Remembering Those Who Paved the Way for Us

July is Bebe Moore Campbell National Minority Mental Health Awareness Month. I understand the perspective that this designated month may feel unnecessary to some people, especially if they believe that the struggles and contributions of African Americans and other members of minorities are widely known and celebrated. However, it is important to acknowledge that there are still many people who may not have a full understanding of the impact and significance of the contributions of these individuals in this country.

For this article, I will focus on African Americans. My intent is not to take attention away from other members of minorities who have been the victims of discrimination and violence but to focus on the issues I know best from personal experience.

I had to go to a segregated school by law when I grew up because of the belief that African Americans lacked intellectual prowess for academic or the capacity to experience mental disorders, thereby justifying the absence of mental health treatment facilities and providers. While progress has been made in terms of racial equality and social justice, there are still ongoing issues and challenges that affect the Black community, such as systemic racism, police brutality, and voter suppression.

Given this still oppressive environment, it is important to remember that the struggles and accomplishments of Black Americans are an integral part of our shared national history and deserve to be recognized and celebrated. One such individual is Solomon Carter Fuller, M.D., who made groundbreaking contributions to psychiatry and neuroscience and left a lasting impact despite the significant racial discrimination and barriers he faced. Dr. Fuller broke the color barrier by being the first African American psychiatrist in this country and was one of the first Black physicians to teach on the faculty of a multiracial medical school in the United States.

Dr. Fuller was born in Liberia in 1872 and raised in the United States. His family had emigrated from Petersburg, Va., to Liberia because of the oppression that African Americans faced at that time. He attended Boston University School of Medicine and later worked with renowned psychiatrist Dr. Alois Alzheimer in Germany. He was among the first to identify the neuropathological changes that characterized Alzheimer’s and was the first to translate much of Alzheimer’s pivotal work into English. He published what is now recognized to be the first comprehensive review of Alzheimer's disease and went on to become an associate professor of both pathology and neurology at Boston University.

In a nonresearch capacity, Dr. Fuller was critical in establishing a foothold for African American physicians in psychiatry through his selection and training of three young trainees at Tuskegee Veterans Administration Hospital in Alabama.

Margaret Lawrence, M.D., and Jeanne Spurlock, M.D., played major roles as women trailblazers in psychiatry who broke barriers for other Black women. Margaret Lawrence was born in 1914 and grew up in New York City. She attended Cornell University and went on to study medicine at Columbia University, where she was one of only two African American students in her class. In 1948 she became the first African American resident admitted to the New York State Psychiatric Institute. Dr. Lawrence enrolled at Columbia University's Columbia Psychoanalytic Center and was the first Black women to obtain certification in psychoanalysis.

Dr. Spurlock was born in 1921 and attended Cornell University for her undergraduate degree. She then attended Meharry Medical College in Nashville and completed her residency in psychiatry at Bellevue Hospital in New York. Like Dr. Lawrence, she faced significant barriers in her career due to her race and gender but went on to become chair of the Department of Psychiatry at Meharry Medical College and later deputy medical director at APA for 17 years as head of its Office of National and Minority Affairs.

Both Drs. Lawrence and Spurlock worked to promote diversity and inclusion in psychiatry. Their contributions paved the way for future generations of African American women to pursue careers in mental health, and they continue to inspire us today.

History is still being made. Altha Stewart, M.D., was elected APA’s first Black president and served in that position for the 2018-2019 term. Among the many awards she has won are the 2017 Lifetime Achievement Award of the Black Psychiatrists of America and APA’s Solomon Carter Fuller Award in 2021. She is currently senior associate dean for community health engagement and director of the Center for Health in Justice-Involved Youth at the University of Tennessee Health Science Center.

While we are rightfully proud of the contributions that these and many other Black psychiatrists have made to patient care, administration, research, and education, one cannot help but wonder why we are still talking about “firsts” when African Americans have been in this country for centuries. While I look forward to the day when such milestones are no longer necessary to note, we should always take the time to remember and honor the trailblazers who persevered with courage and fortitude and paved the way for others to follow in their footsteps. ■

William Lawson, M.D., Ph.D., is the founder and director of the Institute for Reducing Disparities, president of Senior Psychiatrists, director of psychiatric research for the Emerson Clinical Research Institute, and a professor of psychiatry and behavioral sciences at the George Washington University and the University of Maryland School of Medicine.