Mount Sinai Seminar on Racism and Mental Health Draws an International Audience of Nearly 500 Participants


As the COVID-19 pandemic continues to reveal the significant racial disparities that exist in health care access and treatment across the United States, Mount Sinai’s neuroscience community is additionally exploring the profound connections between racism and mental health through a new seminar series.

The first seminar, “The Impact of Racism on Mental Health,” held virtually on Monday, January 25, featured two guest speakers, and drew nearly 500 members of the general public, and researchers and students from 35 universities across eight nations. It was sponsored by The Friedman Brain Institute, as part of its Diversity in Neuroscience initiative known as #DiverseBrains, and the Mount Sinai Office for Diversity and Inclusion. The seminars aim to raise awareness and address the inequities—and amplify the work of researchers studying the various effects of racism on minds and bodies.

The seminar was organized and moderated by Aya Osman, PhD, a third-year postdoctoral fellow at the Seaver Autism Center for Research and Treatment. Dr. Osman is studying the role of the gut microbiome in various neuropsychiatric disorders, including autism and addiction, in the lab of Drew Kiraly, MD, PhD. It was co-moderated by Joseph Simon, a fourth-year PhD neuroscience student studying social influences on decision-making in the laboratory of Erin Rich, MD, PhD, in the Nash Family Department of Neuroscience.

Participants included, clockwise from top left: co-moderator Joseph Simon; speaker Tanja Jovanovic, PhD; Aya Osman, PhD, event organizer and moderator; and speaker Monnica Williams, PhD, ABPP.

The aim of the seminars, said Dr. Osman, is to make research findings more accessible to the public and to increase scientific collaboration with researchers studying similar topics. “We hope this lecture series will open our eyes to the ways racism can be perpetuated and spark dialogue around dismantling structural racism in the mental health field and discuss ways to heal from its impact,” Dr. Osman said.

Eric J. Nestler, MD, PhD, Nash Family Professor of Neuroscience, Director of The Friedman Brain Institute, and Dean for Academic and Scientific Affairs at the Icahn School of Medicine at Mount Sinai, welcomed the participants. “We launched #DiverseBrains about five and a half years ago to promote diversity and inclusion, and to create an optimal climate throughout The Friedman Brain Institute,” said Dr. Nestler. “And no conversation is more at the heart of our original goals than today’s topic.”

Invited speaker Monnica Williams, PhD, ABPP, Associate Professor, School of Psychology, University of Ottawa, and Canada Research Chair for Mental Health Disparities, gave a presentation on “Racial Trauma and New Directions in Healing,” which drew from existing research data. “We know there are profound connections between racism and mental health,” said Dr. Williams. “We have research over the past 20 years that shows definitive links to just about every major mental illness to experiences of racism and discrimination,” she said, citing post-traumatic stress disorder (PTSD), stress, anxiety, depression, obsessive-compulsive disorder, substance and alcohol abuse, eating disorders, severe psychological distress, psychosis, disability, and suicide.

Dr. Williams also discussed the growing use of medical psychedelics and the research that shows it may hold promise in helping to decrease the negative impact of racial trauma in minority populations. However, she pointed out that her own research has uncovered that minorities are greatly underrepresented in psychedelic medicine studies, with 82.3 percent of the people involved in these studies, as both patients and researchers, being white. “We can now make a strong case that future clinical trials need to examine the efficacy of psychedelics as an adjunct to psychotherapy for individuals with race-based trauma,” Dr. Williams said.

Speaker Tanja Jovanovic, PhD, Professor of Psychiatry and Behavioral Neurosciences, and the David and Patricia Barron Chair for PTSD Neurobiology at Wayne State University in Detroit, addressed the topic of “The Biological Impacts of Racism—Implications for Negative Health Outcomes.” Dr. Jovanovic’s research focuses on the interaction of traumatic experiences, neurophysiology, neuroendocrinology, and genetics in stress-related disorders in adults and children in high-risk populations. In her seminar presentation, she examined racial differences related to neurobiology and how the stressors of racism affect the brain.

