Well, thank you for joining us today. We are going to have a wonderful conversation today and a presentation by Dr. Anik Forrester. The title of today's presentation is part of the Center of Excellence grant that we receive here, and the title is Approaching Diversity, Equity, Inclusion, and Social Justice through Creating Sustainable Organizational Change. So as I previously mentioned, this is funded through a grant funding for the Striving for Excellence series was made possible by a grant from SAMHSA of the U.S. Department of Health and Human Services. Next slide. You'll also be able to receive continuing education credit. So more instructions on at the end of the presentation on how you can actually claim for credit. So thank you again. Next slide. In addition, if you'd like today's handouts, as I said, it's a wonderful presentation as I already got a sneak peek. If you do follow instructions, if you're using either the desktop version of this program or the Instant Join view, you are able to download the PDF of the slides and you can follow along or take down notes. Next slide. In addition, this is meant to be a dialogue and Dr. Forrester is open to receiving questions during the presentation, not just at the end of the presentation. So you can participate in the Q&A by either using the desktop option of the questions or the chat or the Instant Join webinar, clicking on the question mark symbol to display the questions area. Next slide. Dr. Forrester has no financial relationships or conflicts of interest to report. Next slide. And now for our main speaker, again, it's my privilege to introduce Dr. Forrester as a graduate of the Howard University College of Medicine in Washington, D.C. She completed her psychiatry training, residency training, as well as psychosomatic medicine fellowship training at Thomas Jefferson University Hospital in Philadelphia. She is a diplomat of the American Board of Psychiatry and Neurology. She is board certified in the subspecialty of the psychosomatic medicine renamed consultation liaison psychiatry. She serves as the Department of Psychiatry Chief of Diversity, Equity, and Inclusion, and is the chair of the Department of Psychiatry Diversity Committee. Dr. Forrester serves as a director, again, serves as a director for the Consultation Liaison Psychiatry Fellowship at the University of Maryland Medical School of Medicine, she is also the coordinator of the Cultural Psychiatry Resident Course. As Chief of Diversity, Equity, and Inclusion for the Department of Psychiatry, Dr. Forrester provides strategic vision and leadership for all the department's diversity and inclusion activities and oversees the development and implementation of key goals related to diversity, equity, and inclusion. And now, please welcome Dr. Forrester for her presentation. Thank you so much. I'm happy to be here and happy to present this content to you on behalf of the American Psychiatric Association in coordination with the SAMHSA grant that Gabriel just mentioned. Today, we're going to talk a little bit about how diversity, equity, inclusion, and social justice concepts can be applied in academic psychiatry, we're going to really describe and understand what the current landscape looks like, and I'm going to discuss and introduce the concept of organizational change management. A lot of organizations now are trying to understand how they are going to change how they are approaching diversity, equity, and inclusion, and also social justice. We're going to talk about stages of change in organizations and then how organizational change management can be applied to DEI and social justice. So, I want to give a little bit of a disclaimer that this talk is not going to give sort of any definitions of terms related to diversity, equity, inclusion, and social justice. There's a need to kind of have at least a basic level of understanding of what those terms mean, and it's important to have an up-to-date understanding of the history of academic medicine, psychiatry, mental health care, both systems and practices, as well as the history of bias and structural barriers to diversity, equity, inclusion in medicine and psychiatry as a foundation for the concepts that we're talking about today. And so, luckily, there's already some great resources on this very platform that can help to shape your foundation or your understanding of this history, including some very excellent talks that I've personally reviewed and seen, one by one of my former fellows, Dr. Daniel Hairston. So, I encourage people who are looking to sort of understand a little bit of the history of what we're going to be talking about to review some of these talks. And then there's lots of great resources available out there for those who want to look further than just this platform. So, in academic medicine, there's sort of like a before and after to describe what diversity and inclusion has looked like, so really looking at before 2020. So, I'm saying before and after because I want to make sure that people understand that there have always been efforts, coordinated efforts, individual efforts, to really bring attention to matters of diversity, equity and inclusion and social justice to academic medicine, basically since the 1960s. So, I want to make sure that we're not just really talking about this sort of modern approach, but really understanding that this is sort of a next step in an evolution practice that's been going on for a very long time. But essentially before 2020, and we all sort of know about the evolution in social justice that happened in 2020, sort of in the context of COVID, the death of George Floyd, and just sort of an awakening, a national awakening about matters related to racism, structural racism, discrimination. And so, kind of everybody's consciousness sort of shifted. And in academia, what had happened before 2020 was that institutions focused on having like an office of diversity or a dean or vice dean for