Working Together Against Racism

When psychologist Milo Dodson, PhD, traveled to Wisconsin to direct hip-hop artist Common’s Dreamers & Believers Summer Camp for youth in 2013, he was still scrambling to finish his dissertation. But after a few late nights of writing, Dodson realized his doctoral work at the University of Illinois at Urbana-Champaign—on race-related stress, the N-word and racial identity development—was highly relevant to his campers, black youth from Chicago. So he began weaving it into their nightly fireside chats.

Dodson led conversations among 30 or so boys about what it means to be black and how race-related barriers and values shape their experience—for instance, their interactions with law enforcement officers.

“It quickly became clear how critical it is to use research and how applicable research is when brought straight into the community,” he says.

Historically, psychological research has been used both to fight and to perpetuate racism. In 1954, a “friend of the court” brief highlighting the damaging effects of segregation, including the seminal doll study by psychologists Kenneth B. Clark, PhD, and Mamie Phipps Clark, PhD, was a key piece of evidence in the Brown v. Board of Education case that ultimately led to the desegregation of public schools. Yet psychological research has also been exploited to promote racist ideologies, for instance, through efforts to tie race to intelligence (Neisser, U., et al., American Psychologist, Vol. 51, No. 2, 1996).

“When it comes to racism, psychologists have moved the needle both in very positive ways and unfortunately also in some harmful ways,” says Shawn Jones, PhD, an assistant professor of counseling psychology at Virginia Commonwealth University who studies racism­-related stress. “We as a field now have a responsibility to be on the right side more often than not.”

Today, psychologists are conducting research on the causes and effects of racism, including disparities in mental health care and the effects of racial microaggressions; designing interventions to mitigate those effects; adapting clinical practice and pedagogy to reflect the diversity of patient and student populations; and working to shift national policies to address racism and racial disparities. They are also working to “decolonize” psychology by incorporating more inclusive practices into the discipline, such as indigenous approaches to healing and wellness.

“Racism can be a nefarious stressor that impacts us individually, interpersonally, institutionally and structurally,” Jones says, “which is why addressing it requires psychologists to work at a variety of levels.”

The work involves partnering with experts from other disciplines, including public health professionals, sociologists and psychiatrists, all of whom bring specialized knowledge to the table.

“This isn’t something that any one person can solve,” says Dodson, now a senior staff psychologist at the University of California, Irvine (UCI) counseling center. “Fighting racism is going to be an ongoing struggle and battle. As we continue to resist hate, we also need to find ways to support each other and to be increasingly collaborative.”

Defining and documenting racism

In recent years, psychologists have helped redefine the way we understand racism as a society. Much of the public used to think that only discriminatory laws or overt acts of interpersonal discrimination, such as the use of racial slurs, counted as racism. But today, many people recognize that systemic disadvantage and more subtle microaggressions are also a key part of the racial-minority experience in America and cause great harm. Psychologists have helped to document those consequences. For example, a meta-analysis on microaggressions—subtle yet hostile racial slights—found they were linked to negative outcomes such as stress and anxiety (Lui, P.P., & Quezada, L., Psychological Bulletin, Vol. 145, No. 1, 2019).

Systemic disadvantages, meanwhile, manifest themselves in many ways, including disparities in employment, housing, health care—and mental health care.

Psychologists and other researchers at The Ohio State University’s Kirwan Institute for the Study of Race and Ethnicity analyze both explicit bias and implicit bias—unconscious stereotypes that can contribute to systemic discrimination—and release yearly reports that provide a global view of disparities across criminal justice, education, health and housing. Researchers there have demonstrated that African American children are more likely to be disciplined than white children for the same action, that mortgage applications from whites are more likely to be accepted than those from African Americans with the same credit scores, and that Asian Americans may receive differential treatment from mental health-care providers because of the assumption that they are a high-achieving group (State of the Science: Implicit Bias Review, 5th ed., Kirwan Institute, 2017).

New large-scale studies that disaggregate results by race and ethnicity are also revealing low mental health service utilization among African Americans, Latinx, Asian Americans, Native Hawaiians and Pacific Islanders (National Survey on Drug Use and Health, Substance Abuse and Mental Health Services Administration , 2018).

And the ongoing lack of racially inclusive research—as evidenced by, for instance, the dearth of studies with Latinx participants in clinical and forensic psychology and the lower enrollments of racial and ethnic-minority participants in many clinical trials and other health research—means that persistent disparities in outcomes continue to be ignored.

Pernicious effects, effective interventions

As the data stack up on these racial inequities that continue to define American society, some psychologists are studying how this climate affects minority youth and what might be done to cope with and mitigate that reality.

Jones studies racism-related stress, including how vicarious experiences of racism—such as discrimination against a loved one or a nationally publicized police shooting—can have a deleterious effect on the psychological well-being of black youth. For instance, he and his colleagues staged a vicarious discrimination experience in his lab in which black research participants witnessed an experimenter favoring white individuals, and then documented participants’ increased distress, especially among those who believed that whites hold negative views of blacks (Hoggard, L.S., et al., Journal of Black Psychology, Vol. 43, No. 4, 2017).

