Addressing the Role of Civil Rights in Mental Health

February 5, 2020

“Of all the forms of inequality, injustice in health is the most shocking and the most inhuman …”
– Dr. Martin Luther King Jr., at a press conference before the annual meeting of the Medical Committee for Human Rights in Chicago, 1966

Catherine E. Lhamon, chair of the U.S. Commission on Civil Rights, presented a lecture, “The Fierce Urgency of Now – Fighting for Civil Rights in 2020,” at McLean Hospital on January 23. This special event to honor the Reverend Dr. Martin Luther King Jr.’s legacy was co-sponsored by the hospital’s Department of Postgraduate and Continuing Education and the Dimensions of Diversity Committee.

Lhamon, who was appointed as chair of the commission by President Barack Obama in December 2016, assessed the state of civil rights in America today and described her agency’s multipart mission. She also detailed her commission’s recent policy work.

The commission, said Lhamon, acts as “the nation’s eyes and ears on civil rights” and makes “recommendations for what federal civil rights policy should be.” The Civil Rights Act of 1957 created this independent, bipartisan federal agency.

Watch Lhamon’s recent lecture on civil rights and mental health

According to Lhamon, when it comes to civil rights, we “have distance yet to travel to achieve the ideals that Dr. King promised.” She added that the fight for civil rights is an enduring struggle that now requires particular vigilance in today’s social climate.

Lhamon said that in the past year alone, the commission has released reports on the prevalence of hate crimes in the U.S., collateral consequences of incarceration, separation of children and families at the border, immigration detention center conditions, and discipline of students of color with disabilities. “What we have documented in these reports distills to this: the impulse to discriminate remains strong in this country.”

She commented on conditions at immigration detention centers and the impact of separating children from their families. The commission, said Lhamon, heard evidence that conditions at detention facilities have worsened since 2015, including evidence that “facilities lack trained medical personnel and medicine, that medical staff are not routinely present at detention facilities, and wait times to see a doctor can be weeks long, regardless of how dire the situation is.”

Included in the evidence was testimony from the American Academy of Pediatrics (AAP). The AAP asserted that “even brief detention can cause psychological trauma and induce long-term mental health risks for children,” and “there is no evidence indicating that any time in detention is safe for children.”

Martin H. Teicher, MD, PhD, director of the Developmental Biopsychiatry Program at McLean Hospital, addressed these concerns in a 2018 paper. He referenced data showing that the detention of unaccompanied asylum-seeking minors is associated with a high incidence of post-traumatic stress disorder, anxiety disorders, depression, aggression, and suicidal ideation.

The treatment of children in schools is also a present concern, said Lhamon. She cited a recent commission report on school discipline.

“When we learn, for example, from the most recent school year,” said Lhamon, “that black students with disabilities were almost three times more likely to be suspended compared to white students with disabilities, we have reason to be concerned.” She further stated that multiracial boys with disabilities were seven times more likely to receive at least one out-of-school suspension compared to their white peers.

She said that it’s hard to believe that such disparity is a “mistake” or “unintentional.” She also stressed that these practices aren’t justified.

“The weight of the empirical evidence does not show that students of color, or students of color with disabilities, misbehave more frequently or more severely than other students,” said Lhamon.

Kimberlyn Leary, PhD, MPA, executive director of Policy Outreach at McLean Hospital, served as an advisor to the White House Council on Women and Girls and worked with Lhamon’s office on policy initiatives focused on school discipline and girls of color.

“High rates of school expulsion and suspension among girls of color may look like an education problem at first, but there is evidence suggesting that those most at risk have experienced high rates of trauma. This makes school suspensions a mental health problem as well,” said Leary. She is working with the research team at the McLean’s Program in Education, Afterschool and Resiliency (PEAR) to explore how school-based health centers could better meet the needs of students if staff were trained in trauma-informed care.

“I hope the strongest take-home from our conversation today will be the reminder that each of us has capacity, and, I think, moral imperative to take steps within our power to improve justice in our communities”– Catherine E. Lhamon, chair of the U.S. Commission on Civil Rights

The good news, said Lhamon, is that “we are on an upward trajectory, moving away from exclusionary, harsh school discipline,” and focusing more on helping students who act out. While celebrating this success, she urged others to be proactive in promoting civil rights.

“I hope the strongest take-home from our conversation today will be the reminder that each of us has capacity, and, I think, moral imperative to take steps within our power to improve justice in our communities. I see the work done here at McLean Hospital as a key component of that work, and I appreciate you for it.”

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