The Yale Psychiatry Anti-Racism Task Force has spent the last 11 months working to address issues of diversity, equity, and inclusion in the department.
The task force was formed in September 2020, in the wake of a national reckoning with systemic racism amid the COVID-19 pandemic. The steering committee has met since October 2020, while subcommittees began meeting in February and March 2021. Initially the plan was for each subcommittee to have 17 months to work toward achieving its objectives, but that timeframe will likely be extended given the time it takes to change systems.
John Krystal, MD, Robert L. McNeil, Jr. Professor of Translational Research and Professor of Psychiatry and of Neuroscience, and Chair of the Department of Psychiatry, said it’s expected that the task force will be a “longer, more ambitious initiative in the end.”
“This is the largest and most important initiative in our department,” Krystal said.
The task force is comprised of a steering committee, co-chaired by Krystal and Cindy Crusto, PhD, Professor of Psychiatry, and includes the co-leaders of six subcommittees and a data and evaluation workgroup. The structure was designed to enable the task force to undertake a broad agenda and to have wide representation from faculty, staff, trainees, and individuals from institutions affiliated with the department and from the broader New Haven community or beyond while keeping working groups relatively small. The task force is now in the process of refining subcommittee goals and action plans and is transitioning to the implementation phase, Krystal said.
The task force was designed to address racism in the same vein as the response to the COVID-19 pandemic, Krystal said, in which people from all levels within the department came together with a high sense of urgency to address the crisis.
“We are bringing that pandemic mentality to the work of anti-racism,” Krystal said.
Since the task force’s inception, BIPOC faculty have been promoted within the department and there has been a concerted effort and commitment to pursuing and ensuring diversity in the hiring process and among incoming trainees and faculty. The social justice, diversity, equity and inclusion, and anti-racism curricula for psychiatry residents and interns has also been expanded, and the scope of grand rounds topics and speakers has increased.
At the steering committee’s July 8 meeting, the task force provided an update on its progress over the last several months and invited Darin Latimore, MD, Deputy Dean and Chief Diversity Officer and Deputy Title IX Coordinator at Yale School of Medicine and all subcommittee members.
“Your department is ahead of the university in having conversations about anti-racism,” Latimore said. “I commend each one of you for the efforts you’ve made. Just having these conversations in a real way is demonstrating leadership.”
Krystal said: “The work is hard and slow. At times, one might feel discouraged about the pace of progress. Hearing that we were ahead of the game was a little surprising, but also it made me feel proud of the work that we were doing together. It was a reminder that we should not take our work for granted.”
The Faculty Development Subcommittee
The faculty development subcommittee is charged with focusing on the barriers and challenges that hinder the process of career and faculty development within the department, explained Nii Addy, PhD, Associate Professor of Psychiatry and of Cellular & Molecular Physiology, Director of Scientist Diversity and Inclusion at the School of Medicine, and co-chair of the subcommittee. So far, the committee has identified challenges in the areas of mentoring and advising, as well as aspects of belonging and recognition, retainment and value.
“As we’ve talked about these problems, it’s an example of the complexity of the work and understanding what are departmental or schoolwide problems that affect many, many faculty but these systematic issues impact BIPOC faculty especially,” said Samuel Ball, PhD, Associate Dean for Faculty Affairs and faculty development subcommittee co-chair.
The Community Subcommittee
The community subcommittee’s role is to, through an anti-racist framework, examine the department’s relationship with the world, starting in New Haven, and what can be done to improve it.
This is the largest and most important initiative in our department.
John Krystal, MD, Robert L. McNeil, Jr. Professor of Translational Research and Professor of Psychiatry and of Neuroscience, and Chair of the Department of Psychiatry
Subcommittee co-chairs Michelle Silva, PsyD, Assistant Professor of Psychiatry and Director of the Connecticut Latino Behavioral Health System, and Michael Sernyak, Jr., MD, Professor of Psychiatry and CEO of the Connecticut Mental Health Center (CMHC) explained that the subcommittee has determined that health and access to health care are a direct result of both historical and current segregation and systemic racism in public policy regarding how services are delivered, where they are located, how they are funded and the intended recipients of care. They explained that structural racism and lack of engagement with the community has impacted the community’s experience of health care.
