Dr. Christin Drake is Clinical Associate Professor and Vice Chair of Diversity and Equity in the Department of Psychiatry at NYU Grossman School of Medicine. On this episode, Dr. Drake discusses ongoing efforts to improve mental health equity, including by improving psychiatric services for underserved groups, gathering better data, and boosting diversity among health care providers. She also discusses the importance of integrating mental health care into perinatal services and challenges the conventional wisdom about stigma toward mental health care in the Black community.
00:00 Introduction
00:55 Dr. Drake's Vision for Equity in Mental Health Care
03:46 Addressing Racial Inequities in Psychiatry: A Critical Conversation
04:45 The Importance of Representation and Mentorship in Psychiatry
10:32 Building Foundations for Health Equity: Data and Systemic Change
22:16 Integrating Psychiatric Care into Perinatal Health
33:31 Rethinking Mental Health Stigma in the Black Community
38:08 Future Projects and Closing Thoughts
Visit our website for more insights on psychiatry.
Podcast producer: Jon Earle
Dr. Christin Drake is Clinical Associate Professor and Vice Chair of Diversity and Equity in the Department of Psychiatry at NYU Grossman School of Medicine. On this episode, Dr. Drake discusses ongoing efforts to improve mental health equity, including by improving psychiatric services for underserved groups, gathering better data, and boosting diversity among health care providers. She also discusses the importance of integrating mental health care into perinatal services and challenges the conventional wisdom about stigma toward mental health care in the Black community.
00:00 Introduction
00:55 Dr. Drake's Vision for Equity in Mental Health Care
03:46 Addressing Racial Inequities in Psychiatry: A Critical Conversation
04:45 The Importance of Representation and Mentorship in Psychiatry
10:32 Building Foundations for Health Equity: Data and Systemic Change
22:16 Integrating Psychiatric Care into Perinatal Health
33:31 Rethinking Mental Health Stigma in the Black Community
38:08 Future Projects and Closing Thoughts
Visit our website for more insights on psychiatry.
Podcast producer: Jon Earle
NOTE: Transcripts of our episodes are made available as soon as possible and may contain errors. Please check the corresponding audio before quoting in print.
DR. THEA GALLAGHER:
Welcome to NYU Langone Insights on Psychiatry, a clinician's guide to the latest psychiatric research. I'm Dr. Thea Gallagher. Each episode, I interview a leading psychiatric researcher about how their work is shaping clinical practice. Today, I'm pleased to welcome Dr. Christin Drake, Clinical Associate Professor of Psychiatry here at NYU, as well as the department's Vice-Chair of Diversity and Equity. Her areas of expertise include psychiatric care for minoritized people, women's health, and perinatal psychiatry.
In our conversation, Dr. Drake talks about promoting equity in psychiatry and improving access to mental health care. She reflects on progress that's been made over the past four years, as well as steps—such as better data—for pushing equity forward. Lastly, she talks about the importance of integrating psychiatric care into perinatal health.
All right. Well, Dr. Drake, thank you so much for being on the Insights on Psychiatry podcast.
DR. CHRISTIN DRAKE:
Thank you for having me.
DR. THEA GALLAGHER:
Can you talk to us a little bit about the overview of your work and what you're passionate about now in your career?
DR. CHRISTIN DRAKE:
Sure, thank you. I hold the role of Vice-Chair for Diversity and Health Equity here in the Department of Psychiatry, and that means I have a sort of broad responsibility for ensuring equitable care and developing programs and initiatives to improve access to equitable, high-quality care across our department, across our departments and our sites.
Also, a role in providing education on equity, and we focused on racial equity and mental health in particular over the last few years, with a goal of developing, helping to develop structurally humble trainees, to add to the psychiatry workforce. And also, on the faculty and staff side, working to promote an equitable employment and learning environment here in our department. In my clinical life, I focus on women's mental health and perinatal psychiatry, also psychiatric care of people experiencing extreme social conditions, insecure housing, homelessness, poverty.
