Minority to Priority
The Southeast Addiction Technology Transfer Center (ATTC) Regional Center is leading a special initiative called Minority to Priority. As part of the initiative, the Southeast ATTC hosted a compelling “Ask the Expert” session (https://attcnetwork.org/centers/southeast-attc/minority-priority) entitled “Implicit Racial Bias and Micro-Aggression as They Relate to Behavioral Health Treatment and Recovery, Including SUDs,” in July. The session, led by Dr. Nzinga Harrison, included discussion on the link between substance use, mental health, and racism for African-American/Black patients. Participants were able to submit questions to Dr. Harrison, which she responded to on the spot, with her own reflections, while also pointing to key resources for self-directed learning and follow-up. The Southeast ATTC’s Director, Dawn Tyus, noted that the reception for the “Ask the Expert” session “has been overwhelming,” and numerous people have requested similar events in the future. One participant commented, “This information was very helpful. I will certainly implement it whenever I can to help people be better informed.”
The Southeast ATTC is located at Morehouse University School of Medicine and has been a leader in advancing resources related to African-American/Black communities for the SUD treatment and recovery services workforce. For example, Southeast’s faith-based initiative has focused on building the capacity of African-American faith communities to support congregants’ behavioral health needs. The Minority to Priority efforts grew out of this work and have been bolstered by the expertise of Morehouse as an Historically Black College and University (HBCU). “What inspires me and keeps me spearheading these efforts is that I know people do recover. I’m motivated by my ability to advocate and create change that will affect African Americans suffering with substance use disorder,” said Ms. Tyus.
The “Ask the Expert” session with Dr. Harrison included conversation about persistent acts of bias and discrimination and the protests that have grown across cities and towns in the U.S. in the wake of George Floyd’s murder. Dr. Harrison stressed the connection between these events and the healthcare of patients with SUDs. For instance, she noted that African-American/Black people who experience overdose are three times less likely to be referred to treatment, compared to other ethnicities. Dr. Harrison talked about how best to broach the subject of mental health and racism with a patient, including ways to start a dialogue on racism to increase retention and effectiveness of treatment. She highlighted the use of the Perceived Ethnic Discrimination Questionnaire (PEDQ) and encouraged behavioral health providers to be bold and build trust when treating African-American/Black patients. Medications for addiction treatment are a critical, evidence-based aspect of SUD treatment for many people, and Dr. Harrison reminded session participants to look at the cultural, psychosocial, political, environmental, religious, and economic environment of the patient in order to determine the most appropriate treatment approach.
One participant asked what our greatest obstacles to and our greatest strengths are for changing racist policies and practices. Dr. Harrison responded, “I’ll actually answer both parts of the question in the same way. Our biggest barrier is our inability to see racism in ourselves, because we don’t want to be racist. The biggest opportunity is to see racism in ourselves.” This means that health and behavioral healthcare providers need to consider the role that racism plays in the treatment and recovery services available to patients from communities of color, and to be open to listening and valuing patients’ experiences, even when — perhaps especially when — those experiences do not match those of the provider. In an interview following the session, Ms. Tyus emphasized how the illumination of racism in America this summer has affected providers, stating, “Because of the turbulent times we are experiencing, people are raising their awareness of how African Americans are treated and have been treated for centuries. I believe that clinicians are starting to look inward at their own biases to see how their actions play a part in perpetuating racism and how can they can change to be a part of the solution.”
For all of the resources related to the Southeast ATTC’s Minority to Priority initiative, please visit https://attcnetwork.org/centers/southeast-attc/minority-priority. For other ATTC resources related to building health equity and inclusion, visit https://attcnetwork.org/centers/global-attc/clas-resources. In addition, the ATTC and PTTC Networks co-sponsored a series on Social Determinants of Health (SDH) at the intersection of the COVID-19 pandemic and substance use. You can find notes and associated materials from these sessions at https://attcnetwork.org/centers/network-coordinating-office/emerging-issues-around-covid-19-and-social-determinants-health. Finally, our funder, the Substance Abuse and Mental Health Services Administration (SAMHSA) has several recently released resources that pertain to these conversations: The Opioid Crisis and the Hispanic/Latino Population: An Urgent Issue and The Opioid Crisis and the Black/African-American Population: An Urgent Issue.