Dr. Brandi Jackson is a psychiatrist for our Englewood health care center and a clinician at Rush University & cofounder of MedLikeMe – an online magazine that provides a space for black and brown med student and doctors. Her passion for social justice and medicine go hand in hand – with a dedication to serving the under-served. See below for her thoughts on the current crisis and how HAH is stepping up in ways that many other institutions are not.
It was mid-March, when the news described the sharp uptick in Coronavirus cases, and I knew that this was not a false alarm. Though news outlets reported that coronavirus does not discriminate, I suspected differently – not everyone was at equal risk of dying. As a black woman and community psychiatrist, I knew that statement subverted the truth. It belied the fact that mental health disparities based on race and socioeconomic status are baked into the fabric of our healthcare system. These systemized disparities are codified by thick hospital policy books and maintained by healthcare administrators who have never even heard of critical race theory, let alone applied it to the mental health system.
None of this is news to those who have devoted their lives to dismantling racism in medicine. I was gutted, but not surprised, to learn that 70% of COVID deaths in Chicago were black people, even though blacks make up 29% of the city’s population. I am a psychiatrist at Heartland Alliance Health (HAH), a federally qualified health center where anyone can receive healthcare regardless of ability to pay. The vast majority of our participants are experiencing homelessness, living in poverty and/or seeking safety, and face complex medical issues exacerbated by racial inequities.
As a psychiatrist, I deal in identity and meaning – and see how people are hurt by big-picture policies. Things like red lining, or stop and frisk, or over policing – these policies change the way people think about themselves. So when a person of color sees a doctor, they expect to see someone who does not look like them, and have experienced being talked down to by providers. They’ve had their intelligence questioned, and been given diagnoses that have not been determined by evidence. That results in not speaking up about your pain.
It is difficult to be a black psychiatrist in these times. I find myself trying to comfort black people traumatized by COVID-19 while I process my own trauma. COVID-19 has brought my identity as a medical doctor and as a black person into conflict. As mental health awareness month comes to a close, I have the prickly sense that the mental health fallout is only just beginning. This is particularly true for the black community, which has once again been faced with the stark truth that we are considered dispensable by our own nation. Few realities are more damaging to a psyche than that.
Despite the shortcomings of my profession, I truly believe that most healthcare workers and administrators strive to improve the health of all people. However, they don’t have the tools or knowledge they need to fight the war we find ourselves in.
What medicine needs more than ever are providers willing to do the hard work of being fully present with people. All of it comes down to the interactions in the exam room – and it is challenging work to finally be the one doctor to ask “How are you doing?”
But there is hope. My colleagues at HAH worked to build an environment where patients are respected. When we opened our Englewood health center, people had questions about us – and we worked hard to gain the trust of this community. When the pandemic began, we sprang into action without hesitation. The organization secured COVID test kits and started administering throughout the community. Community Health Centers know that top-down administrations are not nimble enough – or have the relationships – to meet the ever-changing needs of the medically-underserved.
It is possible to eliminate racial health disparities in our lifetime. Systemic racism in medicine was built with intention, and it can be undone with intention. We don’t even need to reinvent the wheel. Patients, social workers, and community health workers know what needs to be done to provide safe, equitable care. The question now is whether medicine at large, is ready to listen.
