Structural Racism, Workforce Diversity, and Mental Health Disparities: A Critical Review

Abstract

Objective Racial workforce diversity has been suggested as a critical pathway to address persistent racial mental health disparities. However, structural racism has been noted to diminish such workforce diversity efforts. The purpose of this critical review is to identify the mechanisms through which structural racism operates in organizations, including mental health organizations, to undermine workforce diversity efforts and reinforce inequities. Methods Using the theories of racialized organizations, the current review critically draws on literature underscoring the racial character of organizations as mezzo-level racialized structures that may systematically activate and uphold white privilege in the mental health workplace. Results Findings suggest that in the context of institutionalized white dominance, workers of color within mental health organizations may experience race-based cultural exclusion, identity threat, and racialized workplace emotional expression, and be burdened by racialized tasks. The workers of color may also become the means for organizations to attract communities of color due to their diverse characteristics, yet workers’ effects to address disparities in mental health are minimized due to potential racialized organizational forces, including the whiteness of organizational leadership and color-blindness. Conclusions and Implications for Practice Structural racism may create resistance to the efforts and effects of a racially diverse workforce within mental health organizations. This review calls for a race-conscious framework that drastically shifts the traditional organizational structure to an inverted hierarchy (i.e., client-centered management) to maximize diversity efforts in the mental health organizational workforce to address racial disparities in mental health.

Narratives of heritage and legacy: Child and adolescent mental health trainees portrayed

“…The rich array of skin tones it includes will project a sense of pride, a message that everyone belongs and contributes to a larger cause (43). It will also help decry and reject long-standing race-based exclusion (44) Heritage and Legacy is a product of its time. It served as a point of community-building during the lengthy isolation imposed by the COVID-19 pandemic.…”

Diversity as a Solution to Health Inequities and Disparities

“…Along with understanding how discrimination results in inequitable adverse mental and physical health outcomes, it is crucial to recognize that an important solution to these disparities is diversity. In mental health care, the meaning of diversity varies from distinctions in biological and physiological makeup (e.g., skin tones, neuronal makeup, body shape) to variations in workforce, worldviews, cultural identity, and self-perceptions (Chapman, 2020; Gopalkrishnan, 2018; Kyere & Fukui, 2022).…”

Introduction to the special section on racial disparities in psychiatric rehabilitation services.

“…Applying race-conscious approaches to research design, data collection, analysis, interpretation, and implementation for addressing structural racism is important. Keep in mind that our racialized experiences are deeply rooted within a larger system (Kyere & Fukui, 2022). Without race-conscious approaches to racial disparities, we continue to burden and victimize racially minoritized individuals.…”