Mar 4, 2022 | Diversity and Inclusion, Inside Mount Sinai Psychiatry, Mental Health, Psychiatry
Sidney Hankerson, MD, MBA, holds two new leadership roles at the Icahn School of Medicine at Mount Sinai: Vice Chair for Community Engagement for the Department of Psychiatry, as well as Director of Mental Health Equity Research for the Institute for Health Equity Research (IHER) in the Department of Population Health Science and Policy.
Mount Sinai’s Department of Psychiatry is pleased to welcome Sidney Hankerson, MD, MBA, to our faculty. Dr. Hankerson holds two leadership roles at the Icahn School of Medicine at Mount Sinai: Vice Chair for Community Engagement for the Department of Psychiatry, as well as Director of Mental Health Equity Research for the Institute for Health Equity Research (IHER) in the Department of Population Health Science and Policy.
Dr. Hankerson has received several prestigious awards, including the American Psychiatric Association’s Nancy C.A. Roeske, MD, Certificate of Recognition for Excellence in Medical Student Education, and he was chosen as a 2021 Emerging Leader in Health and Medicine by the National Academy of Medicine. Last year, New York City Mayor Bill de Blasio appointed him Chair of the Community Services Board of the New York City Department of Health and Mental Hygiene. In that role, he identified two priorities. The first is addressing behavioral health care needs in children and adolescents, given the rise in suicide attempts—particularly in Black and Latinx youth. The second is addressing the workforce shortage to meet the increased demand for mental health care. “Figuring out how we address the shortage and demand for these vulnerable populations is crucial,” he said. “Ideally, we can bring in early-stage clinicians and researchers to be on the ground and develop new models of care and engagement and delivery models.”
At Mount Sinai, Dr. Hankerson’s primary focus is in reducing racial and ethnic disparities in mental health treatment, particularly depression. “My overall charge is to really integrate principles of community-based participatory research—partnering with community organizations, and working in lockstep with community members to develop, implement, and test culturally relevant mental health interventions,” he said. To that end, he has launched an initiative in Harlem that trains church members as community health workers to screen for depression and provide brief evidence-based counseling. He plans to build on this to create a model for church-affiliated mental health clinics that can be replicated through New York City, as well as nationwide.
“Mount Sinai’s clinical infrastructure and IHER’s expertise in engaging communities of color will be invaluable in working toward that objective,” he said. “I think it will be a very nice fit, both clinically, because Mount Sinai serves many patients who call Harlem home, and because our churches are among the most trusted institutions in the African American community and have long been natural havens for mental health support.”
Dr. Hankerson believes his most important job is to listen and learn from the faculty. “It’s a priority for me to learn and identify the wonderful things Mount Sinai is already doing in the community, and to try to expand it to give it a bigger platform as well as to identify opportunities that are yet untapped,” he said. “One of the things that’s so exciting and novel about Mount Sinai is the DEI Committee within Psychiatry. To have such a robust committee dedicated to DEI is really phenomenal, so I am really excited to work with them.”
Updated on Jun 30, 2022 | Community, Diversity and Inclusion
Angie, a then 34-year-old Spanish-speaking patient with Down syndrome admitted with acute COVID-19, received personalized care, language services, and in-person visits from her loved ones that contributed to her recovery.
Through the COVID-19 pandemic, New Yorkers with disabilities have faced challenges and inequities in several areas, including employment, vaccines, and housing. Representatives from the Mayor’s Office for People with Disabilities (MOPD) discussed these issues in a virtual talk hosted by the Office for Diversity and Inclusion (ODI) at Mount Sinai. The session, “The Aftermath of COVID-19 in New York City,” can be viewed here.
The talk was part of the Raising Disability Awareness Virtual Talk Series, launched by ODI in 2020 for Disability Awareness Month in October, which featured speakers from around the Mount Sinai Health System and the community to raise awareness and promote an inclusive and equitable workplace and health care environment for people with disabilities.
Panelist Eliezer Ramos, a Business Engagement Associate for the NYC: ATWORK Employment Initiative at MOPD, addressed the importance of increasing resources to the population after the COVID-19 pandemic. “Our goal is to make New York City the most accessible city in the world,” he said. According to Mr. Ramos, “People with disabilities are more than twice as likely to live in poverty. Unemployment rates for New Yorkers with disabilities increased more quickly during COVID-19. And they’ve remained the highest they’ve ever been.”
