Letter to the Editor: UCLA Department of Psychiatry and Biobehavioral Sciences combats racial inequity

“What has been the department’s response to last year’s Daily Bruin article?”

The young Black applicant applying to our psychiatry residency training program looked at us with expectation, referring to the article that was published on Feb. 17, 2022 – one year ago – about racism in the UCLA Department of Psychiatry and Biobehavioral Sciences.

The three of us had already been at work to address the issues highlighted by that article before it was even published, yet the article stressed the urgency of action and has since been a daily source of motivation for us as our department reckons with its past and looks to its future. In July, Helena Hansen assumed the role of interim chair of psychiatry, and in October, Enrico Castillo assumed the role of associate vice chair for justice, equity, diversity and inclusion of psychiatry, joining Eraka Bath who has served as inaugural vice chair for JEDI in psychiatry since 2018.

When the article was first published, some voiced disbelief. Trainees would bring up the article to faculty supervisors looking to start a dialogue, only to be told that the faculty members and trainees quoted in the article “had an axe to grind” and were “airing dirty laundry.”

Although they may not have intended it, faculty who remained silent added to the harms experienced by the racially and ethnically marginalized faculty, staff and trainees who were left to address racism and other forms of discrimination in our department on their own.

Today, one year after the article, we still face racialized inequities in our department, but we have been hard at work to address issues raised by the article and to increase our accountability to diverse, under-resourced patients and communities in Los Angeles.

Over 80 faculty, staff and trainees formed anti-racism learning groups, raising awareness of racism and building skills as allies for racial justice. In September, UCLA Health and the LA County Department of Mental Health entered into a landmark contract to cover hospital services in the Resnick Neuropsychiatric Hospital for Medi-Cal-insured patients of all ages – thanks to a persistent and dedicated group of residents and faculty. UCLA’s Public Partnership for Wellbeing with the Department of Mental Health continues to provide workforce training and technical support to help enhance services in our county. Our trainees, staff and faculty continue to develop nationally recognized innovations in justice, equity, diversity and inclusion. Bath is the senior advisor to the David Geffen School of Medicine’s Anti-racism Roadmap and co-leads UCLA’s Anti-Racist Transformation in Medical Education program.

In concert with the UCLA Health system, our department is helping to prioritize community engagement and dialogue with individuals living in the neighborhoods surrounding the future UCLA psychiatric hospital – under construction in Mid-Wilshire – to plan for the hospital to foster economic development and educational opportunities for community members. Additionally, our department has expanded clinical and research partnerships with Charles R. Drew University of Medicine and Science, a minority-serving medical school in South LA. The medical school includes the development of a Social Medicine Collab that uses human-centered design to bring integrated mental health and primary care to youth-serving organizations in primarily Latino and Black neighborhoods in South LA, using cultural and athletic events as a platform.

Other initiatives that are being launched include the expansion of Holistic Review – which has already been in use in our psychiatry residency training program – for admissions in all of our department’s clinical and research training programs, the adoption of a department-wide team-based racial upstander policy, and the establishment of an anti-racism task force to address racism in clinical and educational settings. The task force is analyzing quantitative patient data on the use of restraints and involuntary medications for agitated patients to identify and help address any inequities in care prompted by race and/or ethnicity. Faculty with research endowments have contributed to the creation of a series of Anti-racism Mental Health Research Seed Grants for residents, fellows and postdoctoral students to support research on the effects of discrimination and interventions to stem discrimination on mental health.

This year, for the first time in our history, we held a town hall focused on justice, equity, diversity and inclusion with data provided by the Psychiatry Diversity Advisory Council, the Office of the Interim Chair and the department’s Office of Justice, Equity, Diversity and Inclusion. We continue to host these events, sharing data and updates on recruitment and retention, education and training, research, and community engagement. Our efforts correspond with the DGSOM Anti-racism Roadmap’s commitment to data, accountability and transparency.

“What has been the department’s response to last year’s Daily Bruin article?”

We tell the applicant we are glad that he asked, not because the problems have disappeared, but because that article reminds us of where we used to be, how far we have come in a year and all of the ways we must continue to evolve. Today, we take an important step in that direction.

The UCLA Department of Psychiatry and Biobehavioral Sciences apologizes to faculty, staff, trainees and patients for direct and indirect acts of racism. We commit ourselves to the critical work of rooting out racism in all aspects of the psychiatry department, the Semel Institute for Neuroscience and Human Behavior and the Resnick Neuropsychiatric Hospital, in partnership with the UCLA Health Office of Health Equity, Diversity and Inclusion, the DGSOM Office of Justice, Equity, Diversity and Inclusion and our diverse LA community.

Our department’s response is one of openness to dialogue and to change.

The authors would like to acknowledge the Psychiatry Executive Committee for their support for and edits to this letter.

Helena Hansen, a psychiatrist-anthropologist, is the interim chair of the Department of Psychiatry and Biobehavioral Sciences, interim director of the UCLA Semel Institute for Neuroscience and Human Behavior at the David Geffen School of Medicine at UCLA and interim physician-in-chief of the Resnick Neuropsychiatric. Hansen is professor of psychiatry and co-chair of Research Theme in Translational Social Science and Health Equity at DGSOM, as well as associate director of UCLA’s Center for Social Medicine. She has published widely in clinical and social science journals ranging from JAMA and NEJM to Social Science and Medicine and Medical Anthropology, on faith healing of addiction in Puerto Rico, psychiatric disability under welfare reform, opioids and race, ethnic marketing of pharmaceuticals and structural competency.

Enrico Castillo is the Associate Vice Chair for Justice, Equity, Diversity and Inclusion at the UCLA Department of Psychiatry and Biobehavioral Sciences.

Eraka Bath is the Vice Chair for Justice, Equity, Diversity and Inclusion at the UCLA Department of Psychiatry and Biobehavioral Sciences.