The medical subspecialties of addiction psychiatry and addiction medicine are collaborating with the Yale Department of Psychiatry on a new program to help train minorities and increase their participation in the two subspecialties, and also focus on providing treatment to underserved populations.
The Substance Abuse and Mental Health Services Administration (SAMHSA) has awarded a grant for $1 million each year for five years to the American Academy of Addiction Psychiatry (AAAP) in collaboration with the American College of Academic Addiction Medicine (ACAAM).
In the field of public health and medicine, minority representation among clinicians has been underrepresented, and in the field of addiction medicine specialty training even more so. While African Americans, Hispanic Americans, and American Indians represent nearly 30 percent of the U.S. population, they collectively comprise less than 10 percent of all physicians and a much smaller percentage in addiction fields.
The new Yale-based training program, Recognizing and Eliminating disparities in Addiction through Culturally-informed Healthcare (REACH), will build on the existing infrastructure and partnerships between AAAP and addiction psychiatry and addiction medicine fellowship programs at Yale.
“As medical director on this project, I am elated that SAMHSA has provided the necessary resources to address the shortage of physicians in the addiction workforce, while also providing a platform for these providers to receive deliberate training in culturally-informed care,” said Ayana Jordan, MD, PhD, assistant professor of psychiatry at Yale School of Medicine. “REACH is an innovative program that will increase the number of addiction providers from underrepresented backgrounds, while also teaching the existing workforce about structural competence and ways to improve outcomes for people with substance use disorders.”
Given the high co-morbidity of medical illnesses among patients with substance use and mental health disorders, the REACH program draws strength from its collaborative nature between addiction medicine and addiction psychiatry with a teaching curriculum that highlights the value and effectiveness of these two disciplines working together. Finally, the REACH program includes an advisory committee made up of racially and culturally diverse policy makers, addiction medicine and addiction psychiatry physicians, community physicians, and activists who will ensure curricula strong in diverse clinical and training perspectives.
“SAMHSA has set the bar high, and REACH will undoubtedly make strides in changing the face of addiction physicians and ways in which all people receive quality care,” Jordan said. The grant will provide funding for the recruitment and training among early career trainees, including medical students, residents, and fellows in Addiction Psychiatry and Addiction Medicine.
The gaps in care for minority populations have disproportionately affected them by lack of appropriate services. Several factors contribute to this trend:
- Social and cultural stigma associated with accessing substance use treatment
- Mistrust of the medical system due to historic maltreatment of minority clients
- Lack of healthcare coverage
- Circuitous and difficult pathways to care
- Lower socioeconomic status
- Absence of culturally informed treatment options
- Minority populations seeking treatment from minority professionals
This innovative REACH training program takes advantage of the collaborative nature and didactic training modules presently held between addiction psychiatry and addiction medicine, which emphasize the unique medical and mental health needs often overlooked when addressing minority patients with substance use disorders.