DR. THEA GALLAGHER:
I mean, it seems like quite a large undertaking. Where did you begin and do you still feel like in the beginning stages of this work? Yeah, tell us a little bit about maybe where you feel like the field is with regard to this topic as well.
DR. CHRISTIN DRAKE:
Yeah, I think I feel this has always been a part of my work. A part of the reason I chose to pursue medicine in a general sense was for the sort of magnitude of the injustice of poor health and poor access to medicine. So that was always a motivator in my career. I think as a psychiatrist, I began working the minute I completed training in various settings and organizations that served people who were experiencing homelessness in New York City. And I think the first few years after residency are always a continuation of training and identity formation as a psychiatrist.
And so I feel very connected to that work, always. It informed my perspective on our responsibilities as physicians and psychiatrists. So I've kind of been doing this always in various settings, but I think, to your question about where we are, I think in 2020 after the murder of George Floyd and sort of more widespread awareness of specifically racial inequities in medicine, we all, across the country, across the globe, began paying more attention to our own sort of local systems. And I think we're very much in the foundation building stage of that work right now, which is in some ways very challenging to realize, but also very encouraging.
DR. THEA GALLAGHER:
Yeah, and I'm sure it can be overwhelming, but also starting somewhere and even having a role such like you have goes to show that there is energy, motivation, money, intention behind this. And speaking of representation, talking about people of color being chronically underrepresented in departments of psychiatry, for example, only 3.6 of full-time faculty identify as Black. What are the most significant factors that explain this problem?
DR. CHRISTIN DRAKE:
It's hard to know the one thing it is, and I think you're right to describe it that way. I think what we're learning is that there are a number of factors. One is the current state, like 2% of psychiatrists in the country identify as Black. And so it's difficult to imagine, as a person considering a career, that that would be a particularly welcoming space, a particularly encouraging space. The presence of mentors is obviously a challenge for people who are seeking racial concordance or identity concordance and their mentorships.
But the root cause is obviously rooted in structural issues and structural racism around who has the privilege to be a physician, who can access higher education, who can access medical education. I think that's the largest problem. Once people are here, once we have a rather diverse group of medical students, I think we can do a pretty good job of... We've had that experience here at NYU. The School of Medicine does a wonderful job recruiting a diverse class, and then we can do our thing, and encourage people to consider careers in psychiatry. But it's really the pool of students who are allowed to access this kind of education and who are encouraged to do so.
DR. THEA GALLAGHER:
Yeah, and it seems like there's the larger systemic issues that you're talking about, even just access to education, to medical school. But it sounds like your role now is really connected to the students that are there, and helping them to feel connected, and flourishing, and growing in their career, because I'm sure it's not just the getting there, it's also the flourishing in the career or feeling, like you said, welcome or safe. And what have you found has been really important in that mentorship role or that mentorship, like that relationship building? Why is that so important, I guess?
DR. CHRISTIN DRAKE:
I think it's all relationships. I mean, I'm a psychiatrist, so I think it's all interpersonal, but I think that for students and for trainees, having someone who can be a support, a real support, if there's been a really difficult day in the hospital, a really difficult day in the library, or a test didn't go the way that someone would like, having someone to rely upon, someone who's got expertise, has been there before, I think that helps a lot. And I do think this sort of pathway work, we're doing a lot of this work as well in the department, trying to be more connected in the city to middle school students and high school students.
We had a group of high school students here last week who were just lighting up the place with their questions. They're studying the neuroscience of addiction and are brilliant, brilliant young people. And so we are definitely trying to put ourselves, as a department, in front of young people, so that they can know us and imagine themselves here, in the space. We have them come here, to One Park, so that they feel that this is a space they're entitled to. I think all of those subtle things, but they're all very person to person. I mean, I think of mentorship like I think of psychotherapy. I think the sort of love and kindness that we offer, as well as our expertise, is the most effective piece.
