Do Black Lives Matter to Consultation-Liaison Psychiatry?

To the Editor:

Over the last 3 months, the coronavirus disease-2019 pandemic has led to a collective and global suffering. In the last 10 days, that suffering has intensified with the murder of George Floyd, which has led to protests across the country and many parts of the world challenging systemic racism. Thousands of Americans are marching to protest the killing of not only Floyd but also Breonna Taylor, Ahmaud Arbery, and so many other Black Americans. The response or lack thereof by American leaders has only fanned the flames. This is a historic moment for our country – and a long overdue acknowledgment that the civil rights movement is unfinished.

This is also a public health crisis. Racial discrimination directly impacts mental health and overall health. , Despite the continued improvement of the overall health of Americans, health disparities affecting specific populations, especially Black Americans unacceptably persists. Centuries of structural and institutional racism, interpersonal racism, and generational trauma has resulted in the long-standing racial and ethnic health disparities and poorer health outcomes in underserved communities, which have only been exacerbated by the coronavirus disease-2019 pandemic. For psychiatry, historically, Black Americans and members of other racial and ethnic minorities have less access to mental healthcare and even when treated receive lower quality healthcare. The recent brutal deaths of Black Americans have been traumatic for many individuals, especially people of color, supporting prior evidence of the impact of police killings on Black American mental health. Hence, for the sake of our patients, we must educate ourselves, stay abreast of current events and their historical and societal antecedents and take action.

Being a physician comes with a tremendous amount of privilege and power. We believe that social responsibility is part and parcel of our privilege and power. As consultation-liaison psychiatrists, we are uniquely trained to appreciate both the medical and psychiatric aspects of the human experience. The current confluence of a widespread viral illness, systematic racism, trauma, economic ruin, and the cessation of life as we have previously known it has reached a dramatic and unprecedented crescendo. It is in this moment that our patients, communities, and society at large need us the most. Our ability to frame the problem within the biopsychosocial model and harness our polymathic understanding of the art and science of medicine to generate solutions is our greatest superpower as a subspecialty. Racism is poison. We can provide the antidote.

As black consultation-liaison psychiatrists, we are acutely aware of the structural racism and anti-black sentiment in this country. We have experienced racism not just in the community at large but in the academe as both trainees and now as attendings. As black parents we worry about whether our children will survive an afternoon jog or simply sleep through the night. We want this country and our institutions to do better for our sakes and that of future generations.

We urge you to educate yourselves about racism in all its forms, support your colleagues and trainees, advocate for communities of color, and hold institutions accountable for their role in the continued social and economic disenfranchisement of black Americans and other ethnic and racial minorities. If you have not brought up the current events related to racial injustice in your team rounds or sphere of influence in your clinical work, consider doing so. If you are a service chief, leader, administrator, or educator and you have not commented about these events to your staff already, consider doing so. Doing something sends a message to all, but especially people of color, that systemic racism is worth confronting and that you are creating a safe space for the conversation to happen.

If you believe that black lives matter, silence is not an option.