Social Justice and Human Rights Activist Urges Psychiatrists To Leave Their Comfort Zones

Psychiatrists need to leave their comfort zone and “get proximate” to marginalized people; change false narratives about the disenfranchised; and tap into their own sense of hope to help create a new era of health, according to the speaker at today’s plenary session.

“First and foremost, we cannot be effective psychiatrists and health care professionals if we allow ourselves to be separated from the people who have stories of addiction, mental illness, or disenfranchisement,” Bryan Stevenson, J.D., founder and executive director of the Equal Justice Initiative, told the packed hall. The Equal Justice Initiative is a human rights organization in Montgomery, Ala.

“It’s easy to isolate ourselves from people who are struggling, suffering, falling down, but we have to get proximate to help people experiencing addiction, impoverishment, and incarceration. We have to hear and see what they are going through to gain insight into their problems and form a new language for helping them,” said Stevenson, who is also the author of the bestseller Just Mercy, and professor of clinical law at New York University School of Law.

Stevenson told the story of when he was assigned to visit a man on death row in a maximum-security facility while still a student at Harvard Law School and with little practical knowledge. His job was to deliver the news that the man had been granted a one-year reprieve from execution. In fact, Stevenson was the first person the man had seen for over a year, aside from death row guards and death row prisoners.

The prisoner drew Stevenson into a hug and thanked him over and over and over because it meant the condemned man could now see his family. In response, the guards brutally shoved and prodded the prisoner to leave the room and wound heavy chains around his arms, legs, and chest. Still, the prisoner left singing a hymn, “I'm pressing on the upward way. New heights I'm gaining every day, still praying as I onward bound. Lord, plant my feet on higher ground.”

“Even in my ignorance, there was a benefit from being proximate,” Stevenson said. He decided at that moment to dedicate his life to helping get people off death row. In addition to getting proximate, Stevenson appealed to psychiatrists to work to change the narratives of racism, discrimination, and stigma and to foster their sense of hope.

Over his career, Stevenson has won several cases at the Supreme Court, including a ruling in 2019 to bar the execution of prisoners with psychosis or dementia and a landmark ruling in 2012 to ban mandatory life imprisonment without parole for children aged 17 or younger. He and his staff have also secured the relief, release, or sentence reversal of 140 wrongly condemned individuals who were on death row. They have also helped release from prison 80 children who were prosecuted as adults.

“Our team’s goal is to work hard, be smart, be tactical. But if I have helped anybody, it’s because I got proximate to a dead man and heard his song. There are songs being sung by people in need: We all need to hear the melodies that are ringing out from people.”

Society’s failure to mount meaningful interventions to deal with the substance use crisis has resulted in a massive shift in the number of people incarcerated: from 300,000 people in the 1970s to more than 2.3 million by the end of the century, Stevenson pointed out.

“We need to change the false narratives about mental illness and substance use that allows some politicians to refer to people with them as criminals who need to be locked up. … Addiction and mental illness are health crises, and we need a health response, not a criminal justice response, to see how much better as a society we can be,” he said.

In 13 states, there is still no minimum age for sentencing children to prison without the possibility of parole, Stevenson pointed out. In fact, it is estimated that 1 in 3 African Americans and 1 in 6 Latinos are expected to be sent to jail in their lifetimes, impairing their ability have a productive life, he added.

“When it comes to people with mental illness, psychosis, or substance use being incarcerated, somehow there is no more urgency or need to treat them. That has to change and I believe you are the people to do it,” Stevenson said.

Stevenson talked about the importance of shedding light on injustice and about the architecture of racism, racial injustice, and discrimination that was erected in this country in order to allow for two and half centuries of enslavement and the Jim Crow laws. “You can be the most talented, the most accomplished, the most educated person in the room and if you’re a Black or Brown person, you still have to constantly navigate the presumption of dangerousness and guilt that is still in existence today.”

Ultimately, Stevenson appealed to psychiatrists to foster their sense of hope. “Helplessness is the thing that facilitates poor care. Our hope is our super power. We need to understand the things that threaten our hope and quiet them,” he said. “This is not the hardest moment our nation has ever faced, and we need to appreciate that. We have an opportunity to do new and glorious things, to create a new age and era of health.”

A lot of life’s biggest successes arise from moments of pain, he explained. “Doing uncomfortable things can feel so intimidating, can feel so challenging, but it is in the midst of it that we often get to have the most rare, the most precious, and the most beautiful experiences that we get to have in our career.” ■