MOPD aims to improve the quality of life for New Yorkers with disabilities, focusing on transportation, employment, financial empowerment, education, technology, housing, health, and access. The hope is that MOPD can expand services in all areas to improve the day-to-day experiences of people with disabilities, Mr. Ramos said. Working with the city and its partners to improve transportation, enhance recruitment for internships and job opportunities, and bridge the digital divide are a few ways MOPD is working for people with disabilities. A report on the city’s current and planned initiatives for people with disabilities is at AccessibleNYC , Mr. Ramos said.
Job Training and the Digital Divide
MOPD uses a hands-on approach to train organizations, such as schools and educational systems, on disability etiquette and awareness. “The more we can do to educate our city, the better,” Mr. Ramos said. Using digital accessibility resources, student groups, and training, the MOPD works to help students reach their goals and inform the educators.
Crystal Rivera, Program Officer for Empowered Cities at MOPD, described how challenging it was connecting people with disabilities with job opportunities. “We had realized a lot of our job seekers were working on job applications and submitting resumes through their mobile phones, because they did not have access to technology,” she said.
Because many job seekers have poor Internet access, and limited use of computers, they had difficulty attending Zoom meetings—which during the pandemic have become an integral part of the working world. “They heavily relied on their cell phone for computer tasks,” Ms. Rivera said. “And many of those who do have computers, lack digital literacy training.” These are some of the disparities that are addressed by Empowered Cities, an initiative to advance equity and economic opportunity for low-income people with disabilities and their families.
A lack of safe and affordable housing is another issue that has disproportionately affected people with disabilities in New York City. Arthur Jacobs, Housing Coordinator at the MOPD, described the steps the office is taking.
Housing and Health
“We continue to develop new accessible units through the set-aside program in the affordable housing lotteries. And that breaks down to a 5 percent set aside for people with mobility disabilities, and a 2 percent set aside for people with vision and or hearing disabilities.” Mr. Jacobs said. New Yorkers who meet requirements can apply for affordable housing through the city’s Housing Connect site.
Mr. Jacobs also shared some insight on how New Yorkers with disabilities can get assistance with post-pandemic housing. “New York City continues to develop new accessible units through the set-aside program in the affordable housing lottery,” Mr. Jacobs said. “It is a great way to ensure that people with disabilities have a space that they can afford and fit their needs.”
Panelists said that like many populations throughout the country, people with disabilities have been affected by misinformation about the COVID-19 vaccine. “We do hear a lot of fear. There’s a lot of misinformation being passed around, a lot of hesitancy from people that have multiple conditions,” Ms. Rivera said, adding that they may have heard false information that vaccines will worsen their condition or give them COVID-19.
The Language Services team at the Mount Sinai Health System provides language translation and interpretation services to support patients with disabilities and those with limited English proficiency. Assistance includes interpretation services in different modalities for inpatient and outpatient care as well as critical communication with patient’s family members. In response to COVID-19 protocols in place, the team developed patient-facing tools, deployed video interpreting equipment and assistive technology to pro-actively meet the needs of patients and families. To learn more about the services offered, please visit the Language Services webpage.
Additional disabilities-related resources are available on the Mount Sinai Office for Diversity and Inclusion site.
Updated on Jun 30, 2022 | Diversity and Inclusion, Psychiatry
The committee co-directors, from left to right: Dolores Malaspina, MD, MS, MSPH, Vice Chair of DEI for Psychiatry, and Shilpa Taufique, PhD, Director of the Psychology Division.
Separate apologies by the American Psychiatric Association and the American Psychological Association in 2021 hopefully marked a turning point for mental health care. For the first time, each association officially acknowledged how the disciplines have enabled and even promoted systemic racism and inequity over the years, with detrimental effects on patients, families, and providers. (The psychology association included a chronology of historical harms inflicted.) The associations pledged to take action.
The Department of Psychiatry has begun initial steps to address similar shortcomings and opportunities, working within Mount Sinai Health System but also looking to influence decisions made beyond our walls. The Psychiatry Diversity, Equity, and Inclusion Steering Committee is a psychiatry-specific committee that meets at least every other week, spans the Health System, and includes 40-plus members. Crucially, those members come from a range of personal perspectives and professional backgrounds, ranging from trainees to department chairs.
The group has also formed subcommittees to focus on specific tasks and projects. Areas of concern include drawing greater diversity into our clinical teams and leadership roles and supporting existing faculty identifying as Black, Indigenous, and/or a person of color (BIPOC). The committee also wants to expand access to marginalized populations and revise the way clinicians approach their care. We are acknowledging the problem, voicing our support, and looking to act as soon as possible.
