Early Childhood Innovation Network, Washington, DC; Health Alliance Network, Washington, DC.
Early Childhood Innovation Network, Washington, DC; MedStar Georgetown University Hospital, Washington, DC.
J Am Acad Child Adolesc Psychiatry. 2022 Jan;61(1):15-22. doi: 10.1016/j.jaac.2021.06.018. Epub 2021 Jul 22.
Structural racism-the ways that institutional policies, practices, and other norms operate to create and sustain race-based inequities-has historically been foundational to the operations of academic medical centers and research institutions. Since its inception, academic medicine has depended on the exploitation of vulnerable communities to achieve medical, educational, and research goals. Research practices have long ignored or taken advantage of the individuals purportedly benefiting from the research, a dynamic most manifestly true for Black, Indigenous, and People of Color (BIPOC) communities in the United States. Reflecting current practices in racial justice work, we intentionally use the term "BIPOC" to highlight shared experiences within racially and ethnically minoritized communities, given the history of White supremacy in the United States. We acknowledge limitations of this term, which collapses myriad unique communities and histories into one construct. Specifically, child and adolescent psychiatry has historically been driven by Eurocentric approaches, paradigms, and methodology. These nonparticipatory dominant research practices have contributed to a lack of culturally responsive interventions for BIPOC communities, a paucity of evidence-based practices with demonstrated effectiveness within BIPOC communities, and disparities in access and quality of care. Mental health research involving BIPOC communities has been replete with exploitation and inequality..
结构性种族主义——机构政策、实践和其他规范运作的方式,导致基于种族的不平等现象持续存在——从历史上看,这是学术医疗中心和研究机构运作的基础。自成立以来,学术医学一直依赖于利用弱势社区来实现医学、教育和研究目标。研究实践长期以来一直忽视或利用据称从研究中受益的个人,这种动态在美国的黑人和其他有色人种社区中最为明显。反映当前种族正义工作中的实践,我们有意使用术语“BIPOC”来突出在种族和族裔少数群体社区内的共同经历,因为在美国存在着白人至上的历史。我们承认这个术语的局限性,它将无数独特的社区和历史归结为一个结构。具体来说,儿童和青少年精神病学一直受到欧洲中心主义方法、范式和方法的驱动。这些非参与性的主导研究实践导致针对 BIPOC 社区缺乏文化响应的干预措施,在 BIPOC 社区中缺乏具有有效性的循证实践,以及在获得和护理质量方面存在差异。涉及 BIPOC 社区的心理健康研究充斥着剥削和不平等。