“Racism impacts biology and should be treated as an illness,” she said. Dr. Jovanovic presented research showing the biological effects in those experiencing the chronic stress of racial discrimination. Altered physiological measures include higher levels of cell-free mitochondrial DNA, a biomarker associated with stress, aging, inflammatory processes, and cell death. Further, her research shows that racial discrimination may alter the automatic nervous system by increasing the activity of the sympathetic nervous system (increasing startle response, accelerating heart rate, constricting blood vessels, and raising blood pressure), and decreasing the peripheral nervous system, or vagal tone, which is associated with rest and regulation of stress responses.

The Mount Sinai Health System has an ongoing commitment to accelerate efforts to dismantle racism and advance equity through priorities established by the Office for Diversity and Inclusion. The BioMedical Laureates Program, for example, is one of the first in the nation to recruit underrepresented candidates and enhance diversity among senior research faculty. It includes an initiative to recruit and mentor Junior Laureates, those just starting their postdoctoral fellowships. Forming the foundation for these and future efforts is the Mount Sinai Health System Task Force to Address Racism, which was established to make Mount Sinai an anti-racist health care and learning institution that intentionally addresses structural racism.

Participants agreed that much work—at many levels—needs to be done on racism and research. Dr. Osman cited a need for an increase in Black faculty, and diversity training among principal investigators. Said Mr. Simon: “We must continue this dialogue in many different forms, and it’s important that we make this information and this outreach understandable for all.”

Indeed, educating the public is a key component of this effort, said Dr. Osman, who cites a need for solid, clear, science-based information that is understandable by the general public, which is driving her extensive public outreach through social and mass media. As this seminar series continues to invite speakers and discuss this topic, an additional goal is to explore grants that would fund further research into the impact of racism on health, and ways to eradicate it. The second seminar is planned for early spring 2021.

 

 

Recognizing Our Colleagues: Rio Rivera at Mount Sinai Queens

“Rio Rivera, a phlebotomist at Mount Sinai Queens, is exceptional! She is excellent at prioritizing ‘stat’ labs to ensure that they arrive to the lab in a timely manner, improving patient outcomes. She is hard-working, kind to all patients and staff, professional, and efficient. I appreciate that she takes her time with hard sticks, accepts challenges, and really does her best to locate the best vein and minimize the number of times a patient is stuck with a needle—decreasing their pain and risk of infection. And very importantly, she is usually very successful at getting the specimen we need! She is a team player. We are so lucky to have her!”

Hoda Farghaly, BSN, RN, 3 East, Mount Sinai Queens

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COVID-19: How Do I Know If My Workplace Is Safe?

COVID-19 has fundamentally changed the workplace. To reduce the spread of the virus, some organizations have allowed more people to work remotely and instituted daily health checks and staggered start and break times for those working in-office.

Even with social distancing signage and the presence of hand sanitization stations, those unable to work from home may still be concerned about office safety. In this Q & A, Dana S. Mazo, MD, MSc, an Assistant Professor of Medicine (Infectious Disease) at the Icahn School of Medicine at Mount Sinai and physician lead for Infection Prevention at Mount Sinai Queens, offers practical advice on how to protect yourself in the office.

How do I know that my office is safe?

The U.S. Occupational Safety and Health Administration (OSHA) has put out a set of guidelines for larger offices during the COVID-19 pandemic. You can check with the facilities department or your manager to see if the building is following these recommendations.

The rules start with conducting a thorough risk assessment to identify potential workplace hazards that could increase risks for COVID-19 transmission. Building owners and facilities managers should modify or adjust seats, furniture, and workstations so employees sit at least six feet apart. OSHA also recommends improving ventilation in the building by increasing total airflow as well as the percentage of outdoor air in the offices. And, housekeeping should clean and disinfect all surfaces that are frequently touched by many people on at least a daily basis.