Jones is also exploring strategies parents and caregivers can use to help black youth learn to navigate their racialized world—by developing a positive racial identity, but also by recognizing the inevitable barriers and biases they will face because of their race. His work builds on foundational research by psychiatrists James Comer, MD, and Alvin Poussaint, MD, by integrating family systems and therapeutic perspectives.

“How do these conversations unfold, what do the dynamics between parents and children look like and how might they be improved?” Jones asks. To answer these questions, he’s conducting a series of mixed-methods studies of how parents discuss race with children and how those conversations differ based on age and gender (Journal of Child and Family Studies, Vol. 28, No. 1, 2019).

The body of research that Jones helped build has informed a family-based intervention known as EMBRace, or Engaging, Managing, and Bonding through Race, which was developed by psychologist Riana Anderson, PhD, assistant professor at the University of Michigan’s School of Public Health. In five sessions, EMBRace provides guidance and structure for black parents and children to explore racial socialization, including by cultivating cultural pride and learning stress management skills (Anderson, R.E., et al., Family Process, Vol. 58, No. 1, 2019).

“Shawn and I are collaborating in the research world, but we’re also seeing that these findings aren’t always trickling down to the folks who need it,” Anderson says. “So, we’re also thinking creatively about how to reach people.”

In that same vein, Anderson and Jones launched a YouTube series, Our Mental Health Minute, to share psychological insights about racial socialization, stereotypes, substance use and other topics with a broader audience.

Other psychologists are also connecting with racial-minority communities in innovative ways. Dodson led discussions about anxiety, depression, emotional vulnerability and race-related stress at Common’s youth camp for five consecutive summers. Now, he speaks regularly at athlete and activist Colin Kaepernick’s Know Your Rights Camp, where he engages kids and teens of color in discussions about mental health.

“It’s really insidious how white supremacy has caused kids of color to internalize thoughts like, ‘I don’t deserve to take care of myself,’” Dodson says. “Part of my work is teaching them that we all have the right to be healthy, and that also means taking care of our mental health.”

Dodson also delivers traditional clinical services at UCI, including a weekly group counseling session aimed at destigmatizing mental health care among black men, and serves as the mental health liaison to the school’s athletics department and esports program.

His racially conscious approach points to a gap that persists in clinical settings: a dearth of services that are culturally relevant for racial- and ethnic-minority patients, despite evidence that culturally adapted psychological interventions are more effective than unadapted versions of the same interventions (Hall, G.C.N., et al., Behavior Therapy, Vol. 47, No. 6, 2016). A recent review of culturally appropriate mental and physical health-care services found a shortage of interventions and significant gaps in the literature evaluating them (Butler, M., et al., Improving Cultural Competence to Reduce Health Disparities, Agency for Healthcare Research and Quality, 2016).

“The general consensus is that there is a continuing lack of culturally relevant services,” says Stanley Sue, PhD, former director of the Center for Excellence in Diversity at Palo Alto University and co-founder of the Asian American Psychological Association. But the situation is improving, he says, citing an increased focus on disparities research and the APA Guidelines on Race and Ethnicity in Psychology, released in 2019.

Psychologist Iva GreyWolf, PhD, has found a creative way to address the shortage of services tailored for racial- and ethnic-minority groups. As an indigenous behavioral health consultant, GreyWolf helps bridge the gap between American Indian and Alaska Native people receiving treatment for trauma and the clinical psychologists hired to provide it, who are typically unfamiliar with indigenous cultures. She travels with providers to Native villages, mentors providers serving these communities and leads training efforts on the history of the indigenous peoples and cultural practices. For example, nonverbal communication and the participation of family members are seen as key parts of the therapeutic experience in many indigenous cultures.

“Unfortunately, it’s common for outside psychologists completely new to the culture to secure short-lived contract positions serving indigenous communities,” GreyWolf says, adding that these temporary appointments can be dangerous and disorienting for patients. “It’s essential to understand the different values and ways of communicating in order to provide true support.”

Activism and advocacy

Other psychologists are helping to address racism through their work as administrators and activists. At Lincoln University in Pennsylvania, one of the country’s first historically black colleges and universities, psychologist and university president Brenda Allen, PhD, relies on her research background in race and educational outcomes to inform her racial equity work. She created the school’s Office of Institutional Equity, which crafts policies and programs to promote racial equity. For example, the campus police force, which is primarily white, completed its first training course on implicit bias during the summer of 2019.

At the University of California, Berkeley, clinical psychologist Élida Bautista, PhD, directs inclusion and diversity efforts for the Haas School of Business. Her role involves training students, faculty, staff and senior leadership on the value of diversity and best practices for inclusion, revising admission and hiring policies to improve racial equity, and consulting on diversity issues when they arise.

“The demographics here have looked the same for a long time, but they’re not reflective of the state we live in,” Bautista says. “I’ve started creating opportunities to question the status quo.”

