Social (In)Justice and Mental Health: a must read! according to Community Mental Health Journal

Social (In)Justice and Mental Health, the newly published book edited by Dr. Ruth Shim and Dr. Sarah Vinson was recently reviewed by Sandra Steingard, M.D. Editor-in-Chief of Community Mental Health Journal, a peer-reviewed journal, calling it “a must read.” 

After what appeared to be a long period of social justice discourse and wake-up calls for many Americans and people worldwide, Dr. Steingard deems this book “long overdue” as it addresses society’s failure to deliver on basic human rights, harming people with mental illness. 

In this review affirms by stating, “My hope is that this book will quickly come to be considered required reading by clinicians, administrators, and students, including those who already understand the urgency of the problems we face as well as those who are just beginning to grapple with them.”

To read the full review, click here.


ABOUT COMMUNITY MENTAL HEALTH JOURNAL

Community Mental Health Journal is devoted to the evaluation and improvement of public sector mental health services for people affected by severe mental disorders, serious emotional disturbances and/or addictions.

Coverage includes:

  • nationally representative epidemiologic projects

  • intervention research involving benefit and risk comparisons between service programs

  • methodology, such as instrumentation, where particularly pertinent to public sector behavioral health evaluation or research

Learn more: https://www.springer.com/journal/10597

ABOUT SOCIAL (IN)JUSTICE AND MENTAL HEALTH

Social justice entails equal access to liberties, rights, and opportunities, as well as care for the least advantaged members of society. The paradigm-shifting new book Social (In)Justice and Mental Health addresses the ways in which society’s failure to deliver on that humane ideal harms people with mental illness.

The editors, at the forefront of the effort to make psychiatry responsive to critiques of institutional racism, argue that in the United States, a perfect storm of unfair and unjust policies and practices, bolstered by deep-seated beliefs about the inferiority of some groups, has led to a small number of people having tremendous advantages, freedoms, and opportunities, while a growing number are denied those liberties and rights.

Mental health clinicians bear a special responsibility to be aware of these structural inequities, to question their own biases, to intervene on behalf of patients and their families, and to advocate for mental health equity. To that end, the book provides a framework for thinking about why these inequities exist and persist and provides clinicians with a road map to address these inequalities as they relate to racism, the criminal justice system, and other systems and diagnoses.

Learn more: https://www.sijmh.com

Systemic, Racial Injustice--Informed Solutions to Shift "Care" from the Criminal Legal System to the Mental Health Care System

This recent article, Systemic, Racial Injustice--Informed Solutions to Shift "Care" from the Criminal Legal System to the Mental Health Care System, written by Dr. Sarah Vinson and Andrea L. Dennis, J.D. has been accepted for publication in the peer-reviewed journal, Psychiatric Services.

Introduction to the article:

The current configuration and function of the U.S. societal structures drives the overrepresentation of people with serious mental illness in the criminal legal system. Although the causes are multifactorial, the mental health system poorly serves those at highest risk of criminal league system involvement. Asserting that the central problem is the division of labor between the mental health system and the criminal justice system, Bofine et al. (1) articulated the need for an “integrated community health system—i.e., “intercept 0” for the coordination and integration of services for this population. Intercept ) is the first step in the sequential intercept model, which describes “how individuals with mental and substance use disorders come into contact with and move through the criminal just system” and helps communities identify resources and gaps in services at each intercept and develop local strategic action plans” (2). At intercept 0, individuals in crisis are diverted into local crisis care services without requiring a call to 911. They are paired with treatment or services instead of arrested or charged with a crime (2). Responsibility for addressing the needs of those with severe mental illness should rest with the mental health system rather than with the criminal legal system. However, the current division of labor between the two systems is just part of the problem. Simply put, the mental health system is not consistently accessible to or effective for those at highest of criminal legal system involvement… Continue reading the full article here.