DR. THEA GALLAGHER:
Yeah, and having those building blocks of those relationships seems really important, because there is a psychological impact on a lack of representation. And even if you make it, again, to the department or you make it to med school, if you feel that underrepresented, that will have an impact on your confidence, how you see yourself, all of that. And so do you find that that's also a kind of place where that relationship building really can bolster confidence, and competence, and all those things that go together?
DR. CHRISTIN DRAKE:
Yes, absolutely. I think the trainees here in our department and in other departments at NYU Langone are often remarking on how important it's for them to see us, those of us senior to them, in leadership positions, and thriving, and enjoying ourselves, and having real say in what's happening. That helps a great deal, because otherwise, if you sort of look around you and look at the levels above you and you don't see yourself represented, then as you're saying, it sends a message that you can't help but feel unwelcome or things will be difficult for you as you move forward.
DR. THEA GALLAGHER:
Yeah, and it sounds like nurturing on an individual level, but then doing some of the other work on the systemic level is important. I know that always comes up in these conversations. Where do you feel there have been... What are you really proud of or happy about that you've seen in the wake of the George Floyd murder that you feel like has impacted healthcare systems? And what do you still feel like needs a lot of work?
DR. CHRISTIN DRAKE:
I think that where most, on this health equity side, where I'm most encouraged is really serious efforts toward collecting the kind of data that we might need to know whether care is being provided in an equitable manner or not. That's what I mean by foundational. We're really, I think, as a country, at the beginning of this. We've done a lot of documenting disparities, which is very valuable. I'm very encouraged by sort of movement and conversations about moving beyond that now, even sort of impatience around that now, that we know that there are disparities, and now we need to know how to impact those disparities and be able to track whether our efforts are effective or not.
So I think that kind of clarity is really, really important and really inspiring. The goal is to have health equity-related data available to everyone. We do health equity-focused quality improvement projects now, and it's wonderful, and there are some incredible projects going. I think we'll be at an even better place when there's not a distinction between health equity QI and QI, that everyone is thinking about this at all times, and has access to the data that they need to track their progress.
DR. THEA GALLAGHER:
And are you looking mostly at faculty and physicians, and that experience, or are you also looking at the patient experience?
DR. CHRISTIN DRAKE:
Both. Yes, yes, both. And there's some work going on in the department around burnout in minoritized providers, but also, I mean, there's a connection of course to the availability of racially concordant care for patients who want that, who request that, but also looking at equitable outcomes for patients.
DR. THEA GALLAGHER:
And unfortunately, we have robust data to show that there are problems there. And so do you think it's about collecting more data or really focusing on how to change the system?
DR. CHRISTIN DRAKE:
I think it's going step by step by step to try to develop solutions to what we know. So, for example, the sort of most often cited disparities in mental health treatment are that Black, and Latinx, and Asian people are much less likely than white people to have treatment for any mental illness of any kind. They have a psychiatric diagnosis, they're much less likely to be getting treatment for that. And so there are, I think, local solutions relevant to each of those communities in each of our systems that can be tried, and examined.
DR. THEA GALLAGHER:
And kind of getting, like you're talking almost a 360 view of the problem, and then how to approach it in a step-by-step fashion?
DR. CHRISTIN DRAKE:
Yeah, and the nuance is important. I think that's another thing that I am encouraged by in recent years, that we realized that there's not going to be a single solution for all of the disparities in mental health. So each system, and each community, and each population needs its own solution. Our Director for the Institute for Excellence in Health Equity, Gbenga Ogedegbe, is often saying that the solutions are hyper local. And that's why this foundational work around data collection and having useful data is a really smart way to go. I think that then leaders of clinical teams can be thinking of solutions that are very relevant to their patient populations.
DR. THEA GALLAGHER:
Yeah, and being in such a data-driven world now, it can't be ignored, so I think that's also really powerful there. And back in 2020, in an article you wrote, you said, "It remains unclear how best to approach the removal of racist ideology and accompanying practices among faculty and physicians." Do you still feel this way? And if so, what do you hope to see change?
