I truly enjoyed working with Dr. Yule and her team at Boston Medical Center this past summer. Last summer, I was an intern at MGH in one the psychology labs and it was not the experience I was looking for or expected. I now realize that my experience last summer was not representative of research and after my internship this summer, I am considering a career in research. Not all research experiences are the same, and not all work environments are the same, and it is something I wish I knew before I started this summer and before I generalized research experiences. But the reality is that you can’t know what a work environment will be like until you’re already there, in my case, doing the research.
While in this position this summer, I gained a deeper understanding of social justice work. Social justice is all about distributing resources fairly and treating everyone equitably. But sadly, when we take a look at today’s world, this isn’t happening in many places. I also learned the causes and consequences of social injustices from talks with psychiatrists, mental health counselors, coworkers, and from the research we were doing. We all need to work as a team to work towards dismantling all these barriers around health disparities, and this is exactly what Dr. Yule and her team are aiming for.
Before starting this position, I did not see how social justice was relevant to research, but as I began to work on projects with my coworkers, I realized that social justice work takes many forms. Many of these health issues that I talk about in this blog and in my previous blogs are often overlooked. It is the reason why social justice work is crucial in underserved populations to aid the growth of communities. The projects I worked on show how important research is during the times that we are living in, especially on evidence-based treatments. Despite how research has shown their efficiency, some providers are reluctant to use them. Research also demonstrates how important it is to address minority populations who lack access to health care, which could be due to structural racism. As a result, we see language barriers in place and people living in high crime and poverty neighborhoods, among other factors.
Earlier this year, my primary investigator received a grant from an ongoing initiative that the NIH has called “Helping to End Addiction Long Term.” This is an effort designed to speed scientific solutions to stem the national opioid public health crisis. It is also an effort to improve prevention and treatment strategies for opioid misuse and addiction, and to enhance pain management. As part of this project, I worked on a task that included assisting with implementing screening for substance use disorders in behavioral health by identifying which screening tools and questionnaires have been translated into Spanish and Haitian Creole, and assisting with Spanish translation. Translating the screening tools into these languages is due to the hospital having a lot of Spanish and Haitian Creole-speaking patients. If we don’t have screening tools available in their language, we cannot help these patients and they are more likely to go untreated. This creates a barrier for them when accessing care that they wouldn’t otherwise face if they were native English speakers. This is why we need to work together to help them overcome these barriers to treatment. Once we are done with project, other researchers will be able to use the translations and other patients will be able to be treated.
I also worked on a systematic literature search focused on screening for substance use in behavioral health clinics. It is important to identify individuals with psychiatric disorders who have a co-occurring substance use disorder to address the disorders that are coexistent in treatment. While there is already a policy-level mandate to systematically screen patients for substance use disorders and deliver brief intervention to treatment and referral to treatment, the majority of the efforts have been concentrated in primary care. Substance misuse is at a higher rate in behavioral health populations, and therefore it is an entry point in getting people who might have a substance use disorder. A decision needs to be made because many people that need to be screened are not being screened. This gives the opportunity for clinicians to intervene early and be able to help their patients before it takes a toll on their patient’s overall health.
I also hope that this systematic review is able to inform other researchers about the importance of implementing screening in settings outside of primary care. We are also using another systematic review on treatment outcomes in adolescent girls to get a better sense of what is out there, in order to inform future research to provide better gender-specific treatments in the future. Lastly, the Department of Public Health will be able to make better informed decisions in terms of policies for medication management in residential treatment programs through another project we worked on and presented to them. All this work impacts social justice reform because, with systematic screening, we will be able to help patients who fall through the cracks in health care, and with systematic screening in place, it won’t be possible that someone who truly needs help will be left out.
Some advice I would give to someone else who wants to pursue an internship or career in my organization is that you have to be self-motivated. Also, if you can try to pick a good team, do so. Don’t be afraid to contact people if you have a question. Some people are always hesitant to do this. However, it’s good to ask if you are ever in that position how they did this or how did they get there. People do like to share their experiences.