Maintaining and Developing Diversity Among Mental Health Providers
The American Psychological Association found that in 2015, 86 percent of U.S. psychologists were white, while just 14 percent came from other racial and ethnic groups—a less diverse representation than the population as a whole.
We need to change who can access our disciplines. For historical reasons, candidates from certain populations often cannot afford to take on residencies and other training programs. We are working to increase salaries and funding to ensure we can recruit a diverse group of trainees to enter the field.
We also want to retain our existing BIPOC faculty by providing the mentoring they seek and ensuring they have support to grow and thrive. Those efforts will likely include pathways to professional advancement and promotion that may not have existed before.
A specific, pending step focuses on how we elicit feedback and handle concerns within our department. While existing reporting mechanisms have a role at our institution, we acknowledge that people may not want to participate because of the punitive nature often involved when expressing concerns. People may wish to help or change rather than to seek punishment of individuals.
In response, we are establishing an anonymous system for raising concerns or seeking advice. We believe this step will reduce hesitations to reach out, open a true dialogue, and give us a timely, ongoing sense of the changes needed across our units, meetings, and department.
Addressing Disparities in Mental Health Care
Historically, the country has featured separate and unequal tracks of mental health services—one for patients with insurance and one for those without. The disparity in access for the latter group has clear implications for both mental and physical health. People with untreated and undertreated mental illness often die several decades before other patients when it comes to conditions such as heart failure and metabolic disease. In addition to the personal burden, these costs weigh heavily on health care expenditures.
We acknowledge equitable solutions to access will take time, and we do not yet have specific projects to announce. But we do have immediate efforts to revamp the care we provide in our clinics. Too often, diagnoses and treatments across psychiatry and psychology have been biased (unconsciously or not) by race and socioeconomic status. For example, BIPOC patients continue to get over-diagnosed with schizophrenia and psychosis.
As a field, we need to assess and account for factors such as exposure to racism, disadvantage, and other trauma—as well as the intergenerational transfer of that trauma. To that end, our committee:
- Seeks to integrate areas where psychiatry and psychology trainees can learn together, right from the start, so providers in both disciplines will think about patients in a more diverse and inclusive manner
- Aims to improve training across Mount Sinai, so clinicians can better assess trauma and help a diverse range of patients
- Works with ongoing clinical meetings to update longstanding protocols and procedures
- Plans to launch a public seminar series on diversity, equity, and inclusion, based on lectures provided to various Mount Sinai departments
Accounting for Social Determinants of Mental Health
We need to challenge existing conventions and assumptions in psychology and psychiatry. For too long, we have overemphasized the small role played by inherited genetic variants and also allowed a racialized biology to linger. While the DSM-5 Steering Committee recently removed language tying biological factors to differences in outcomes by race, we must still place the true drivers of psychological distress and psychiatric disorders front and center.
Those factors come in the form of social determinants of mental health—based on the similar line of research showing one can predict residents’ physical health by zip code. These determinants start very early in life and can include:
- Amount of food you can access, as well as the type and quality
- Experience with racism, stress, and other trauma
- Exposure to toxins because of community environment and infrastructure
- Lack of access to outdoor space and greenery
- Living with inadequate heating and cooling
At Mount Sinai, we are working to incorporate a comprehensive cultural assessment of every patient in our department. It is a significant undertaking—clinicians must take a nuanced approach for each patient and determine how and when to make inquiries—but a necessary one. Doing so can provide the care each patient needs and deserves.
Promoting Diversity Through Research and Looking to the Future
Research represents a final area of focus for our committee—both supporting BIPOC researchers applying for grants and also promoting projects that may lead to more equitable and inclusive mental health care. While the National Institute of Mental Health has shown a greater openness toward funding such work, we will advocate for further movement in this direction.
We know work by our committee and like-minded supporters in our field may ultimately take generations. But we need to start somewhere. We hope to make substantive change in the near term, then continue to build off those improvements—to support our team members, our patients, and their families. By working together, we can make a positive and valuable impact.
Shilpa R. Taufique, PhD, is an Assistant Professor of Psychiatry at Icahn School of Medicine at Mount Sinai and Director of the Division of Psychology. Dolores Malaspina, MD, is a Professor of Psychiatry, Neuroscience, and Genetics and Genomics at Icahn Mount Sinai and Vice Chair of DEI for Psychiatry. Together, they co-chair the Diversity, Equity, and Inclusion Steering Committee within the Department of Psychiatry.
