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.

The book is hands-on, with topics mental health clinicians will
find timely and relevant: The role of social injustice and specific diagnoses
and conditions, including substance use disorders, schizophrenia, personality
disorders, and child trauma, is covered. For example, research has shown that
white psychiatrists are more likely to over diagnose schizophrenia in Black
patients, and this diagnostic bias may partly account for Black men being
involuntarily committed to mental institutions in higher numbers. The authors
advocate for research that prioritizes the needs of participants and
communities, rather than the needs of institutions, and focuses on structural,
not individual-level, differences. Accompaniment, an important strategy for
infusing social justice into clinical practice, is described and modeled. This
process of radical empathy-of trying to minimize power dynamics in clinical
relationships by listening, witnessing, and advocating with patients-is
critically important in confronting mental health inequities. The inadequacy
of current medical and mental health education and training in countering the
powerful forces of social injustice in mental health is discussed in detail. The
authors emphasize that change requires adopting an active practice of self-study
and self-reflection, and accordingly, a list of self-study resources, consisting
of books, documentaries, podcasts, and TED talks, is provided to further the
reader's knowledge and awareness. Of further assistance are the chapter-ending
"Questions for Self-Reflection," which challenge mental health clinicians to
examine their own attitudes and preconceived ideas about race, poverty,
disabilities, and privilege.

Social (In)Justice and Mental Health
addresses the context in which mental health care is delivered, strategies for
raising consciousness in the mental health profession, and ways to improve
treatment while redressing injustice. Clinicians owe it to themselves, their
patients, and their profession to read-and heed-this important work.