DR. CHRISTIN DRAKE:
Yeah, I do think that I feel a little bit more certain in and a little bit more comfortable in our saying that the solutions are many and nuanced. I think that that's a move away from, "We're not sure how to approach this," and a move away from this sort of identifying problems, and toward identifying solutions.
But I do think it's very difficult to know what will change people's practice. That doesn't mean we shouldn't try. So we know, in our department, we approach things from multiple perspectives, as we said, trying to develop health equity QI that will change norms of practice toward promoting health equity. We also engage in faculty development around equitable practices, and obviously trainee education in equitable practices. I think that it is impossible to know in some ways what will change an individual's mind in practice, and how much of it is head and how much of it is heart. But we can work on all of those fronts, and that's been our approach.
DR. THEA GALLAGHER:
Yeah, and it sounds like at NYU, you feel supported and that there's energy and effort behind this mission. What would you like to see in maybe other healthcare institutions that, again, would be important to set the stage for this work to begin, if they haven't already?
DR. CHRISTIN DRAKE:
One thing that we have been lucky to be supported here at NYU is having senior leaders, vice-chair level leaders for diversity and health equity in various departments. So we started in 2020 and 2021 with five departments with vice-chairs, ours was one of them, vice-chairs for diversity and health equity. And the system is designed to have a senior leader who will sit on the chairs' advisory committees, who will sit on departmental appointment and promotion committees, who have connections to the education teams, and have real, real influence and power in the departments to be working on these issues at every level.
Again, a recognition that it is sort of important in every corner of the department, and that the people working on it have the authority to change what needs changing, and the support to change what needs changing. So I think that system has worked very well here for a number of reasons. One, it's an obvious, I think, show of support from the executive leadership for this work. It shows that it's valued, it shows that it's important.
And I think that junior people in our system see that, feel that, feel inspired by that to do their own work, to imagine their own careers with, held equity front and center as opposed to sidelined. And it also creates incredible energy, where we can be collaborating with other departments, and sharing our knowledge, and sharing our work, and be working across our system. Our patients in the system interact with various departments as they receive their care, as the families receive their care.
So I think that's working really well. It also has been wonderful as a collegial community. Another problem with people doing diversity work and or people doing health equity work is high rates of burnout. It's really such a difficult topic. It's been very difficult to move. And I've found, and I know my colleagues who have my position in other departments have found the community of us very, very helpful, both strategically, to amplify the work, to share our learnings, but also for us as individuals to stay motivated and to be supported.
DR. THEA GALLAGHER:
Yeah, it sounds like there's a real energy, and momentum, and excitement, and then also greater chance for collaborators in the health system. I think that the worst thing, or not the worst thing, but a bad thing could be if you just kind of create a role and a title, but again, leave these individuals out to get burnout or do the work on their own. But it sounds like you've had the opposite experience, where it's felt, yes, there's high rates of burnout because of the overwhelm of the nature of the work, but having collaborators, and momentum, and energy, and support behind the role, it's not just a title that checks off a box. It's really meaningful work.
DR. CHRISTIN DRAKE:
Absolutely. Yeah, absolutely. The design of this out of our Office of Diversity Affairs runs a faculty leadership development program, and a part of the program is sort of developing a program that might be impactful for the enterprise, and pitching it to the executive leadership. And there was a group that pitched this, like the presence of senior vice-chair level leaders in [inaudible 00:21:15], and the institution did it. That's what we're doing. So I think it's really meaningful as well that it came from mid-career folks who were interested in becoming leaders saying what they thought they needed to be effective leaders in this space.
And it strikes me as such one of the things I love about our institution is that ideas and initiatives come from every level, from students to trainees, and junior faculty, mid-career faculty, and it's really working. And I think part of the reason it's working is because it was designed by the people who would be doing the work.