How should I clean my office?

Start by cleaning the major high-touch surfaces—such as your desktop, keyboard, mouse, and the arms of your chair—with a sanitizing wipe. Hard surfaces, such as desks and chairs, are more likely to hang onto germs than porous materials, such as paper. If you’re not sure whether to clean, remember an extra swipe can’t hurt.

It is important to clean surfaces after someone else has touched them, since it is possible to transmit the virus by touching a contaminated surface with your hand and then touching your face, especially mouth, nose or eyes. If someone else used your work space within the past three days, make sure to clean before you start work.

Having a personal air purifier might be helpful in your immediate area. But what would be more useful would be if the entire building follows OSHA recommendations on air flow during this time.

Do I need to wear a face covering throughout the entire day?

If you have a closed office all to yourself, you don’t need to wear a face covering until someone wants to come into your space. If you share the office with someone, you’ll want to wear your face covering all day. This recommendation is especially important if desks are closer than six feet apart, but when people are sharing office space for an extended amount of time, six feet is not a hard boundary.

Open office plans are a different story as you may sit close to several people. Plus, there are those who walk by on their way to a meeting, the lunchroom, or the bathroom. The safest advice is to wear a face covering, even if co-workers are more than six feet apart. Throughout the Mount Sinai Health System, employees are required to wear face coverings at all times, unless in a closed office by themselves. But, even if it is safe to take your face covering off because there are no co-workers close by, keep it handy. If someone stops to chat, try to keep a distance of six feet and put your face covering on. You may be thinking that if your colleague seems fine, and it’s just the two of you, you don’t need to cover your face. But remember, your office mate could be infectious but not have any symptoms.  Also, sharing the air with that person means you are at risk for everyone that person has had contact with—on their way to work, in the supermarket, or at home.

How should I navigate elevators and communal office spaces?

Always wear a face covering in hallways, bathrooms, meeting spaces, kitchens, and any other communal spaces. You never know when someone is going to come around the corner.

When riding the elevator, keep your face covering on. Most buildings limit the number of people on each elevator car, often at 50 percent capacity. This means even before you get to the elevator, you must be careful as lobbies may be full of people waiting for their turn to ride up. If there are so many people that you cannot socially distance, you may want to wait outside the lobby for a few minutes until the area clears. Remember, outdoors is always safer than indoors because of the air circulation and often greater space for social distancing.

Inside the elevator, try to keep an arm’s length away from anyone else and limit conversation as talking forces respiratory droplets into the air. And, if you must push a button for your floor, don’t forget to wash your hands after.

How do I safely eat lunch at the office?

Lunchtime is often the time of greatest risk for transmission, because you have to take off your mask. Also, people let their guard down. You may not have seen your colleagues in months and want to catch up. But you still need to be on guard. It is important to keep at least six feet away from people during lunch when your face covering is off so that you can eat and drink.

Additionally, remember to wash your hands after using highly touched items like the office refrigerator, sink, microwave, or water cooler.

What about the bathroom?

The one place you cannot avoid during a day in the office—other than your desk—is the bathroom. Make sure to keep on your face covering and create as much social distancing as possible. Try not to stand next to someone; if there are multiple sinks or urinals, leave an empty spot between you and anyone else. There are a lot of commonly touched items in bathrooms, so the key here is hand washing. Wash your hands when entering and leaving the bathroom. And, before you flush, close the toilet lid—if possible.

When in doubt, maintain social distance, wear a face covering and wash your hands.

Now that we’re back in the office, are in-person meetings safe?

The best way to meet during a pandemic is virtually. But if the whole point of coming into the office was to be able to interact in person, then you’re going to need to be creative. Face coverings are a given, but you also need to think about ways to maintain social distance. One option, if possible, is to meet outdoors. If that isn’t an option, think about using a large auditorium, even for a group of a dozen people, as it’s easier to keep six feet apart if you have a few people in a large space.

