Guest Blog: Working to Improve Disparities in Access to Care for African American and Hispanic Patients

As part of PRMS’ ongoing efforts to support the behavioral healthcare community and promote the organizations that work towards this mission, we are pleased to feature William B. Lawson MD, PhD, DLFAPA, as a guest blogger this month. Dr. Lawson is a founder and Director of the Institute for Reducing Racial Disparities, Professor of Psychiatry and Behavioral Sciences at The George Washington University, Adjunct Professor at the University of Maryland College of Medicine, and Director of Mental Health Research at Emerson Clinical Research Institute. Dr. Lawson shares more about what drew him to the field of psychiatry, his career path, and how his work benefits Senior Psychiatrists, Inc.

I grew up in rural Virginia and had no real role models in medicine, nor had anyone in my family joined the medical profession. My mother was an elementary school teacher, and my father was unusual among the men in the area in that he had finished high school. The nearest physician was 20 miles away, and the nearest hospital was 50 miles away. Limited health care access was given while I was growing up, and a medical career was not on the agenda in the public schools.

I was always interested in the farm animals at our home and how living things worked. Although my father wanted me to become a doctor, I was initially not interested, but I eventually became interested in science as a way of understanding behavior. Inspired by observing our farm animals, I pursued animal research, which led me to seek graduate education as a research psychologist and psychobiologist. Later, as a faculty member, I studied an animal model of diabetes. This was the ‘70s, and I had no political interests, but recognized early the problem of access to care. At high school reunions I was often the only male because others had succumbed to various, often preventable, diseases.

The community that I grew up in was heavily segregated by race and income, and I gradually began to recognize why family members and friends died earlier than those who moved away. My research interests evolved into health care, and I found myself being invited to comment and speak on racial disparities. At the time, the widely read newspaper in the local community often published articles about the inherited intellectual inferiority of Black people, which helped to justify the segregated school system - ironically, the African American women described in the book and movie “Hidden Figures” were at the same time doing the computations necessary for successful manned space flights not far from my hometown. I ended up serving as a local chair of the Association of Black Psychologists, which led the effort to show that many intellectual tests were racially biased. Efforts by that organization helped to remove such tests as a basis for school assignment.

One of my graduate students suggested that I apply to medical school, stating that I would be able to make a bigger impact on disparities in access to care. To my surprise, I was accepted to the University of Chicago, partially because the Nobel prize-winning diabetes team found my diabetes animal research interesting. As a student, I was to continue developing my research skills, while doing my medical studies. At the same time, I found myself appreciating issues around attitudes and beliefs in influencing access to medical care. Plus, I was drawn to the discoveries being made in psychiatry showing that medication could be as effective as psychotherapy.

I remember a visit I made to the Central State Hospital in Petersburg, VA, a historic place as the first psychiatric hospital for African Americans, to see a great uncle who had been there for decades, who finally improved enough to return home with the help of medication. Psychiatry appeared to be a way for me to bring together my interests in improving access to care, promoting research, and addressing disparities. I would then seek academic positions that addressed the severely mentally ill, including underserved ethnic minorities.

I completed my psychiatric residency at Stanford University and spent time at the Veterans Administration Hospital, where we focused on psychopharmacology related to treatment utilization. One variable that consistently stood out was race, which allowed us to show that African Americans were not more likely to be violent, contrary to widely held beliefs. After my residency, I did a fellowship at the intramural program at the National Institute of Mental Health (NIMH) on a special unit at St. Elizabeth’s Hospital in Washington, DC, developed to identify novel treatments for the severely mentally ill. St. Elizabeth’s was also historic – built partially by slaves and serving a heavily African American population. I also had a faculty position at Howard University, a Historically Black University (HBCU). That experience allowed me to further address disparities in care and potential factors that contributed to differential treatment response.

Throughout my career, I have had many additional research and faculty opportunities with programs and other HBCUs that serve mentally ill minority communities, continuing to support the development of programs and legislation that impacted disparities in care – racial and ethnic disparities in diagnosis and access to health and mental health treatment, and segregation in mental healthcare facilities, the Veterans Affairs (VA) system, and even the correctional system. These opportunities have led me from my residency at Stanford in California, to Howard University in Washington, DC, to developing the new Dell Medical School in Austin, TX.

Back in the District of Columbia area, I founded a company that addresses disparities by working with clinical trial groups focusing on African Americans, and one primarily working with Latinos. Moreover, we are working to improve access to treatment for opiate abuse, which has been exacerbated by the coronavirus pandemic. The experience amplified the need to address disparities in care and community agencies that often do not serve African Americans. Learning from the AIDS epidemic and the pandemic, we are working with Howard University to mobilize local churches and address the opiate abuse crisis that is causing more deaths in African Americans then the Covid pandemic.  

These experiences have shown me the crucial role that Senior Psychiatrists, Inc. can play in psychiatrists’ lives. The organization provides an institutional memory found to be particularly important in providing perspective during the pandemic. Information about community awareness, education, and treatment approaches are important to prevent reinventing the wheel. Senior Psychiatrists provides needed mentorship as our field continues to grow and garner larger numbers each residency match cycle, and also directly and indirectly provides needed manpower as the ability to be effective with advanced years is increasingly more common. Moreover, technologies such as virtual services and the increased use of physician extenders in psychiatry has expanded the need for our services. There is now an increased appreciation of aging research, clinical needs, and providing improved quality of life throughout the lifespan.

To learn more about the Senior Psychiatrists organization, its mission, future projects, available opportunities, and for more details on upcoming Lesson Learned virtual events and speakers, please visit http://www.seniorpsych.org. And be sure to read our prior blog posts on this flourishing organization, “Now Is the Perfect Time to Join Senior Psychiatrists,” “Senior Psychiatrists’ Mission to Mentor and More,” and “Psychiatric Career Advice from Senior Psychiatrists Members.”

To learn more about the superior psychiatry-specific insurance program and comprehensive services offered by PRMS, click here.