a statement about the struggle to reach consensus. As another example, although many DISC members support the use of preferred pronouns to promote inclusion (e.g., “they and them”), this change was challenging for some members, because it departs from historical ways of communicating in certain languages.

One problem encountered across settings pertains to the fact that despite widespread departmental interest in DEI efforts, many people do not engage with the initiatives. For efforts to advance, greater participation is needed by more parties, including leaders. In addition, it is challenging to identify the best actions to take to promote DEI. After the departmental forum that resulted in a list of potential actions, prioritizing action steps has been complicated.

Data are needed to determine the department’s current state and to capture change. Data collection could allow for examination of discrepancies between what people believe they know about an aspect of cultural competence and their actual knowledge regarding a specific aspect (e.g., trans and/or gender diversity) of cultural competence before and after a training session. However, data related to cultural competence often are hard to gather or access, and their reliability may be questionable. Finally, although we are grateful for the funding we have received for activities, the funds have been limited. The impact of the DEI efforts enumerated above would be greater if additional resources were available.

Future efforts will be dedicated to creating and embarking on a strategic action plan that incorporates initiatives designed to be transformative. DEI efforts will be assessed to determine their effectiveness, and stakeholder feedback will inform future activities designed to support culture change (11, 12). Optimally, transparency about assessment findings will stimulate discussion, garner buy-in from more stakeholders, and motivate organizational change. More courageous conversations will be planned to facilitate and empower everyone to speak and hear the voices of all parties. Such communication may include small group discussions, mechanisms for anonymous suggestions, and in-person DEI consultations. Increased activities outside the workplace for faculty from underrepresented backgrounds could promote collegiality and connection and reduce isolation and marginalization (13). Data could be used to advocate for resources (money, staff) to advance the DEI agenda. Supporting colleagues’ engagement in DEI to mitigate against burnout and optimize resilience will be a priority.

DEI must be integrated within the department’s mission. An infrastructure must be established to foster conversation and strategic plan implementation. Leaders must be trained and encouraged to create a community in which all parties acknowledge their biases and commit to strengthening their DEI competencies; action plans are implemented and evaluated; and structures and systems that perpetuate bias and discrimination are altered.

It is our hope that sharing the initiatives undertaken within our academic department of psychiatry will allow others to build on this example. Promotion of DEI is an ongoing collaborative process to ensure that all department members feel welcome, included, heard, respected, and valued. Our future efforts will assess the outcomes of our strategic plan and the impact of our DEI efforts and will articulate dynamically evolving best practices.

The authors thank the department chair and members of the three diversity subcommittees for their engagement in diversity, equity, and inclusion initiatives.