Across academia, psychologists have also created crucial opportunities to bolster research efforts by and about racial-minority groups. To improve opportunities for Latina doctoral-­level researchers, Silvia Mazzula, PhD, associate professor of psychology at the City University of New York’s John Jay College of Criminal Justice, founded the multi­disciplinary Latina Researchers Network (LRN) in 2012. With nearly 3,000 members across psychology, public health, political science and other disciplines, the LRN provides mentorship and collaboration opportunities for a demographic underrepresented in academia.

“Often psychologists of color enter spaces and they’re the only one in their department or institution,” Mazzula says. “That’s a very difficult place to be, which is why networks like this are so important to provide additional support and mentorship.”

While collaboration among academics is essential, some psychologists have turned their gaze outward to focus on addressing racial issues in the public sphere. Dodson co-hosts a podcast, Mental Health Is R.E.A.L. (Reflecting Empathy and Love), with Los Angeles radio personality Yesi Ortiz. The program, which reaches tens of thousands of listeners, most of whom are black or Latinx, seeks to normalize mental health, for instance, by featuring celebrities like Common and artist-activist Gina Belafonte discussing their experiences in therapy.

“My primary goal is to put research directly in the hands and hearts of people of color,” Dodson says. “Podcasts, radio and TV are avenues that allow me to connect directly with the people.”

Meanwhile, applying the insights about racism gained from ongoing research and practice, some psychologists are also working to shift policies at the highest levels of government to improve racial equity in the United States.

At SAMHSA, for example, licensed clinical-community psychologist Larke Huang, PhD, helped launch in 2012 and now directs the Office of Behavioral Health Equity, where she works at the interface of research, practice and policy.

She has focused on reducing racial disparities in substance use and mental health care by requiring SAMHSA grantees to demonstrate—rather than merely claim—that they are serving racial-minority groups. A new policy Huang helped institute requires grant recipients to submit a disparity impact statement showing their efforts to serve vulnerable populations, including racial minorities. For example, an analysis found that a jail diversion program was disproportionately diverting white people from jail because of mental health problems and not equitably diverting people of color with similar problems. In such cases, the policy requires grantees to show how they will reduce disparities using practices supported in the psychological, organizational management and quality improvement literatures. For instance, the jail diversion program might serve more people of color by minimizing the role of implicit bias in decisions about who should be diverted to a mental health facility.

Huang also helped launch the National Network to Eliminate Disparities in Behavioral Health (NNED), a network of nearly 2,000 community organizations that primarily serve Latinx, African American, Asian American and Native American populations. NNED supports such groups by providing training and technical assistance to both fledgling and established organizations working to develop and test behavioral health interventions for minority populations. Huang says many of these organizations develop innovative and promising programs but would benefit from partnerships with research psychologists trained to conduct formal evaluations, who could help them build stronger evidence bases to support their expansion.

“We also need to talk more about how we pay for these initiatives,” Huang says. “Oftentimes, health disparities and inequities are left out of the financing formula.”

Psychologists are working in the legislative branch as well. Judy Chu, PhD, a psychologist and U.S. representative for California’s 27th Congressional District, has fought several of the Trump administration’s racially problematic policies, including the effort to bar citizens of several Muslim-­majority countries from entering the United States. Her National Origin–Based Antidiscrimination for Nonimmigrants (NO BAN) Act, which would reverse the travel and asylum ban and eliminate the extreme vetting requirements authorized by a recent executive order on refugees, now has more than 200 co-sponsors in the House. Chu also helped apply pressure to shut down a temporary shelter for unaccompanied immigrant children in Tornillo, Texas, and has passed bills that set humanitarian standards for such facilities.

“It’s so important to have psychologists in Congress, because the policies of this administration have so much impact on people’s mental health and on their experiences of trauma,” Chu says. “We have a responsibility to stop the permanent harm these policies can cause.”

Chu is also spearheading the Increasing Access to Mental Health in Schools Act—which would provide student loan forgiveness to mental health professionals who deliver services in low-income schools—as a way to improve care for racial- and ethnic-minority communities.

Ultimately, some psychologists say that speaking up about racial inequities is a professional obligation that’s essential for moving the field forward.

“It’s incumbent upon psychologists to have conversations with one another and the public about race, and not just rely on activists to do that work for us,” Dodson says. “We ourselves need to be activists.”

Interdependent Roles

Psychologists apply their expertise on racism from all areas of the discipline, including:

  • Basic science: Psychologists conduct research on the causes and effects of racism, including disparities in mental health care.
  • Clinical research: Clinician-scientists design interventions to mitigate the effects of racism.
  • Clinical psychology: Clinicians treat patients in culturally competent practices to address the consequences of racism.
  • Advocacy and policy: Policy influencers advocate for local and national policies that will address racism and racial disparities.

Further Reading

APA Guidelines on Race and Ethnicity in Psychology
2019

The Racial Healing Handbook
Singh, A.A., New Harbinger Publications, 2019

Toward a Racially Just Workplace
Roberts, L.M., & Mayo, A.J., Harvard Business Review, 2019

This article was reprinted with permission by the American Psychological Association (APA).

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