Researchers (JAMA) Call for Structural Competency in Psychiatry (


Excerpt from piece in Mad in America written by Zenobia Morrill:

Advocacy, therefore, becomes a fundamental part of the structural competence framework.  Clinicians are encouraged to expand notions of individual healing and work toward rectifying oppressive and inequitable social systems.

“Structural competency thus advocates deeper understandings of how institutional discrimination and its often invisible, systemic oppressions can produce racialized, gendered, and socioeconomic status–related ‘symptoms’ in clinical settings.”

The structural competence framework consists of a series of benchmark skills, including, but not limited to, the following:

  • Recognizing the structures that shape clinical interactions,” such as social conditions and institutional policies that shape patient presentation
  • Rearticulating ‘cultural’ formulations in structural terms,” by accounting for neighborhood and institutional factor
  • “Observing and enacting structural interventions” through community-based projects that address patient need
  • Developing structural humility” through community and interdisciplinary collaboration alongside the reality that systemic change often requires long-term commitment resulting in progressive change

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