APA and BPA Leaders Seek Common Ground

APA and the Black Psychiatrists of America need each other.

That’s what APA CEO and Medical Director Saul Levin, M.D., M.P.A., and APA President-elect Altha Stewart, M.D., agreed on in a joint discussion at the 2018 Spring Educational Conference of the Black Psychiatrists of America (BPA), in Memphis last month.

“We need to work out a better relationship with APA,” Stewart told colleagues at the BPA meeting, referencing a relationship over several decades between the two organizations and between APA and some of its African-American members that was sometimes fraught with difficulty. “If we don’t have a relationship with APA, we won’t be able to make our contribution as the organization uniquely representing black psychiatrists,” she said.

The first African-American president-elect in APA’s history, Stewart (who is a long-time member and former president of the BPA) said she hoped that the two organizations would work out a clearly articulated plan to align interests around issues of mutual concern—attracting African-American and other minority medical students to psychiatry and addressing health disparities, institutional racism that may exist in medical schools and training programs, mass incarceration, and gun violence.

Stewart said that the centrality of faith and worship in African-American communities makes BPA a natural partner in APA’s efforts to reach out to faith-based communities. “We are the center of the mental health and faith-based partnership,” she said. “We know how to integrate that into the work we do with our patients.”

Stewart and Levin spoke at the conclusion of a three-day meeting featuring speakers on diversity and inclusion in academic medical centers, race and access to mental health care, racial disparities and inclusion of minority individuals in clinical trials, and the influence of race on substance use policy and the opioid epidemic. The meeting also featured the screening of a short, independent film titled, “Black Korea,” dramatizing the subculture of children born of marriages between Korean women and black servicemen stationed in Korea (see story below).

Speakers at the meeting underscored a legacy of mistrust of the health care system generally among black Americans, noting especially the lasting effect of the Tuskegee syphilis study, conducted by the U.S. Public Health Service between 1932 and 1972 to study the natural course of syphilis in African-American men. The study was conducted without patients’ informed consent; even after penicillin became available in 1947, the treatment was not offered to enrolled patients. The BPA meeting also took place just days after an unarmed African-American 22-year-old, Stephon Clark, was shot and killed by police in Sacramento.

Levin said the effect on black communities of such events, past and present, is an important perspective that needs to be acknowledged and recognized by APA. He added that it was important to him, personally, to attend the entire three-day BPA conference and listen to all of the speakers.

“These are voices that need to be heard in our Association,” he said. “You represent a viewpoint that is not often-enough heard at APA. This is part of what we do as psychiatrists—keeping open the lines of communication with the people in our lives. If we don’t do it, we both suffer.”

Stewart recounted the history of the BPA, which was founded 50 years ago when black members of APA—including Chester Pierce, M.D.—decided “that no more were they going to be dismissed.” Stewart added, “There were people who put a lot on the line for us to be here together today.”

On May 9, 1969, a story ran in the New York Times under the headline, “Racism Is Called a Health Problem,” outlining demands by BPA founders to “the all-white leadership of APA” to address racism in America. One year later the American Journal of Psychiatry ran a special section titled “Institutional Racism in Psychiatry,” with articles by (among others) Melvin Sabshin, M.D., who would become APA’s medical director in 1974, and Paul Fink, M.D., who went on to become APA president for the 1988-1989 term. He wrote an article entitled “Beware of Whites Bearing Gifts.”

In 1971 APA created the Committee of Black Psychiatrists, an occurrence that Stewart called “a sentinel event” for all minority groups in psychiatry. “Black psychiatrists led the way in helping APA recognize the unique and special needs of minority groups within its membership,” she said.

Today, Levin said the two organizations need each other more than ever during a time when the country is divided politically. “We have to put aside past battles and disagreements and stick together,” Levin said. ■