DR. THEA GALLAGHER:
Yeah, that's always helpful to, again, have that commitment to the work from the people who want to see it happen and flourish. And it sounds like, again, that is happening, and hopefully more healthcare systems will also follow suit. I know many have, but like you said, it's been a slow process. Segueing now a little bit, but also, we've been talking a lot about faculty physician experience, and moving into the patient experience, especially with regard to perinatal health, because I know that's an interest of yours, but I think it's also an area where there has been such a light shown on disparities.
That data is just sadly very... I don't know if the word is "impressive", but it's just sadly overwhelming, understanding the data on maternal mortality and mental health, and those being both your interests, both perinatal health and mental health, can you talk a little bit about, yeah, what you think about these issues that people are facing?
DR. CHRISTIN DRAKE:
Yeah, I think they're very, very connected. The thing that I most want us to be shouting from the rooftops and alarmed about is the fact that mental health conditions are the number one cause of maternal mortality. That's true in the United States, and that's true in New York City. It's not true in every state, but it's true here in our city. I'm always, always astounded by the fact that people are surprised by that. That's been true since 2017.
We've got another set of data, 2019 data from New York City, that shows that suicides and overdoses are the number one cause of maternal mortality in our city. And so we also have very innovative work. I think an extension of Arline Geronimus' work around allostatic load and weathering to make a sort of stronger connection between high rates of maternal mortality among Black birthing people due to cardiovascular conditions, also to experiences of interpersonal or structural racism and disadvantage, all of it is stress to my mind. And so therefore, all of it is sort of ours, as psychiatrists, and I think it's an area in which we can be much more impactful. And there's so much opportunity to be collaborating with our colleagues in obstetrics and in pediatrics, people who are seeing people in the perinatal period during pregnancy and the one year after.
DR. THEA GALLAGHER:
Do you feel like there should be embedded psychiatric care as just common practice?
DR. CHRISTIN DRAKE:
Yes, 100 percent, 100 percent, there should be. We're talking about the gravest outcomes here, but perinatal mood and anxiety disorders are the most common complication of pregnancy. Highly treatable, has profound generational impact, to treat for our parents, and for their infants, and their children. So yes, I think that to not have access to mental health is to not be providing complete care perinatally.
DR. THEA GALLAGHER:
Yeah, and again, as overwhelming as it sounds, it also sounds like you're pretty hopeful that it's treatable. Are you talking from the point of medication management or psychotherapy? What are the gold standard interventions that you recommend?
DR. CHRISTIN DRAKE:
Yes, it depends on the problem, but for what is very common, the perinatal mood and anxiety disorders, medications and psychotherapy are very effective. That depends a bit on the point at which a person is able to engage in care. And so, the earlier, the better. There's an interesting bit of data around pregnant people who are using substances. There are racial disparities in who is able to access medications for opioid use disorder during pregnancy. So Black people, Latinx people are much less likely to access those medications and are more likely to be treated with methadone than buprenorphine.
Buprenorphine has a benefit to infants who are born to people who use substances during their pregnancies, in that those babies remain in the hospital for less time, are less likely to need medications to manage neonatal opioid withdrawal syndrome, and are born at higher weight. So it's a significant benefit to the infant to using buprenorphine over methadone. So that disparity is often discussed, and it should be discussed, but one bit of that data that I think is really interesting is that people who have a diagnosis, a preexisting diagnosis of depression or anxiety, that disparity is mitigated for them, which I can't help but interpret, we can't be certain what that means, but those people are also more likely to have a mental health professional on their care team.
And so to me, it sort of highlights that being involved with people who have pre-existing psychiatric concerns, including substance use disorders, being involved in their care through their pregnancies, can be helpful to mitigate some of the racial disparities that we see, that can have incredibly important outcomes to those infants. Again, that's a generational impact, and that's why this field is so, I think, for those of us... We're all in this because we want to help, we want to be impactful, I think. And so I think being involved in people with people in the perinatal period has incredible potential for that.