Updated on Jun 30, 2022 | Community, Diversity and Inclusion, Featured, School
Michelle Tran and her friend Howard Chen donate a personal safety alarm to a senior in Manhattan’s Chinatown in April 2021.
When Michelle Tran is not pursing her MD/PhD degree with a specialization in cancer immunology at the Icahn School of Medicine at Mount Sinai, she is busy helping Asian Americans protect themselves against hate crimes through Soar Over Hate, the non-profit she created last March.
Soar Over Hate has since raised more than $100,000 and distributed more than 24,000 protective noise-making devices primarily to elderly and vulnerable Asian Americans in New York City and San Francisco—as well as to the Mount Sinai Health System’s essential health care workers who commute to work. Her organization has established a need-based college scholarship fund for local high school students, arranged community health fairs in Manhattan’s Chinatown, and offers free, culturally competent mental-health therapy—either remote or in-person—in several languages, including Mandarin, Cantonese, and Korean, to victims of anti-Asian hate crimes.
Mount Sinai medical students volunteered with Soar Over Hate to distribute 1,000 personal safety devices, whistles, and booklets about reporting hate incidents to elderly in Manhattan’s Chinatown in April 2021. In addition to Michelle Tran, student volunteers included: Alyce Kuo, Serena Zheng, Axel Epié, Fred Kwon, Rachel Levantovsky, and Matthew Lin.
Recently, Ms. Tran was among 10 “fearless change makers” who were named 2021 L’Oréal Paris Women of Worth by the popular beauty brand. L’Oréal Paris USA donated $20,000 to Soar Over Hate and, in November, flew Ms. Tran and the nine other Women of Worth award recipients to Paris for a special ceremony. On Thursday, December 16, at 8 pm, the women and their non-profit work will be featured on an NBC special hosted by L’Oréal Paris and including guest appearances by Helen Mirren, Camila Cabello, Gemma Chan, and Eva Longoria. One of this year’s awardees will receive an additional $25,000 for their philanthropy.
“Asian hate, unfortunately, does exist,” says Ms. Tran. “I felt very disheartened by what was going on in my backyard and with the people around me who were being harassed, and attacked, and physically hurt, and I wanted to do something. A colleague of mine was attacked on his way to work and he still avoids the subway. The long-term impact of these incidents leaves a mental scar. So we’re helping to address the healing of the community, and we’re empowering youth with scholarships.”
In the fall, Soar Over Hate provided six low-income high-school seniors in New York City with scholarships of between $500 and $1,000, based on their essays about addressing anti-Asian hate.
Initially, Ms. Tran started her charity as a GoFundMe page with the help of teenager Tiffany Yuen. Ms. Tran is Ms. Yuen’s mentor through the organization, Apex for Youth, which partners Asian American professionals with low-income youth. The money they raised was used to purchase personal safety alarms and whistles for the elderly and supported several community events that featured self-defense classes and health screenings.
Michelle Tran in Chinatown
But Ms. Tran soon realized she could continue to pursue her two “passions” of growing her charity and focusing on her MD/PhD studies by combining efforts with her friend Kenji Jones, who ran a similar Asian American grassroots effort. That is when they developed the current line-up of services for Soar Over Hate. This fall, she was thrilled to learn that she had received a L’Oréal Paris Women of Worth award.
Ms. Tran also credits her mentors at Mount Sinai with providing support for her advocacy work. She works in the lab of Nina Bhardwaj, MD, PhD, Director of Immunotherapy and Co-Director of Cancer Immunology, who serves as her Principal Investigator. Ms. Tran is a co-President of the Asian Pacific American Medical Student Association at Mount Sinai, supervised by Nolan Kagetsu, MD, Clinical Professor of Radiology, and Ann-Gel Palermo, DrPH, MPH, Senior Associate Dean for Diversity, Equity, and Inclusion. She is also a student representative on Mount Sinai’s Committee on Anti-Asian Bias and Racism, which is led by Amanda J. Rhee, MD, Associate Professor of Anesthesiology, Perioperative and Pain Medicine, and James C. Tsai, MD, MBA, President of the New York Eye and Ear Infirmary of Mount Sinai, and Chair of Ophthalmology at the Mount Sinai Health System.
