JAMA Psychiatry special section on Structural Competency

Structural Competency and Psychiatry

The essays in this Viewpoints section emerge from a growing body of literature that posits structural competency as a new conceptual framework for reducing inequalities and promoting social justice in US medicine and psychiatry. Whereas previous models such as cultural competency focus on identifying clinician bias and improving communication at moments of clinical encounter, structural competency encourages clinical practitioners to recognize how social, economic, and political conditions produce health inequalities in the first place. Structural competency calls on health care professionals to recognize ways that institutions, neighborhood conditions, market forces, public policies, and health care delivery systems shape symptoms and diseases, and to mobilize for correction of inequalities as they manifest both in physician-patient interactions and beyond the clinic walls.

Structural Competency and Psychiatry 
Jonathan Metzl, MD PhD., Helena Hansen MD, PhD.

From Cultural to Structural Competency– Training Psychiatry Residents to Act on social Determinants of Health and Institutional Racism
Helena Hansen, MD, PhD., Joel Braslow, MD, PhD., Robert M Rohrbaugh, MD.

Advocacy as Key to Structural Competency in Psychiatry
Laurence J. Kirmayer, Knorick R, Rousseau C.