About Psychiatric Services

Psychiatric Services, established in 1950, is published monthly by the American Psychiatric Association. The peer-reviewed journal features research reports on issues related to the delivery of mental health services, especially for people with serious mental illness in community-based treatment programs. Long known as an interdisciplinary journal, Psychiatric Services recognizes that provision of high-quality care involves collaboration among a variety of professionals, frequently working as a team. Authors of research reports published in the journal include psychiatrists, psychologists, pharmacists, nurses, social workers, drug and alcohol treatment counselors, economists, policy analysts, and professionals in related systems such as criminal justice and welfare systems. In the mental health field, the current focus on patient-centered, recovery-oriented care and on dissemination of evidence-based practices is transforming service delivery systems at all levels. Research published in Psychiatric Servicescontributes to this transformation.

PHR Medical and Mental Health Experts Find that Protestors Experienced Trauma from NYPD Attack in the Bronx in June 2020

April 20, 2021 — United States — Released by Physicians for Human Rights

After the New York City Police Department (NYPD) kettled and attacked a group of about 300 protestors during an anti-police brutality protest in the Bronx on June 4, 2020, demonstrators experienced both individual and collective trauma, according to an independent assessment conducted by medical and mental health experts with Physicians for Human Rights (PHR). 

Due to the harms sustained by both individual protestors and the broader Mott Haven community, the PHR experts call on the City of New York to take substantive and meaningful actions to repair the damage caused by the city’s police force on June 4, including redress for the individual protestors and measures to address the broader community trauma in Mott Haven, South Bronx.

PHR medical and mental health experts conducted an independent assessment of the Notices of Claim of 23 of the Mott Haven protestors. A Notice of Claim is an approximately two-page form used to notify the City of New York that someone intends to file a lawsuit against a city agency, which summarizes injuries but does not provide an exhaustive account of the incident. PHR’s clinicians cannot offer formal diagnoses because they did not conduct clinical interviews with or examinations of the demonstrators. However, following a thorough review of available documentation, the experts conclude that all 23 of the claimants report mental health symptoms consistent with traumatic exposures to the violent actions of the NYPD on June 4, 2020.

In the experts’ opinion, protestors’ descriptions of their experiences meet the diagnostic criteria for traumatic events in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Nineteen of the 23 claimants describe experiencing cardinal symptoms of post-traumatic stress disorder (PTSD), depression, or anxiety since the events at the Mott Haven protest and police crackdown.

The analysis was conducted by Michele Heisler, MD, MPA, Sarah Y. Vinson, MD, and Jack Saul, PhD, who are leading experts in the fields of public health, human rights, and mental health, with research and writing support from Brianna da Silva Bhatia, MD.

The Bronx Defenders, a Bronx-based legal assistance nonprofit organization, is representing these 23 Mott Haven protestors, each of whom was detained and arrested by the NYPD during the June 4, 2020 protest. These 23 people are members of the Mott Haven Collective that is now calling for the City of New York to provide reparations to the community to begin to repair the damage caused by the NYPD’s June 4 attack and the long history of racially-biased police violence in the Bronx. In December 2020, the Bronx Defenders asked PHR to provide an analysis of the physical and psychological consequences of the individual and community-level trauma stemming from these police actions, including an analysis of both mental and physical harms.

The resulting expert statement offers five key sets of insights: an analysis of the patterns and types of traumatic events experienced by the 23 protestors; a review of the scientific literature about mental health harms resulting from police violence; an assessment of the mental health symptoms described in the protestors’ Notices of Claim, and their relation to diagnostic criteria for psychological disorders; a targeted review of the scientific literature on community trauma relevant to the NYPD actions on June 4, 2020; and recommended principles to guide individual and systemic responses to address the harms sustained by individual protestors and the Mott Haven community.

