Table of Contents

Structural Violence with Child Welfare Systems

Nicole King Cotton, MD; Melissa D. Carter, JD; and Courtney L. McMickens, MD, MPH, MHS

Disabled Individuals and Structural Trauma: Implications for Mental Health Providers

Sarah Y. Vinson, MD; and Abdul Kamara, LLM

Approaches to Addressing the Structural Trauma of the Mental Health Care System

Alexander Chang, MD; Tamkeenat Syed, MD, MPH; and Michelle P. Durham, MD, MPH

Addressing Structural Trauma: The Psychiatric Clinician Leader’s Role

Sosunmolu O. Shoyinka, MD, MBA; Rachel M. Talley, MD; and Pamela McClenton, LCSW

Sponsorship Statement: This CME activity is jointly sponsored by AKH Inc., Advancing Knowledge in Healthcare and Psychiatric Annals.

Support Statement: There is no commercial support for this activity.

Learning Objectives:

1. Identify factors that contribute to structural violence in the child welfare system.
2. Recognize the manifestations of ableism societal structures and the mental health clinician’s role in identifying and addressing them.
3. Understand how to implement concrete solutions for addressing barriers for vulnerable patients who struggle to access mental health care.
4. Understand three factors specific to psychiatry that perpetrate structural trauma.

Author names and affiliations:  See authors above

Guest Editor: Sarah Y. Vinson, MD

Reviewer names:  Andrew A. Nierenberg, MD, Editor, and Lenard A. Adler, MD, CME Coordinator, Psychiatric Annals

Disclosure statement:  In accordance with the Accreditation Council for Continuing Medical Education’s Standards for Commercial Support, all CME providers are required to disclose to the activity audience the relevant financial relationships of the planners, teachers, and authors involved in the development of CME content. An individual has a relevant financial relationship if he or she has a financial relationship in any amount occurring in the last 12 months with a commercial interest whose products or services are discussed in the CME activity content over which the individual has control. Relationship information appears at the beginning of each CME-accredited article in this issue and also on this page.

Faculty members report the following financial relationships:  Andrew A. Nierenberg, MD, has disclosed the following relevant financial relationships: Appliance Computing Inc. (Mindsite); Astra Zeneca; Brain Cells, Inc.; Brandeis University; Bristol Myers Squibb; Clintara, Dianippon Sumitomo/Sepracor; Eli Lilly and Company; EpiQ, Forest; Johnson and Johnson; Labopharm; Merck; Methylation Science; Novartis; PamLabs; PGx Health; Shire; Schering-Plough; Sunovion; Takeda/Lundbeck Pharmaceuticals; Targacept; Teva: Consultant. APSARD; Belvoir Publishing; Boston Center for the Arts; University of Texas Southwestern Dallas; Hillside Hospital; American Drug Utilization Review; American Society for Clinical Psychopharmacology; Bayamon Region Psychiatric Society; Baystate Medical Center; Canadian Psychiatric Association; Columbia University; Douglas Hospital/McGill University; IMEDEX; International Society for Bipolar Disorders; Israel Society for Biological Psychiatry; John Hopkins University; MJ Consulting; Massachusetts Association of College Counselors; Medscape; MBL Publishing; Physicians Postgraduate Press; Ryan Licht Sang Foundation; Slack Publishing; SUNY Buffalo; University of Florida; University of Miami; University of Wisconsin; University of Pisa; SciMed: Honoraria / travel expenses. Appliance Computing, Inc.; Brain Cells, Inc.: Stock options. AHRQ; Cephalon; Forest; Mylan; NIMH; PamLabs; Pfizer Pharmaceuticals; Takeda; Elan; Shire: Grant / research support.
Lenard A. Adler has disclosed the following relevant financial relationships: research grants paid to New York University (NYU) on Dr. Adler’s behalf from Sunovion Pharmaceuticals, Shire Pharmaceuticals, Lundbeck, Enzymotec, Purdue Pharma; personal fees for consulting or advisory boards from Sunovion Pharmaceuticals, Enzymotec, Shire Pharmaceuticals, the National Football League, Major League Baseball, Shire Pharmaceuticals, Otsuka Pharmaceuticals, Alcobra Pharmaceuticals; and royalty fees from NYU School of Medicine for license of Adult ADHD rating scales and training materials.

Authors report the following financial relationships: Sarah Y. Vinson, Nicole King Cotton, Melissa D. Carter, Courtney L. McMickens, Abdul Kamara, Alexander Chang, Tamkeenat Syed, Michelle P. Durham, Sosunmolu O. Shoyinka, Rachel M. Talley, Pamela McClenton have no relevant financial relationships to disclose.

Accreditation statement(s):  This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of AKH Inc., Advancing Knowledge in Healthcare and SLACK Incorporated. AKH Inc., Advancing Knowledge in Healthcare is accredited by the ACCME to provide continuing medical education for physicians.

Credit designation: AKH Inc., Advancing Knowledge in Healthcare designates this enduring material for a maximum of 3.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Release date:  November 1, 2021.  Expiration Date:  December 1, 2024.

How to participate:  To participate in this CME activity, you must read the learning objectives, read the articles, complete the CME posttest, and complete the evaluation. Provide only one (1) correct answer for each question. A satisfactory score is defined as answering 70% of the posttest questions correctly. Upon receipt of the completed materials, if a satisfactory score on the posttest is achieved, AKH Inc., Advancing Knowledge in Healthcare will issue an AMA PRA Category 1 Credit(s)™ certificate.

Target audience:  This CME activity is primarily targeted to patient-caring psychiatrists, physicians specializing in psychiatry, and others allied to the field. There are no specific background requirements for participants taking this activity.

Unlabeled and investigational usage statement:  The audience is advised that this continuing medical education activity may contain references to unlabeled uses of FDA-approved products or to products not approved by the FDA for use in the United States. The authors have been made aware of their obligation to disclose such usage.