“We have no Black patients…and we decided to fix it”: Lessons from a diversity initiative

Abstract

Over the year 2020, two seminal events have brought the issue of healthcare inequities among communities of color, particularly African-Americans, into the forefront. The first of these is the COVID-19 pandemic which has laid bare disparities in health outcomes among communities of color. The second is the social justice movement triggered by police brutality against unarmed Black citizens, which has shone a spotlight on how structural racism impacts societies and creates disadvantages.The impact of these 2 factors on geriatric mental health merits further attention. In this session, we will present an initiative to increase outreach to underserved communities undertaken at McLean Hospital – a tertiary level psychiatric hospital affiliated with Harvard Medical School. The goal of this outreach was to make the geropsychiatry outpatient clinic's services available to clinicians and patients in African-American communities. It was also intended to address the problem that the clinic serves very few patients from these communities, possibly because of challenges related to accessing the clinic and more broadly, lack of awareness of available services.The first presentation will provide historical context around underrepresentation of persons of color within the geropsychiatry clinic. It will also outline how clinicians conducted a comprehensive needs assessment and developed a strategic plan for outreach into African-American communities in collaboration with experts in clinical operations and process improvement. This presentation will also discuss how clinic staff aimed to incorporate cultural humility into this process.The second presentation will outline the process of determining resources that may be required to provide a high level of care to patients of color. This includes a discussion on how the clinic's processes and systems were reorganized to optimize access to interpretation, social work and case management services and care coordination with PCPs who may not be part of the healthcare. This presentation will discuss how we performed outreach and the outcomes of this initiative.The third presentation/discussion will dissect the outcome of this initiative and focus more broadly on understanding the deep-rooted historical, cultural, social and economic factors underlying inequities in healthcare, especially among African-Americans.The session will conclude with a dialogue between the presenters on how to internalize the lessons learned, and then open up for audience participation.