This is particularly relevant with respect to a recently published study in The American Journal of Psychiatry, which delves into the impact of systemic racism on the risk of psychosis at the individual and community levels. While the mental health of BIPOC individuals has long been negatively impacted by systemic racism, this study is the first to review the social determinants of psychosis in a U.S. context.
Understanding Social Determinants of Psychosis in the U.S.
In a review of secondary research, the authors draw connections among inequitable social and economic systems within the U.S. that contribute to the risk of psychosis, which refers to hallucinations, delusions, etc. While there can be a variety of contributing factors, this racial analysis found links among neighborhood factors, cumulative trauma, and obstetrical complications, as these experiences continue to be impacted by structural racism, particularly for Black and Latinx communities. The authors recommend community-partnered participatory research (CPPR)—a variant of community-based participatory research (CBPR)—which centers the needs of the community in conducting research by partnering with them to utilize their insights and can be helpful in avoiding such abhorrent violations as the 1932 Tuskegee Experiment.
With Oppression Comes More Barriers
Brittany A. Johnson, LMHC, says, “From reading this article, readers leave with a basic understanding and knowledge around how systemic racism impacts the mental and physical health of the individuals who grow up and remain in the environment. In order for change to occur readers will need more information especially around how to be change agents.” Given how interconnected oppression and privilege can be, Johnson felt that it would be helpful for readers to keep in mind the number of different barriers that make it more difficult for someone to change their situation. Johnson says, “In terms of context, it would be helpful for readers to understand that most people still live or interact with these communities and the stereotypes are still impacting many lives today. Overall, it’s important to know that people who have experienced systemic racism are trying to make sense of why it happened to them, why it happens in general and how they can do something different to impact change.”
CPPR Approaches Invest in Communities
Renato (Rainier) M. Liboro, PhD, describes the following recommendations of the researchers for addressing structural racism and the social determinants of psychosis as implementable:
Targeted and strategic funding prioritiesTrauma-informed and culturally competent training of healthcare professionalsDevelopment of empirically-supported intervention and treatment programs
While there can be value in research, Liboro cautions that recommendations can be implemented only if taken seriously in the U.S. context. As a practitioner of CBPR who conducts studies that examine social determinants that impact the mental health of minority populations and other underserved communities, Liboro highlights the value of such approaches for the meaningful involvement of stakeholders from the communities that the research is intended to support, which promote:
Civic ParticipationCommunity EngagementCollaborationSocial JusticeDiversityInclusionEquity
Liboro says, “The meaningful involvement of racial and ethnic minority key opinion leaders, community stakeholders, and people with lived experience in research is critical in producing on-the-ground, real-world, and sometimes, even almost immediate benefits to relevant individuals and communities.” Liboro continues, “It promotes shared responsibility, credit, and ownership of knowledge between institutional scholars and the community, generated from collaborative research that not only contributes to the important scholarly work dedicated to addressing the adverse effects of systemic racism but also provides results that are personally meaningful to the communities the research is meant to help.”
