“Mental Health Equity is Health Equity”
A 2-Day Speaker Symposium featuring unique, diverse, and inclusive voices in the Mental Health Equity Movement
September 28th and 29th, 2021 from 11 am – 2 pm EST via Zoom
Nearly 400 listeners signed into the Kennedy Stacher Center for Mental Health Equity’s (KSCMHE) inaugural, virtual speaker symposium entitled “Mental Health Equity is Health Equity.” Sponsored by the American Psychiatric Association Foundation, the event attracted participants from all over the world, representing academia, public health disciplines, allied health professionals, students, legislators, activists, and researchers. Carried over two three-hour sessions, featured speaker experts were representative of intersectoral and intersectional backgrounds, both in professional and personal identity, as they tackled addressing behavioral health equity in: i) policy and data, ii) clinical services delivery, iiii) cultural humility, and iv) uplifting invisible voices.
Day 1 Highlights
Day 1 began with a viewing of the “Mental Health Equity is Health Equity” campaign video, which featured messages from several leaders in the field including Dr. Saul Levin, President and CEO of the American Psychiatric Association, Dr. Arthur Evans, President and CEO of the American Psychological Association, and Dr. Kameron Matthews, Chief Medical Officer for the Veteran’s Health Administration. Audience members then heard welcome remarks from former Congressman and KSCMHE co-founder, Patrick J. Kennedy, who spoke about his family’s deep legacy in promoting civil rights and mental health parity, and the importance of addressing the traumas of racism. He was followed by 16th Surgeon General of the United States and KSCMHE co-founder, Dr. David Satcher, who encouraged participants to leave the symposium more committed to mental health equity. Daniel Dawes, JD, Executive Director of the Satcher Health Leadership Institute, discussed how mental health is often overlooked in overall health equity work, and the symposium was part of an effort to move the needle of mental health equity for all. Lastly, Dr. Miriam Delphin-Rittmon, Assistant Secretary for SAMHSA, discussed the impact COVID-19 has had on disparities and the importance of understanding the long-term mental health impacts the pandemic will have on society.
Panel 1: Policy and Data (September 28, 2021 from 11:30-12:30 PM)
After this invigorating introduction, audience members listened into the first panel of the day on Policy and Data. The panel featured the following experts:
- David Lloyd (National) – Senior Policy Advisor, Kennedy Forum
- Dr. Mary Roary (National/Washington, DC) – Director of Behavioral Health Equity, SAMHSA
- Kristin Toliver, LMSW (Atlanta, GA) – Region 14 Director, Georgia Division of Family and Child Services
- LaShawn Robinson, MSW (New York, NY) – Deputy Chancellor of Climate Wellness at NYC Department of Education
- Dr. Octavio Martinez (Austin, TX) – Executive Director, Hogg Foundation for Mental Health
Moderated by KSCMHE Director, Madhuri Jha, LCSW, MPH, the panelists discussed various points of urgency in the policy landscape, and how data influences decision-making. Dr. Mary Roary made several points around the importance of prioritizing prevention at a national level, and the long-term cost-saving that comes from interventions that do that. David Lloyd, an expert in parity policy, keyed into the fact that if parity is not widespread and federal, equity cannot be attained. Kristen Toliver, brought the child welfare lens into the conversation and discussed the value of transparency in funding streams so agencies can best prepare for the unforeseeable. Dr. Octavio Martinez, introduced a theme that would be heard through both days of the Symposium: the value of disaggregating data and how communities of color are not a monolith. LaShawn Robinson discussed her role in prioritizing holistic wellness for children in school, and highlighted the impact that COVID and remote learning have had on families in New York City. This led to another common theme heard around the value of trauma informed care and the potential for a trauma informed system.
Legislation such as, the National Suicide Designation Act: 988 and the George Floyd Justice in Policing Act were also highlighted, and how best practices like mobile psychiatric and crisis units, and culturally attuned care can create avenues for equity. Dr. Martinez highlighted that prior to COVID there was a mental health epidemic in the United States, and this number is only increasing exponentially. All panelists discussed the need to treat children and adults as a whole person and echoed LaShawn Robinson’s comments on the value of multi-tier and collaborative systems of support. David Lloyd stressed the urgency in being vocal about injustices in the US system, as Kristen Toliver highlighted how COVID-19 revealed gross inadequacies and gaps in services for youth and families. In response to an audience member who asked, “What is a first step that someone in the community can take to advocate for change?” Dr. Roary responded and closed with powerful words, “It starts with YOU! Volunteer in your passion!”