Wherever you go, you should take the basic COVID-19 precautions: face coverings, hand sanitizer, and disinfecting wipes. Some people also wear gloves, but most experts recommend against it. Because gloves can lead to complacency and you could easily end up touching your face or not washing your hands sufficiently. If you do wear gloves, remain vigilant.

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Treating Patients As Family by Dr. Jeremy Boal

Part of what makes MSBI so unique is that our employees, regardless of discipline or role, create genuine connections with patients and take care of them even beyond their basic medical needs. We recently discharged a very special person who touched the hearts and souls of so many of our colleagues. I am inspired by the way so many of you cared for this patient as if he is family. 

This patient’s story is complicated. He is developmentally delayed and needs full-time care. Both he and his father, who was also his sole caretaker, contracted COVID-19 early on in the pandemic’s arrival in our region. His father did not recover, which left his son orphaned and anxious about being taken from the only home he has ever known.

Early on, Rachael Holbreich, MD, the psychiatry intern serving on 9 Silver, helped staff connect with him.

“Because he mainly expresses himself with non-verbal cues, it became apparent that the staff needed to adapt to better understand and communicate with him. I tried to set an example that he was a kind and loving person who does express his needs. This demonstrated that we can work with him and help him transition during this difficult time,” said Dr. Holbreich.

The staff quickly learned to understand our very special patient and took every step to help him heal, adopt him as their family, and find a new, stable home environment that met his needs.

When I say every step, I mean it:

  • Our social workers and physicians accompanied him to many group home interviews and oversaw his care until we could get him a new guardian. Our staff helped fit him for hearing aids, framed photos of his family in his room, and danced and made music with him.
  • Our psychiatry and music therapy teams regularly came to check in with him.
  • Denise Green, PCA on 9 Silver, would let him help with the linen to keep him busy. He loves the singer Selena, and she would play Selena videos for him on available workstations.
  • Fanny Castillo on our environmental services team would take him on walks through the unit. “He didn’t always understand what we were saying, but we always had a good time,” said Fanny.
  • Vivian Frimpomaa on our food services team also took incredible care of him. He preferred to eat his meal in the hallway, and she would help set up his table and put the condiments he liked directly on his food. She paid special attention to the menu items he liked.
  • It is impossible to name everyone who cared for him during his time with us, but it was a labor of love and based on teamwork across many different disciplines.

One of my favorite stories is that Alicia Tennenbaum, LCSW, our Senior Director of Social Work, advocated and got an expedited hearing to appoint him a guardian. She coordinated with the guardian to go to the patient’s home to gather some belongings like his stuffed animals to bring him comfort. His father had put a mechanism on the door to keep him from wandering out, and the guardian got locked inside the house. He had to climb the out the window and down the fire escape to get out. It was worth it. Having a few items from his home comforted our very special patient during this transitional time.

This new guardian cares deeply about him, and we recently discharged him to a group home in Queens. Paul Guzman, 9 Silver PCA, took the day off for his discharge so he could accompany him to his new home to ensure that he felt comfortable with the transition. Mr. Guzman has since traveled two hours each way to visit him multiple times and plans to continue twice a week. They have a special connection.

“When he got a certain look, I knew I needed to sit right next to him and just be there. Sometimes he needs to sit quietly near someone he trusts,” said Mr. Guzman. He is regularly in touch with the caretakers at the group home where he now lives.

“It was unexpected love. I will always be there for him,” he said.

Some of the other staff members have also checked in with him via FaceTime.

“I checked in with his new community, and he is doing very well. I’m thankful; he now has a community. We have improved his life in so many ways,” Ms. Tennenbaum said.

This is because of your extraordinary teamwork and compassion.

I am in awe of the compassionate, connected care you provide to our patients each and every day.

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