diversity. Some institutions would favor pipeline or pathway programs as an avenue to introduce representational diversity into settings where usually underrepresented minorities were not as adequately represented in the numbers. And it was rare to see systemic approaches to diversity, equity, and inclusion that affected an entire institution or organization. And so, what happened as a result is that underrepresented students, faculty, and staff felt isolated or had limited ability to contribute to institutional change outside of the established avenues. And much of these avenues focused on representational diversity. Let's have a few representatives of each of the sort of underrepresented groups, whatever the groups were, to be here. And let's figure out ways to have them be here and have them stay here, but not really to affect the way that the organization or the institution runs. And so, what's happening now after 2020 is that there's a lot more attention and conversation about structural racism, bias, and how these historical themes are having an ongoing impact in academic medicine. And so, what's happening is there's more attempts to highlight DEI-related efforts. There's more intentional inclusion of funding to support these efforts. Before, the funding was to support like specific positions or specific offices. But now, we're thinking about more global efforts on an organizational front. And now, there are new discussions about implicit bias and how it's manifesting in healthcare. So, we'll talk a little bit about that. And what's also happening is that there's a greater exposure to and understanding of the narratives and experiences of those who have been marginalized or underrepresented. What's happening is more people want training and education about this because they're kind of hearing these new perspectives. And now, we're seeing these new committees and subcommittees that are thinking about organizational equity. And I know that this is happening not only in the American Psychiatric Association, but in a lot of other of the subspecialty organizations are really thinking about how to look at organizational equity. So, what's happening? How is this really sort of coming to life? So, there's a lot of changes in the landscape. Institutions are realizing that they're ill-equipped to foster large-scale organizational change, especially in the DEI and social justice space. But why is that? When we really look back at the history, academic medicine has been tied to really thinking about scientific and clinical pursuits, advancing medical knowledge, providing clinical care. But there's never been this much focus about how structural racism really affects those pursuits and how our current medical practice and the structure of how, like, our organizations, our hospitals, our healthcare system operates. So, really, many of our large organizations are really ill-equipped to make real and sustainable change when it comes to diversity, equity, inclusion, and social justice. And some leaders of these organizations also feel ill-equipped to make these changes, either due to their own lack of knowledge or personal discomfort related to saying or doing the wrong things. And we've had some recent sort of very public examples of this in psychiatry, where you have leaders sort of on social media saying things that are inappropriate, receiving some backlash, either being forced to be silenced or issue an apology. And so, thinking about those examples, other leaders feel more restrained, not more empowered, because everybody's sort of worried about being canceled or having some sort of negative consequence if they say or do something that people don't like in the DEI space. And so, what's happening is it's easier to maintain the status quo in terms of our operation, because it's too much of a risk sometimes at the organizational level to shift things, especially given what people are seeing and that inherent sense of fear that a lot of people may have. So, there's a few cautionary tales. A lot of these efforts are playing catch-up to a system that really wasn't designed for inclusivity. I would like the people that are here today and the people that may see this in the future to really look at the current boards of directors or trustees for the large medical specialty associations and look at these people and think about, do they represent a larger membership in these organizations? Do they have the right understanding, the right perspective to be able to create organizational change? Is the leadership really prepared for this? And what would that change actually look like? And so, I want us to really start to think about that, because it's about having the knowledge, the experience, and the perspective to be able to do this. So, let's talk a little bit about what the organizational mindset is like. So, in a large organization, if we're going to make significant changes, it's usually from a top-down approach. So, the leadership says, we're going to make a change. Here's how I want to do it. They may delegate some of the responsibility to other members of the organization, but they have sort of set the tone that we're going to make a change. Many organizations already have mission statements that describe their core values. And a lot of the core values may make some statements about diversity, equity, and inclusion, and some may not, not directly. So, the organization, on the face of it, is committed to the values that are described in these statements, but individual commitments can really vary from that. And it's very, very difficult to measure how individuals contribute to the mission of the organization. And it gets even harder in the DEI and the social justice space. How do you know who's committed to diversity, equity, inclusion, and social justice? I can't tell just by looking at a person what their level of commitment is. I also can't tell by what they say. And at the organizational sort of level of