Silva said the next step is to improve the understanding of how Yale interfaces with its surrounding community, and to begin to determine how to best carry out the subcommittee’s proposed activities and goals.
The Research Subcommittee
The research subcommittee is co-chaired by Chyrell Bellamy, PhD, Associate Professor of Psychiatry, and Marina Picciotto, PhD, Charles B.G. Murphy Professor of Psychiatry and Deputy Chair for Basic Science Research. Zach Harvanek, MD, Fourth-Year Resident and member of the research subcommittee, presented on behalf of Bellamy and Picciotto, who were unable to attend the meeting. Harvanek explained that the research subcommittee’s role is to address the impact of the legacy of racism on research and to determine how the portfolio of research in the department relates to the processes or impact of racism. The subcommittee particularly hopes to address the recruitment and retainment of BIPOC individuals as participants in research.
“What we want to do is really try to identify the structural barriers to conducting health equity research … and mitigate at least one of them, as a short-term goal. Ultimately, we want to get rid of the legacy of undervaluing health equity research,” Harvanek said.
The Education Subcommittee
The education subcommittee, co-chaired by Amber Childs, PhD, Director of Training for the YSM Doctoral Internship in Clinical and Community Psychology, and Kirsten Wilkins, MD, Director of Medical Student Education, is charged with addressing the legacy of racism on training, increasing the representation of BIPOC individuals, anti-racism training efforts, social justice and healthy equity curricula, and interfacing with the clinical subcommittee regarding the clinical context of training.
Its three main priorities are anti-racism education, providing support for trainees, and increasing the number of Black clinical mentors, Childs and Wilkins said. Its next steps are to perform a needs assessment or departmental survey and to make recommendations for a departmental grand rounds series on anti-racism. Each session in the series would be followed by group discussions and some type of call to action, they said.
The Clinical Subcommittee
The clinical subcommittee is co-chaired by Debra Bond, PhD, Assistant Clinical Professor of Psychiatry, Luming Li, MD, Assistant Professor Adjunct of Psychiatry, and Ismene Petrakis, MD, Professor of Psychiatry and Chief of Psychiatry at the VA Connecticut Healthcare System. The subcommittee is tasked with evaluating the impact the legacy of racism in the clinical workplace by evaluating the climate in the workplace, the clinical outcomes and practices, the access and process of care, and how patients and clinical team members are supported. Bond said at the meeting that the subcommittee planned to break into smaller subcommittees charged with developing more specific ideas as to how to implement those objectives and goals.
The Staff Subcommittee
The staff subcommittee is led by Karima Robinson, Coordinator of Medical and Professional Staff at CMHC, and Kyle Pederson, Director of the CMHC Foundation. The subcommittee’s primary accomplishment designed a concept map that illustrates how people approach, enter, work through, and leave the department. Pederson said the subcommittee is interested in learning more and understanding this process more deeply, and “really drilling down and understanding each area and objectives we can recommend the department can take.”
In the meantime, the subcommittee has identified emerging areas of concern that include staff representation, patient and family inclusion in department change initiatives, communication and transparency, and the reporting process, Robinson said.
Moving Forward
Latimore specifically asked the steering committee to consider how the task force will move forward and continue its work in the weeks and months to come. Specifically, he asked the task force to consider how the department can address the challenges of system change and dealing with resistance to its efforts.
Crusto said it is important for other departments or workplaces considering launching its own task force or similar initiative to have “leadership from the top to provide the vision and drive the anti-racism efforts, to be committed to the vision, and to provide the resources needed to advance the work.”
“Leadership has to be open to feedback and perspectives and experiences that may be different from their own. Leaders must be committed to systems change. You also need a bottom-up approach, too, where there is shared decision making and those most affected by racism have a voice and significant roles in the change process,” she said.