Championing racial equity within mental health systems: Perceptions and experiences among state government organization staff leading the charge.

The COVID-19 pandemic and police brutality, especially the murder of George Floyd, have intensified the focus on racial equity within a diverse array of organizations. While a variety of strategies are employed in the pursuit of racial equity in mental health care, there is a notable gap in recognizing the crucial role of individual staff driving change within organizations. Few studies have examined these individuals and the ways they think about their work and its impact. Here, we examine the ways that state health and mental health authority (SH/MHA) staff understand racial equity in mental health care when faced with unusual support for equity reform following the Summer of 2020. Through in-depth qualitative interviews with 58 individuals working in SH/MHAs of 31 states across the United States, we examine the perspectives and experiences of staff engaging in racial equity work when they sense that sociohistoric events perhaps temporarily lifted constraints. Findings confirm the importance of people in the racial equity work process and show that study participants have the characteristics of champions with (a) a conceptualization of (in)equity that involves White systems, including their own organizations, and the need for persistent, sustainable work, (b) an emotional investment toward racial equity, and (c) autonomous motivations of morality and empathy. This study underscores the profound transformative capacity of champions within organizations. Gaining insight into their perceptions and experiences offers a deep understanding of the qualities of a champion and equips us to bolster their pursuits toward racial equity within mental health systems. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Operationalizing antiracism in health systems: Strategies state government administrative organizations use towards racial and ethnic mental health equity.

Although a growing body of literature recommends strategies for improving racial equity in organizations and populations, little is known about how racial equity goals are operationalized in actuality, particularly in the context of state health and mental health authorities (SH/MHAs) attempting to promote population wellness while navigating bureaucratic and political constraints. This article seeks to examine the number of states engaging in racial equity work in mental health care, what strategies SH/MHAs use to improve their state's racial equity in mental health care, and how the workforce understands these strategies. A brief survey of 47 states found that all but one state (98%) is enacting racial equity interventions in mental health care. Through qualitative interviews with 58 SH/MHA employees in 31 states, I created a taxonomy of activities within six overarching strategies: 1) running a racial equity group; 2) gathering information and data about racial equity; 3) facilitating training and learning for staff and providers; 4) collaborating with partners and engaging with communities; 5) offering information or services to communities and organizations of color; and 6) promoting workforce diversity. I describe specific tactics within each of the strategies as well as the perceived benefits and challenges of the strategies. I argue that strategies bifurcate into development activities, which are activities creating higher-quality racial equity plans, and equity-advancing activities, which are actions directly impacting racial equity. The results have implications for how government reform efforts can impact mental health equity.