Panel 2: Clinical Services (September 28, 2021 from 1:00 – 2:00 pm EST)
After a short break, session attendees reconvened for the second panel of Day 1, a discussion on behavioral health equity and clinical services delivery. Moderated by Madhuri Jha, featured panelists included:
- Nigel Kennedy (New York City)– Attending Psychiatrist and Assistant Professor, Mount Sinai Hospital Inpatient Psychiatry
- R. Dale Walker (Oregon) – Medical Director, One Sky Center and member of Cherokee Nation
- Sidney Hankerson (New York City) – Assistant Professor and Co-Director, Columbia-Presbyterian Hospital System
- H. Westley Clark (Santa Clara, CA) – Dean’s Executive Professor at Santa Clara University and former Director at SAMHSA
Dr. Westley Clark kicked off the discussion by addressing barriers to care as they relate to stigma and provider comfort in communities of color and people affected by co-occurring disorders. He stressed how this has been exacerbated throughout the COVID-19 pandemic due to the widespread isolation felt by all. Dr. R. Dale Walker (Cherokee), spoke about his breadth of work with American Indian/Alaska Native communities, and the “confusing distribution of services” between the 574 federally recognized tribes. He highlighted the many barriers that geographic, rural isolation and resource deprivation create in tribal medicine, and the need to diversify care strategies amongst the many different cultures that tribal communities represent. Much like the first panel, panelists agreed that communities of color cannot be seen as a monolith, and best practices are those that address structural racism as a social determinant of health. Dr. Sidney Hankerson highlighted the experience of black communities that he works with and the historic distrust in traditional mental healthcare settings. Dr. Nigel Kennedy echoed his colleagues and discussed how he works with his unit team to ensure that treatment is individualized from patient to patient. Reminiscent of Panel 1, panelists in this second session expressed similar sentiments around the value in cross-sector work as it relates to clinical service delivery, as well as the importance of adequately training a workforce to utilize a “whole person model.” Dr. Hankerson highlighted his success in collaborating with faith-based, predominantly black congregations in New York City, and how he has trained faith leaders on screening for depression and anxiety. This spawned into an important discussion on community empowerment and participation.
The panel of physicians all agreed that language choice and addressing fears head on with patients and caregivers are critical to empowering communities to seek care before crisis hits. The panel also took an important look at the criminalization of mental illness and drug use and how important it is for healthcare provider systems to frame treatment of affected folks as a social justice issue. There was consensus on the gross misunderstanding and invisibility of the experience of Native people who live with mental health or co-occurring disorders, and the importance to accurately capture the burden of disease in this population. Dr. Kennedy addressed the downfalls of insurance influence on care and shared his concerns about how the mental health crisis that has been exacerbated by COVID-19. He detailed his own experience as a unit chief and urged that insurance companies should shift the authorization of medical services to meet the demand. Lastly, the theme of trauma-informed care was brought up again in this panel as it relates to imagining equitable care systems in a post-COVID world. Dr. Clark stressed that conditions and the needs of people cannot be lumped together, as he said, “We cannot treat all issues as the same! Not all people are the same!” He was echoed by his peers, who highlighted how the role that telehealth service delivery, if administered equitably, can be a game-changer in the way marginalized communities can access points of care.
Day 2 Highlights
Day 2 began with welcome remarks again from KSCMHE co-founder, Patrick J. Kennedy, followed by Morehouse School of Medicine President and Dean, Dr. Valerie Montgomery Rice. Dr. Rice took our audience through a reflection on her own journey in medicine, and how cultural humility and sensitivity must be part of the education for the next generation of health leaders in order to achieve health equity. The audience then watched a featured short from the “Mental Health Equity is Health Equity” video series by First Lady of New York City, Chirlane McCray who highlighted her family’s own history with mental illness and addiction. She stressed the importance of allocating resources based on need and in direct response to intergenerational trauma. She quoted her father by saying, “If you have your health, anything is possible! There is no full recovery without mental health equity.”
