How psychologists can help achieve equity in health care—advancing innovative partnerships and models of care delivery: Introduction to the special issue.

Abstract

For as long as the United States has been a country, the distribution of good health has been unequal. In this special issue, we consider what psychology can do to understand and ameliorate these inequalities. The introduction sets the context for why psychologists are well positioned, well trained, and needed to champion health equity via innovative partnerships and models of care delivery. A guide is provided for engaging and maintaining a health equity lens in advocacy, research, education/training, and practice efforts for psychologists, and readers are invited to apply a health equity lens to reimagine their existing and forthcoming work. More broadly, the special issue brings together a collection of 14 articles across three core themes: (a) integration of care, (b) intersections between social drivers/ determinants of health, and (c) intersecting social systems. The articles collectively highlight the need for new conceptual models to guide research, education, and practice, the importance of engaging in transdisciplinary partnerships, and the urgency of collaborating with community members in crosssystem alliances to tackle social drivers of health, structural racism, and contextual risks, all of which are fundamental drivers of health inequity. Although psychologists are uniquely positioned to investigate causes of inequality, develop health equity interventions, and advocate for policy changes, our voice and vision have been missing from broader national dialogues around these issues. This issue is poised to provide examples of existing equity work and inspire ALL psychologists to engage for the first time or deepen existing health equity work with renewed vigor and reimagined possibilities. This document is copyrighted by the American Psychological Association or one of its allied publishers.

What role can (and should) clinical science play in promoting mental health care equity?

“…Social justice principles outline several key ways in which we can engage in scientific investigation with a health equity mindset, which can occur at a systemic/ structural level (e.g., understanding structural sources of bias and mistreatment as a profession of clinical scientists, partnering with policymakers and advocates as the institutional or health care network level to address ongoing issues contributing to health equity, and engaging public or legislative bodies by disseminating findings that require structural level changes; Thurston et al, 2023). These efforts are very important to promoting mental health care equity more broadly, but there is also a lot that can be done if taking a health equity mindset at the individual level.…”

“…This has certainly not been without its challenges, but we believe in showing this full commitment to social justice principles across the research activity spectrum because we have witnessed how such an approach can promote health equity in the communities we serve. And, thankfully, we are not alone in this pursuit of incorporating social justice in all aspects of scientific work, which is gradually growing (Thurston et al, 2023).…”

“…Understanding this history is crucial to future change; taking responsibility for the systemic racism and discrimination that have been interwoven into the way we fund and conduct clinical research with various groups (and which forms the basis for a lot of our current understanding about mental health phenomenology and effective treatments) is going to be central to being able to appreciably improve clinical science approaches as we move forward . In this spirit, some important scholarship has arisen in just the past few years focusing on the promotion of mental health care equity, including taskforce recommendations from the American Psychological Association (see Presidential Task Force on Psychology and Health Equity, 2023) and an excellent special issue on this very topic published earlier this year in the American Psychologist (see introduction to this special issue by Thurston et al, 2023). On this note, let us turn to reviewing some of the more recent accomplishments of scholars in the field who have aimed to more thoughtfully and intentionally incorporate a social justice and healthy equity lens in their mental health care work in a few specific domains, specifically via community-based research and treatment adaptation work, task-shifting methodologies, utilization of technological tools, and engagement in policy efforts.…”

“…Importantly, such a movement has been ongoing and certainly more long-standing than it has been in clinical science in related fields such as social work and counseling psychology (e.g., Atteberry-Ash, 2023; DeBlaere et al, 2019; Lee et al, 2022), which have provided invaluable and admirable direction around how to integrate social justice principles to achieve health equity more broadly. I am only one of a growing chorus of scholars calling for our discipline of clinical scientists and practitioners to incorporate social justice principles utilized in these related disciplines more centrally into our work to appreciably achieve mental health care equity (e.g., Asnaani, Charlery White, & Phillip, 2020; Marshall-Lee et al, 2020; Thurston et al, 2023). These efforts have been impeded by significant barriers that contribute to an almost ideological resistance to such a movement within the context of clinical psychology (see helpful review on this topic by Ali & Sichel, 2020).…”

“…Understanding this history is crucial to future change; taking responsibility for the systemic racism and discrimination that have been interwoven into the way we fund and conduct clinical research with various groups (and which forms the basis for a lot of our current understanding about mental health phenomenology and effective treatments) is going to be central to being able to appreciably improve clinical science approaches as we move forward (Asnaani, Gutierrez Chavez, & Kaur, 2022). In this spirit, some important scholarship has arisen in just the past few years focusing on the promotion of mental health care equity, including taskforce recommendations from the American Psychological Association (see Presidential Task Force on Psychology and Health Equity, 2023) and an excellent special issue on this very topic published earlier this year in the American Psychologist (see introduction to this special issue by Thurston et al, 2023).…”