Ruth S. Shim

The youth mental health crisis is reaching epidemic proportions, stemming from both single and complex traumatic experiences. Because children and adolescents spend a considerable amount of time in schools, educational settings present both opportunities for and threats to youth mental health. This article outlines how the principles of equity-centered trauma-informed education can be applied in educational environments to enhance the mental health of students. The authors discuss policy recommendations aimed at prioritizing predictability, flexibility, empowerment, connection, and unconditional positive regard. Effectively implementing these policies can help protect young people from structural sources of trauma in the educational system and ensure that schools do not become additional sources of trauma for youths in the United States.

Time between the onset of psychosis and the start of treatment significantly influences outcomes. Rapid access to care is essential, yet barriers such as stigma, difficulties with navigating the mental health system, and financial constraints prolong this process. This mixed-methods study aimed to assess how these barriers affect participation in early psychosis services. A directed content analysis of telephone log data was conducted from intake assessments at an early psychosis clinic. Stepwise logistic regression and analyses of variance were used to evaluate the impact of barriers on assessment completion and time from referral to assessment. Of 1,048 individuals screened for early psychosis services, 201 completed a telephone assessment. Individuals who dropped out had a higher proportion of barriers overall than did those who completed the assessment (p<0.01). Greater than 50% of interactions included at least one barrier, with logistical issues being the most common. Increased barriers were correlated with longer assessments and lower completion rates. Adults and Hispanic participants reported more barriers, compared with adolescents and non-Hispanic individuals, respectively. Significant contributors to nonengagement included unknown gender, public insurance, and various barriers. Identifiable barriers to intake assessment were frequently reported by clients and were associated with higher intake noncompletion and a longer assessment process. Efforts to address logistical barriers may represent an essential step in improving the linkage process and reducing the duration of untreated psychosis.

On June 24, 2022, the U.S. Supreme Court reversed the landmark 1973 Roe v. Wade ruling, dismantling the constitutional right to abortion that had been upheld for nearly half a century. There are multiple indicators that the far-reaching decision in Dobbs v. Jackson Women’s Health Organization will disproportionately harm historically marginalized groups who already face barriers to equitable health care. In the post-Roe world, reproductive health autonomy is under threat, as indicated by the recent surge of restrictive legislation across multiple states. The Dobbs decision restricts access to essential medical care for millions of people who can become pregnant — including cisgender women and girls; nonbinary, intersex, and Two Spirit people; and transgender men (when not citing others’ work, we use the term “birthing and pregnant people” to be inclusive of all people, regardless of gender; we use “women” when citing research that used that term). In doing so, Dobbs will exacerbate health inequities.

American Journal of Public Health (AJPH) from the American Public Health Association (APHA) Psychotic Disorders and Structural Racism: On Considering Complexity, an article from American Journal of Public Health, Vol 112 Issue 4

Recent controversy over unfamiliarity with structural racism in medicine¹ has highlighted the importance of inclusivity of scientists who are underrepresented in medicine (URM), defined as “those racial and ethnic populations that are underrepresented in the medical profession relative to their numbers in the general population,”² among peer-reviewed journals. While previous studies have examined gender and geographic diversity on editorial boards,³ including psychiatry journals,⁴ there are limited available published data on race and ethnicity of scientists serving on editorial boards of peer-reviewed journals for any medical specialties⁵ because these data are not routinely collected. This study examined numbers of scientists who are URM serving on editorial boards and in leadership positions in peer-reviewed psychiatry/neuroscience journals.

What is race? Should medicine stop using racial and ethnic categories as proxies for social determinants of health, genetic ancestry, or both? What are the most promising approaches to dismantling structural racism in medicine? In this video roundtable, moderated by Dr. Michele Evans, experts from a range of clinical and biomedical backgrounds — evolutionary biologist Dr. Joseph Graves, cultural psychiatrist Dr. Ruth Shim, geneticist and biologist Dr. Sarah Tishkoff, and transplantation nephrologist Dr. Winfred Williams — analyze and discuss these complex questions, seeking common ground on which to build a system of equitable health for all.