Panel 1: Cultural Humility and Sensitivity (September 29, 2021 11:30 AM – 12:30 PM EST)
Moderated by Madhuri Jha, KSCMHE Director, Day 2’s first session of the day was a panel on how cultural humility and sensitivity impacts mental health equity. Featured panelists were:
- Courtney S. Thomas Tobin (Los Angeles, CA) – Professor and Researcher, UCLA Department of Community Health Sciences and African American Studies
- Kaila Tang, LMSW (National) – Chief of Programming at the Asian Mental Health Collective and psychotherapist in practice
- Pierluigi Mancini (Atlanta, GA) – Consultant and Expert in Immigrant Health, and founder of the first ever bilingual behavioral health center in Georgia
Panelists spoke about their own identities being people of color and how it has influenced the way they think about addressing barriers to care in historically marginalized communities. During the conversation, they echoed the previous days takeaway’s that approaches need to acknowledge heterogeneity within communities that are traditionally attached to monolithic labels and the acknowledgement of historical bias and racism as part of the therapeutic experience. Solutions offered by panelists included representation in the workforce, culturally and linguistically appropriate services, and partnering with non-clinical community gatekeepers like barbershop owners or faith leaders. Kaila Tang highlighted the rise in anti-Asian hate rhetoric during the COVID-19 pandemic and how it has increased the need for culturally responsive care for AAPI communities. Dr. Pierluigi Mancini discussed how the experience of Latinx immigrants is often very misunderstood by systems and policy makers, and in turn, community interpretation of what therapy can offer is often based in stigma and shame. Dr. Courtney S. Thomas Tobin, a medical sociologist, stressed the importance of collaborating with the black community as a means to be an ally, and emphasized that the marginalized voice should be the expert voice. Collectively they discussed how points of urgency in the last year and a half due to the pandemic have changed, and that equity must be seen as both a systems issue and a social justice issue.
Keynote Speakers: Uplifting Invisible Voices
After a short break, Madhuri Jha introduced audience members to the two culminating keynote speakers for the Symposium: California State Senator and Pediatrician, Dr. Richard Pan and Director of the Urban Indian Health Institute and member of the Pawnee nation, Abigail Echo Hawk. First to speak was Dr. Pan.
Dr. Pan articulately discussed how his identity as a person of Asian-descent and his identity as a pediatrician has informed his approach to equity as a policymaker. He stressed the importance of seeing racism as a public health crisis, as he discussed specifically the rates of mental wellness concerns increasing in the AAPI community following a slew of violent anti-Asian hate incidents over the last two years. Dr. Pan also discussed the importance of normalizing discussion of mental health. He said, “I ran for office because of the mental health issues I saw in my patients,” as he detailed his physician career working in low-income communities. He highlighted considering himself as someone with “lived experience,” as he acknowledged that mental health issues are in all facets of community life, and rarely discussed. Dr. Pan closed by rallying audience members to see change within themselves, one piece at a time. He discussed the different ways building coalitions can be successful and the importance of connecting with others to understand differences in lived experiences.
In response to the evident and gross invisibility that American Indian/Alaska Natives receive in the equity landscape, KSCMHE prioritized featuring a culminating speaker who identified with and could speak to behavioral health equity in this population. Dr. Pan’s keynote address was followed by Abigail Echo-Hawk, MA (Pawnee). Abigail poetically and candidly shared her families experience with trauma and systemic elimination of Indigenous representation in the United States. She placed emphasis on the history of the boarding school system and how her people have been affected by it. These schools, under “compulsory attendance laws” were created to forcibly remove Native children from their homes to be “conditioned out of their Native heritage.” She chronicled how this resulted in widespread sexual and physical violence, and often disappearance without resolve. Abigail detailed stark and disturbing statistics attached to the rates of experiences of violence, suicide and addiction seen in Native women and children and how loopholes in jurisdiction policies have resulted in the Indian healthcare and justice systems being severely underfunded. Abigail acknowledged her own experiences with such trauma, and efforts by governing leaders to silence her research that details this. She lastly discussed the importance of believing Native stories and voices, as she said “We have a problem of trauma and institutional and structural racism that continues to kill us today.” She closed by stating, “Don’t come to us because we have problems, come to us because we have the answers!” as she urged policymakers to see people with lived experience as critical experts in a quest for health equity.
Closing and Lesson’s Learned
Madhuri Jha, KSCMHE Director, closed the session with her own takeaways from the two days, as she highlighted her experience being a mobile behavioral health director in New York City during COVID-19 and her own identity as a woman of color. She encouraged participants to envision equity as it applies to what she coined, “The Three C’s” – communication, compassion, and community. It is evident from this symposium that achieving behavioral health equity can be done through the following common themes addressed by all speakers:
- Disaggregate data and policies to step away from seeing people of color and other marginalized groups as monolithic
- Prioritize trauma-informed and “whole-person care” in all levels and sectors of systems administration
- Increase diverse representation in workforce and equip allied health professionals with the tools necessary to be culturally responsive
- Partner with community gatekeepers to build bridges where there are service gaps
- Acknowledge the political determinants of health that affect marginalized people and that racism is a public health crisis
- Prioritize the inclusion of and believe the voices of people with lived experience, especially those that have been historically invisible
- Leverage momentum gained during the pandemic era and take action now
- There is no health without mental health!
KSCMHE thanks the APA Foundation for sponsorship of this event, along with our partners at the Kennedy Forum and colleagues within Morehouse School of Medicine. Stay tuned for more programming from our Center this Fall.
For inquiries contact: firstname.lastname@example.org