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The Color of Autonomy: Examining Racial Inequity in Coercive Institutional Practices.

Helen-Maria Lekas1, Crystal Lewis1, Mark V Bradley1

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Racial inequities persist in psychiatric care, highlighting a need for new research approaches. Understanding structural exclusion requires examining power dynamics and current research limitations in psychiatric inequities.

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Public healthRacial-ethnic disparitiesRacismResearch/psychiatricResearch/service delivery

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Area of Science:

  • Psychiatry
  • Health Equity Research
  • Social Determinants of Health

Background:

  • Recent studies reveal persistent racial inequities in routine psychiatric practice.
  • Specific examples include disparities in civil commitment and decisional capacity consultations.

Purpose of the Study:

  • To advocate for a paradigm shift in psychiatric inequities research.
  • To identify key areas for enhancing the understanding of racism and structural exclusion in psychiatry.

Main Methods:

  • Review of two recent articles on racial-ethnic inequities in psychiatric practice.
  • Discussion of four critical topics for future research.

Main Results:

  • Racial inequities are evident in psychiatric civil commitment and decisional capacity consultations.
  • Four areas identified for improving research on psychiatric inequities: medical authority/power, commitment/consultations as research events, theoretical limitations, and literature gaps.

Conclusions:

  • A paradigm shift is necessary to address racial inequities in psychiatric research.
  • Further research must incorporate critical examination of power structures and theoretical frameworks to understand and mitigate psychiatric inequities.