“The egregious and violent NYPD actions led to significant mental health harms among protestors who experienced violence, arrest, and detention on June 4, as seen in their reports of symptoms of PTSD, anxiety, and depression,” said Michele Heisler, MD, MPA, statement co-author, medical director at PHR, and professor of internal medicine and public health at the University of Michigan. “Beyond the impacts on individuals, the violence perpetrated by the NYPD on June 4, 2020 created community and collective trauma in Mott Haven. As a clinician and researcher on the effects of traumatic human rights violations, it is clear to me that the 23 protestors whose cases we have analyzed, as well as the broader community of Mott Haven, should receive acknowledgement and redress from the City of New York.”

“Police violence not only directly harms the physical and mental health of individuals, it also harms families and communities by contributing to a climate of fear, chronic stress, and lowered resistance to diseases – even among those not directly harmed by police,” said Jack Saul, PhD, statement co-author, licensed psychologist, and director of the International Trauma Studies Program. “Viewing what happened in Mott Haven on June 4 through a collective trauma lens is particularly important in order to address the destruction of human connections by police violence and structural racism. Collective trauma requires collective responses – in this case, a reparative process that includes accountability for unacceptable and illegal behavior and the development of a broader collective narrative which places police violence in the context of societal racial injustice.”

“The path forward must be predicated on a commitment to providing the people of Mott Haven with a sense of safety, support, and security,” said Sarah Y. Vinson, MD, statement co-author, principal consultant of Lorio Forensics, and co-editor of Social (In)Justice and Mental Health. “The most critical mental health interventions are not medication or therapy. They are fed bellies, stable homes, legitimate opportunity, and meaningful connection. Multi-factorial systemic forces are implicated, so multi-factorial systemic solutions are indicated.”

“The Mott Haven protest was peaceful and nonviolent.  It is chilling that instead of protecting the protestors and residents in Mott Haven on June 4, the NYPD intimidated and harmed the community,” said Brianna da Silva Bhatia, MD, statement co-author, internal medicine physician, and PHR research intern. “Police excessive force is a public health crisis that continues to afflict our society.  The physical and mental health harms perpetuated by inequity, systemic racism, and abusive policing damage individuals and communities, resulting in intergenerational trauma.  New York and the NYPD have a unique opportunity now to take responsibility, evaluate the meaning of justice, and initiate a reparative process.”

“PHR’s report confirms what our clients have been saying and living with since the NYPD’s June 4th attack in the Bronx: the racially-biased police violence that day caused trauma to both the protestors and the community, in addition to the serious physical injuries that many suffered,” said Seth Packrone, an attorney with the Impact Litigation Practice at The Bronx Defenders, the legal group representing the Mott Haven Collective. “City officials must provide substantial support and resources to the Bronx and injured protesters now to begin to repair the damage the NYPD has wrought.”

To respond to the individual and collective harms stemming from the June 4 police violence in Mott Haven, the expert authors of the statement recommend eight principles to guide efforts to secure justice and accountability at the individual and systemic levels: 

  1. The Mott Haven community must be involved in all decisions and plans, in order to promote community recovery.

  2. Inclusive, evidence-based, and person-centered mental health resources must be provided for protestors and community members.

  3. A health workforce must be created that understands trauma, ensuring that health care services for the community of Mott Haven meet the highest standards of trauma-informed health care.

  4. Funding must be increased for services that help meet social determinants of health, including social services, housing, employment, education, healthy food, green space, and other community services.

  5. Law enforcement and governing must be aligned with anti-racist actions and policies, including through monitoring and documenting inequities in order to identify racist practices and policies in law enforcement and governing.

  6. There must be accountability for police officers who used excessive force, with a guarantee that perpetrators of police violence will be disciplined and held to account by their departments.

  7. Health care workers must be empowered to be allies to social justice movements and should be encouraged, supported, and funded to help make underserved communities like Mott Haven safer and healthier.

  8. Reforms must go beyond Mott Haven for equitable and meaningful change, and governing bodies across the United States must rigorously examine police-community relations and the structures and systems that have allowed policing to be violent and trauma inducing.

Read the full expert statement here.


Physicians for Human Rights (PHR) is a New York-based advocacy organization that uses science and medicine to prevent mass atrocities and severe human rights violations. Learn more here.