DR. THEA GALLAGHER:
Yeah, and this issue of the buprenorphine and the methadone, is that just bad medical practice, or it sounds like that's different maybe even than stigma, unless... What's happening there, if you're saying this is pretty well documented that this can have benefits?
DR. CHRISTIN DRAKE:
Do you mean why would anyone give a person methadone during their pregnancy?
DR. THEA GALLAGHER:
Right, where there's an alternative. It's not like, "Oh, our hands are tied." It seems like there is an alternative with better outcomes?
DR. CHRISTIN DRAKE:
Yes, some of it might be the challenge of people who have particularly more serious mental illness, and people who are using substances are less likely to have a planned pregnancy than people who don't have those conditions. And so sometimes, the situation is one in which a person becomes pregnant and they're already being maintained on methadone. And it can be, it's a bit of a challenging decision to decide to switch someone who's already taking methadone if they're stable to buprenorphine. But again, the fact that those disparities are lessened by the involvement of a psychiatrist makes me also wonder about the support for people who are working, the mental health teams who are working in a methadone maintenance program might not feel that they have the expertise with working with people in the perinatal period to make that kind of a switch or to be thinking proactively.
I think proactively my patients who have opioid use disorder and who might become pregnant, I work on changing them. I work on getting them out of a methadone program and onto buprenorphine, in anticipation so that they're well set up. But I think it takes some comfort, which is why I think educating... There are programs like Project TEACH, that's a national program now, that seeks to improve provider comfort with prescribing medications, psychiatric medications for pregnant people.
I think there's a lot that can be done from an educational perspective to improve the likelihood that people would be beyond optimized medications. Some of it is, yeah, I think some of it is not thinking... We're talking about racial disparities, and so some of it also has to be what providers imagine for their patients. So if you don't imagine the best outcome, if you're sort of demoralized by what you're seeing in the communities that you take care of, I think there's a high risk of that too, with provider burnout as well, to not be able to imagine that this person, this pregnant person, should have every advantage in their pregnancy. So yeah, I think that's just bad practice.
DR. THEA GALLAGHER:
Yeah. It sounds like, though, one of the aspects you're coming from is hopefully from a population health perspective with more education, both to the patient and maybe the provider who is integrated with or is working with the patient, but might not have the psychiatric training. But it seems like with more education, and collaboration, and communication, some of these problems could be solved down the road?
DR. CHRISTIN DRAKE:
Yeah, 100 percent, and I think we can do that. That's something that we can do as people who have a lot of expertise, I think. I think that can go a long way, to just be talking about this as though it's ours. I think that's the thing. I'm trying to socialize that the contribution of mental health conditions to maternal mortality is squarely ours as psychiatrists and mental health professionals. And so the more I think we can own that and be communicating about it, the better access patients will have.
DR. THEA GALLAGHER:
Communicating about it, and like you said, hopefully for systems to integrate more psychiatrists into OB/GYN care, right?
DR. CHRISTIN DRAKE:
Yes.
DR. THEA GALLAGHER:
Yeah. Moving on a little bit to stigma surrounding mental health in the Black community, what role does that play and what strategies can clinicians use to combat this stigma? Say they are working in private practice or even maybe in a clinic, what are some suggestions that you have?
DR. CHRISTIN DRAKE:
I think that making ourselves known, again, sort of using the human connection, we were talking about this in mentoring. Our own Dr. Ayana Jordan and Dr. Sidney Hankerson has done really interesting work engaging in Black faith-based organizations, using religious leaders and church communities to promote awareness and reduce stigma, reduce hesitance around mental health treatment.
So I definitely think there's work to show that going to people where they are is helpful. I also think that to what we were talking about earlier, having a diverse workforce helps, having the ability to offer racially concordant care helps. And I struggle a little bit, to be honest, as a Black psychiatrist with the idea that stigma, of course there's stigma around mental health conditions, but my experience has also been that whenever we offer high-quality care, people come. I've never been sitting, and I know you've never been sitting, waiting for people to come.
