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The book provides a foundation of knowledge on the social and environmental underpinnings of mental health and mental illnesses for clinical and policy decision making, with a goal to improve the mental health of individuals across diverse communities and the mental health of the nation.

After the death of George Floyd and amid the glaring racial inequities of the COVID-19 pandemic, the United States entered into a \"racial reckoning\" in which the health impacts of structural racism became more obvious to a wider segment of the population than ever before.1 This reckoning led the fields of medicine and public health to call for greater emphasis on examining the detrimental health effects of structural racism. For example, a PubMed search of the term \"structural racism\" found a 354% increase in journal references between 2019 and 2021.In a policy statement issued in October 2020, the American Public Health Association officially declared that structural racism is a public health crisis, and in April 2021, the Centers for Disease Control and Prevention followed suit in declaring racism a \"serious public health threat.\"2,3 Yet, with all this renewed attention and focus, the precise mechanisms by which structural racism drives health inequities and health outcomes largely remain unclear.

Centering Women of Color in Academic MedicineRecent diversity efforts in academic medicine have failed to support retention of women of color by creating a truly inclusive and equitable climate in which all faculty members can thrive.

Opioid abuse and addiction have increased in frequency in the United States over the past 20 years. In 2009, an estimated 5.3 million persons used opioid medications nonmedically within the past month, 200 000 used heroin, and approximately 9.6% of African Americans used an illicit drug. Racial and ethnic minorities experience disparities in availability and access to mental health care, including substance use disorders. Primary care practitioners are often called upon to differentiate between appropriate, medically indicated opioid use in pain management vs inappropriate abuse or addiction. Racial and ethnic minority populations tend to favor primary care treatment settings over specialty mental health settings. Recent therapeutic advances allow patients requiring specialized treatment for opioid abuse and addiction to be managed in primary care settings. The Drug Addiction Treatment Act of 2000 enables qualified physicians with readily available short-term training to treat opioid-dependent patients with buprenorphine in an office-based setting, potentially making primary care physicians active partners in the diagnosis and treatment of opioid use disorders. Methadone and buprenorphine are effective opioid replacement agents for maintenance and/or detoxification of opioid-addicted individuals. However, restrictive federal regulations and stigmatization of opioid addiction and treatment have limited the availability of methadone. The opioid partial agonist-antagonist buprenorphine/naloxone combination has proven an effective alternative. This article reviews the literature on differences between buprenorphine and methadone regarding availability, efficacy, safety, sideeffects, and dosing, identifying resources for enhancing the effectiveness of medication-assisted recovery through coordination with behavioral/psychological counseling, embedded in the context of recovery-oriented systems of care.

Social justice entails equal access to liberties, rights, and opportunities, as well as care for the least advantaged members of society. The paradigm-shifting new book Social (In)Justice and Mental Health addresses the ways in which society's failure to deliver on that humane ideal harms people with mental illness. The editors, at the forefront of the effort to make psychiatry responsive to critiques of institutional racism, argue that in the United States, a perfect storm of unfair and unjust policies and practices, bolstered by deep-seated beliefs about the inferiority of some groups, has led to a small number of people having tremendous advantages, freedoms, and opportunities, while a growing number are denied those liberties and rights. Mental health clinicians bear a special responsibility to be aware of these structural inequities, to question their own biases, to intervene on behalf of patients and their families, and to advocate for mental health equity. To that end, the book provides a framework for thinking about why these inequities exist and persist and provides clinicians with a road map to address these inequalities as they relate to racism, the criminal justice system, and other systems and diagnoses. The book is hands-on, with topics mental health clinicians will find timely and relevant: • The role of social injustice and specific diagnoses and conditions, including substance use disorders, schizophrenia, personality disorders, and child trauma, is covered. For example, research has shown that white psychiatrists are more likely to over diagnose schizophrenia in Black patients, and this diagnostic bias may partly account for Black men being involuntarily committed to mental institutions in higher numbers.• The authors advocate for research that prioritizes the needs of participants and communities, rather than the needs of institutions, and focuses on structural, not individual-level, differences.• Accompaniment, an important strategy for infusing social justice into clinical practice, is described and modeled. This process of radical empathy -- of trying to minimize power dynamics in clinical relationships by listening, witnessing, and advocating with patients -- is critically important in confronting mental health inequities. • The inadequacy of current medical and mental health education and training in countering the powerful forces of social injustice in mental health is discussed in detail. The authors emphasize that change requires adopting an active practice of self-study and self-reflection, and accordingly, a list of self-study resources, consisting of books, documentaries, podcasts, and TED talks, is provided to further the reader's knowledge and awareness. • Of further assistance are the chapter-ending \"Questions for Self-Reflection, \" which challenge mental health clinicians to examine their own attitudes and preconceived ideas about race, poverty, disabilities, and privilege. Social (In)Justice and Mental Health addresses the context in which mental health care is delivered, strategies for raising consciousness in the mental health profession, and ways to improve treatment while redressing injustice. Clinicians owe it to themselves, their patients, and their profession to read -- and heed -- this important work.

Even with great advances in behavioral health policy in the last decade, the problems of mental illness and addiction persist in the United States-so more needs to be done. In this article, which is part of the National Academy of Medicine's Vital Directions for Health and Health Care: Priorities for 2021 initiative, we describe the steps needed to improve outcomes, focusing on three strategies. We argue for transforming the behavioral health system to meet people where they are, decriminalizing mental illness and substance use disorders to facilitate recovery, and raising awareness of social context and social needs as essential to effective care. We call for supporting structures in the workforce and structures of accountability, outcome measurement, and more generous financing of behavioral health care. These steps have costs, but the enormous benefits of a major transformation in behavioral health policy far outweigh the expenses.

Abortion Restrictions and Mental Health InequityApplying an intersectional lens encompassing structural racism, reproductive injustice, and mental health makes it clear that the Dobbs decision will exacerbate health inequities.

In this video roundtable, moderated by Dr. Michele Evans, experts from a range of clinical and biomedical backgrounds analyze and discuss complex questions about race in medicine, seeking common ground on which to build a system of equitable health for all.