CAGR Issues Urgent Call to Stand Up and Don’t Stand By

#BlackLivesMatter, #WhiteCoatsforBlackLives, #SayHerName, #BLM, #NoJusticeNoPeace, #GoodTrouble, #EndPoliceBrutality, #ICantBreathe.

These are hashtags symbolizing an uprising in support of Black Americans lives. A hashtag, by definition, identifies a message on a specific topic, but in many cases, it is perceived as drawing a line in the sand declaring your allegiance. In 2020, if you were not in support of a cause, then you were against it and its supporters—you were thereby subject to cancellation. As I write this article, I realize that despite how much I unequivocally state that I support Black Lives 100%, I know many will question my stance. I wish that did not matter to me, but it does. As an educated Black woman, I have spent my life trying to demonstrate that I am “Black enough” regardless of my individual choices and political opinions, while navigating my life in predominately White circles. I have often been silent out of fear of judgment or retaliation, but at 50, I have become that “auntie” who speaks up nevertheless.

I am a proud member of the Assembly and APA’s Council on Advocacy and Government Relations (CAGR). CAGR advocates at the state and federal levels toward the goal of improved quality of care and treatment. My engagement with CAGR is critical—as one of only 2% of practicing Black psychiatrists in the United States, my engagement is critical to address not only historical mental health disparities but also current issues that are negatively impacting the mental health of minority members.

I support Black Lives and I support law enforcement, because I do not view them as mutually exclusive. It is a fact that Black Americans account for less than 13% of the U.S. population, but they are killed by police at more than twice the rate of White Americans. It is a fact that people of color, especially those with mental illness, are more likely to be killed at the time of arrest. In 2018, a study found that a quarter of the 1,000 people shot by law enforcement had a mental illness. I believe that the majority of the men and women in public service are law-abiding individuals who respect all members of the community; however, racist officers in videos captured by body cameras and bystanders have tarnished the reputation of the larger population of police officers. This negative portrayal is ubiquitous because the majority of officers often stand silently behind the blue line in support of those who trample on the civil rights of Black individuals. In this case, silence equals complicity.

The disparities in the number of unarmed killings of Black men has led many to call for defunding the police. In Minneapolis, where George Floyd was the victim of a homicide, the city council voted unanimously to advance its plan to eliminate the police department and create a new public safety unit, an action popularly known as defunding the police. This vote sparked outrage, as well as thoughtful discourse. Completely defunding the police is not a sustainable goal for a large city, but changing the scope of policing is.

In 2015 and 2016 combined, police fatally shot nearly 500 people with mental illness. In 2017, police killed more than 230 people with mental illness. Why? Partially because law enforcement’s role within health care expanded to include transporting patients to hospitals and treatment centers, permanent posts in emergency rooms, and performing mental health welfare checks. Reimagining law enforcement would redirect the majority of these activities to unarmed personnel, who receive advanced training in crisis intervention and nonviolent de-escalation techniques. Why? Because a patient with an altered mental status should not have access to a weapon, and a weapon should not be introduced to the crisis. A patient who is psychotic, depressed, manic, or actively suicidal will often move unexpectedly, become severely agitated, be disorganized, and lack the ability to follow directions. These behaviors place them at risk when interacting with armed officers. As stated by Cathy Wallace, mother of Walter Wallace Jr., who was shot by police during a mental health crisis, “When you come to a scene where somebody is in a mental health crisis [and] the only tool you have to deal with it is a gun, that’s a problem.” She added, “I’ll tell you this as well: The police department should have a problem with that because they are setting their officers up for failure.” By greatly decreasing law enforcement’s role in mental health treatment, patient safety will be positively affected, and law enforcement could redirect resources to address violent crime.

Therefore, I urge law enforcement to expel officers who abuse their authority. Officers state they merely wish to return home safely at the end of a shift. Black children, men, and women simply want to make it home after a jog, a drive, a walk to the store, ride a bike, or a call for help. Moreover, once at home, we want to play a video game or rest in bed without being murdered. Whether police are in or out of uniform, we want to be treated in a way that demonstrates that Black Lives Matter.

As a physician leader, parent, and grandparent, I challenge all psychiatric physicians to become a part of this movement by attending city council meetings; meeting with local, state, and federal legislators; and participating in crisis intervention training. If you need guida nce, please consider joining APA’s political advocacy network, Congressional Advocacy Network (CAN). Psychiatrists who join CAN are given tools to effectively advocate on issues. We need to bring about change in our culture and policing. To quote Hamilton x Black Lives Matter, “This is not a moment, it is a movement.” Together, we can fulfill the promise of America—to make it great for everyone. ■