So I think that there's a way in which perhaps stigma and appropriate mistrust get conflated, and when we can offer very high-quality, structurally and culturally humble services, people come. I worry a little bit that in mental health, we are sort of sitting back a little bit, sort of trying to figure out how to make people think different things than they think about us and our services, as opposed to offering the services, being a bit more forward with offering the services. My experience is that that works.
DR. THEA GALLAGHER:
Yeah, and I think when I was even asking that question about stigma, it's so interesting, because it kind of puts the onus on the individual, or like, "Oh, it's just the way that it is," instead where I think we can look back at a lot of psychiatric research and problems in the past were created by this community.
DR. CHRISTIN DRAKE:
100 percent.
DR. THEA GALLAGHER:
And so are we a part of the solution as well to be like, "Oh, well, we created the mistrust, but now there's mistrust, that's a stigma." And I think it's a really good point that you're making of, "Okay, so since we created the problem, what are we doing to fix it?" Create greater access, and safety, and communication, and racially concordant care. And you said also maybe embedding in communities that are already thought of as safe and a safe space for people as well. And it seems like it might be all of those prongs together that would make the work more meaningful?
DR. CHRISTIN DRAKE:
Yes, I agree, I agree. I think that that requires humility on our parts. That's what we're talking about. It requires serious self-esteem and serious willingness to sort of own what we've done as a field, even if we as individuals didn't do it, and to be humble. But I found that that stance is very effective. Like, "I understand why you wouldn't want to come and seek mental health treatment. I know the history that I understand your reaction to that history, but I promise you I will try to do better." I think that stance is one that we should encourage in the people we teach, and we supervise, and also support, because it's not an easy stance to take. You know, you have to be quite confident and quite strong.
DR. THEA GALLAGHER:
Yeah, and I think it's a stance that needs to be taken by the system and by the individual who is educated about the histories and understanding exactly why people could get to a place of mistrust, like you said. But I think it takes humility at the large level, the macro level, and then the micro level. So can you discuss any ongoing or future projects that you're excited about or that might have implications for clinicians?
DR. CHRISTIN DRAKE:
I'm excited, we're doing, my team, my little team is doing a bit of research in stigmatizing and disrespectful language in the medical literature. I'm very interested in the ways in which we speak about and write about patients, and the impact that has on the way that patients are treated. So right now, we're doing a review of adherence or non-adherence to the AMA and the American Psychological Association manual of style around respectful language in the literature on perinatal mental health in racially minoritized people.
The literature, if you type in the words "psychiatric condition", "substance use", "pregnant", and "Black", the sort of vitriol that comes up on your screen is really astounding. Lots of disrespectful language, a real paucity of patient-centered language, even in more modern publications. So I'm very interested in that, the sort of things that can be going on in the background, like obvious, low-hanging fruit that can be changing culture.
You know, if students are not seeing disrespect, then perhaps they'll feel more respectful, more hopeful, more humanist as they encounter people who are highly stigmatized in our field. So I'm excited about that work, and there's tons of energy around this. There's very exciting work coming out of Michigan and out of Hopkins around this disrespect in the medical record. And so our contribution is disrespect in the literature.
DR. THEA GALLAGHER:
Yeah, and I think with the work you're doing, the theme that keeps coming to mind is it's in the micro, it's in macro, and coming at it from all sides, step by step, but also large-scale interventions as well. So again, I think the work is really inspiring, and I think we're all excited to continue to partner with you and all the people doing this work, and ourselves included. So thank you so much for being on the podcast.
DR. CHRISTIN DRAKE:
Thank you for having me.
DR. THEA GALLAGHER:
Thanks so much for that conversation, Dr. Drake. If you enjoyed this episode, be sure to rate and subscribe to NYU Langone Insights on Psychiatry on your podcast app. For the Department of Psychiatry at NYU Langone, I'm Dr. Thea Gallagher. See you next time.