Journal Article Annotations
2022, 2nd Quarter
Annotations by Arslann Arshed, MD, MS, MSHA
The Structural Racism and Suicide Prevention Systems Framework includes cultural racism, institutional racism, interpersonal racism and intrapersonal racism. The authors describe how these elements impact suicide risk identification and management. Cultural racism is defined as negative attitudes and beliefs about racially and ethnically minoritized populations embedded in societal values and practices. Institutional racism is defined as laws, policies, and regulations embedded in organizations that consolidate power among White people. Interpersonal racism is defined as behavioural manifestation of racial or ethnic prejudices during interpersonal exchanges. Intrapersonal racism is defined as the internalization of negative attitudes and beliefs about oneself due to exposure to racism. Critical opportunities to measure and mitigate structural racism include provision of culturally informed behavioural health services in outpatient and schools settings as well as through community crisis response interventions.
Strengths and weaknesses:
The article introduces a new suicide prevention framework based on well-defined existing thought on health disparities. However, there remain limited data around the application of this theoretical framework.
C-L psychiatrists must consider the impact of racism and its manifestations in different aspects of social and health systems when evaluating suicidality in ethnoracially minoritized youth.
Cumulative trauma is a concept that is used to explain syndromes that result from repeated injury or are aggravated by repetitive insults. The authors emphasize how cumulative trauma due to structural racism may contribute to the intergenerational transmission of depression. As ethnoracially minoritized individuals are exposed to the insults of structural racism, this increases their risk of depression in themselves and their offspring.
Strengths and weaknesses
The article uniquely intersects intergenerational trauma with structural racism and provides concrete examples on how to disrupt structural racism. There are limited data and experience to inform the implementation of this framework
C-L psychiatrists should consider the impact of intergenerational transmission and family history of structural racism in the evaluation of depression in medical settings.
The article discusses an anti-racist framework for academic psychiatry that begins with the intentional decision to strive towards antiracism. Anti-racism is defined as ideas and behaviours that aim to mitigate or eradicate racism and establish justice and equity across all races. A four-stage developmental framework of anti-racist progression is introduced: Dismissing, Acknowledging, Analysing, and Enacting when witnessing racism or racist policies. The article uses language introduced by Ibram X,. Kendi, advocating for an anti-racist framework, which can be applied to all ethnoracial backgrounds, as well as non-Hispanic White Americans. As psychiatry and C-L programs develop DEI curricula, this article introduces foundational language and framework for evaluating and changing current structures.