Presidential Session Aimed at Achieving Equity in Psychiatry

The Department of Psychiatry at the Louisiana State University Health Sciences Center in New Orleans is sponsoring the Presidential Session at APA’s 2022 Annual Meeting on the guided book discussion of Race and Excellence: My Dialogue With Chester Pierce by Ezra E. H. Griffith, M.D. As two African-American psychiatrists operating within academic settings, Dr. Pierce served as a mentor to Dr. Griffith in the progression of his career. The session will be chaired by Cynthia Turner-Graham, M.D., who is also a presenter with one of the authors of this article (Dr. Bailey).

Dr. Pierce has a distinguished standing within the field of psychiatry. He received his bachelor’s and medical degrees from Harvard and earned the rank of commander in the U.S. Navy. Among numerous other accomplishments, he served as president of the American Board of Psychiatry and Neurology and was the founding president of the Black Psychiatrists of America. He wrote more than 180 books, articles, and reviews, primarily on extreme environments, racism, media, and sports medicine. In the 1970s he first proposed the term “racial microaggressions.”

Over the course of their mentor relationship, Dr. Griffith met regularly with Dr. Pierce to gain a perspective on how he navigated the issues of race and oppression as his career progressed in systems that have historically excluded African Americans from leadership positions.

Through the traditional African experience of storytelling, Dr. Griffith’s book presents a unique account of Dr. Pierce’s life experience and the development of his perspectives on race, injustice, discrimination, and equity as his career progressed. Dr. Griffith was able to process and discuss his own experiences in juxtaposition to their shared as well as divergent life histories.

This Presidential Session serves as an initial meeting that will lead to ongoing guided discussions critical to the progression of racial and ethnic minorities broadly in society but also specifically in psychiatry and APA. The notion of diversifying the field of psychiatry and traditionally White institutional structures comes with a significant struggle for many Black professionals.

While the session and future guided discussions will be more expansive than the topics covered in this session, it will broadly focus on three key points highlighted within the dialogues between Dr. Pierce and Dr. Griffith, as noted in Dr. Griffith’s book: understanding the structure, process, and operation of majority White institutions and how the organization of these structures have contributed to maintaining the status quo for disempowered groups; defining how various groups operate within what Dr. Pierce termed as “extreme environments”—spaces that present unique challenges that make it difficult for suppressed groups to function, cope, progress, and thrive; and discussing the “tightrope walk” experienced by many Black professionals in the field of psychiatry—the struggle of figuring out the best methods to advocate for change and diversify the field.

As discussed in the book, Dr. Pierce reflected on messages from his father and his own experiences in traditionally White institutions. Understanding how institutional structure, hierarchical power, and privilege repress underrepresented groups can lead to discussions on how to navigate and systematically remove barriers in these environments for diverse professionals.

Dr. Pierce used his experience of living in the extreme environment of Antarctica as a metaphor for the functioning of many African Americans in various spaces in which they have limited control of their environment. While there are factors that can contribute to success, there are other factors, specifically within power structures, that can limit success and devalue contributions by underrepresented groups.

There is substantial debate on the best method to continuing efforts to diversify the field of psychiatry. An ongoing challenge with no easy solutions is creating a system in which Black professionals can successfully navigate traditionally White professional spaces as equals.

The mentor relationship between Dr. Pierce and Dr. Griffith serves as a reminder that our clinical and professional work centers on experiences and opportunities for making changes that will lead to a better future for Black psychiatrists and patients. APA has been supportive of this work. We look forward to the opportunity of engaging meeting attendees on many of the topics discussed by Dr. Pierce and Dr. Griffith. ■

Rahn K. Bailey, M.D., is the chair of the Department of Psychiatry and Assistant Dean of diversity/community engagement at Louisiana State University Health Sciences Center in New Orleans.

Chikira H. Barker, M.A., is clinical research coordinator.

Cynthia Turner-Graham, M.D., is in private practice in Atlanta and the president of Black Psychiatrists of America.