it, I can't tell for a lot of different reasons if the leadership is really sort of ready, committed, able to make this sort of top-down approach. And so, what has been happening in recent years is that organizations have been reacting to some significant events, but really don't have the mechanism to self-reflect or make proactive changes to really think about how they want to adjust. And that sort of flexibility is really called a cultural intelligence, and we'll talk a little bit about that. I think even recently when we're just sort of people are reeling from this revelation that Roe v. Wade may be struck down by the Supreme Court, but when we think about our other organizations, the other branches of government, can they really make proactive changes in response to this new revelation? That would be a sign of a highly culturally intelligent group of people and a highly culturally intelligent organization. So cultural intelligence is a term that can describe the understanding of the impact of an individual, or in our case today, the organizational's cultural background on their behavior, and that understanding being essential for effective business and business practice. This concept translates to any organization where the main driver of success depends not only on the individual efforts, but also the ability to master diverse situations and really do that sort of flexible adjustment. And the individual expression of this concept is called the cultural quotient or the CQ. So I know we're familiar with the IQ, which is the intelligence quotient, but this is a cultural quotient, and we'll talk a little bit about that. So this is what that looks like. So you have at the top here, here's the individual, then you have the climate in the organization coming from, again, usually a top-down approach that's usually expressed by a mission statement or just sort of the sense that people get in the organization as to these are our values, these are the things that we care about. Then there's usually a system or an institution surrounding that organization, and for us, patient care is a part of this. So it's our individual understanding, the organizational climate, the system that supports us and surrounds us, and how then we take care of patients. And what happens is that all of these things converge into how we express our values on a daily basis. And I think COVID has really affected a lot of organizations, especially medical organizations, The climate change, individual understandings of sort of what was important, what are we doing changed, the system had to change to adapt to this sort of unforeseen virus that came from nowhere, patient care had to change, and then our daily expression of how we were really taking care of people changed. And so organizational change management is a sort of field of study that's been around for a very long time, that really describes an approach to creating systematic changes at an organizational level. And so when we're talking about DEI, we have to understand if we're going to make changes related to that, what is the current climate for diversity, we need to have a consensus about what the climate is like. And we need to have a consensus about what needs to change. We also need to understand sort of the level of importance of this, in addition to all the other things that the organization is engaged with and involved with, and in health care, and in psychiatry, there's a lot of different sort of variables that affect what we're doing. But when we're talking about diversity, equity, inclusion, how important is this? And then we must set these as organizational goals. The leadership management needs to commit to these changes. And we need to pay attention to the current makeup of the organization, who's here? Do the individuals that are here reflect the core values that we are trying to demonstrate? And can they help us to implement the changes that we're talking about? So when you think about your current organizations, some questions to sort of ponder, and we can sort of, if people want to jump in here, sort of thinking about what are some of the core values of your organization? How would you know or understand what these core values are, if you're just joining? So not if you've been around a long time, and sometimes that can also be skewed. But what if you're just coming in, walking in the door? How do you know what this organization values? And are there gaps between what we describe about our core values and how we interact with each other daily? Remember that individual expression. How much does the history of our organization affect how we do things today? And I think that's a critical question, because a lot, especially in healthcare and psychiatry, a lot of people do not think about how things are structured the way they're structured, why things are structured the way that they're structured, and does it make sense? Is it inclusive or non-inclusive? And then what are the current challenges that the organization faces, especially related to diversity, equity, inclusion, and social justice? I think people don't really consider these questions to the degree that many of us would want. And sometimes when we're thinking about our organizational cut, if we want specific changes to be made, we'll say we want things to be more diverse. We want to see more representation of X, Y, and Z groups. But if we don't sort of consider these questions, how are we going to get to the change that we want to see? So that's sort of like a first step. If you're thinking about really implementing some organizational level changes, then you got to think about what's the right fit. If we're really going to sort of adjust our core value system, if we're going to adjust sort of our expectations and how we're going to fill these gaps between what we say we want to do and what we are actually doing, what's going to make sense to move us in that direction? And really, if you look at all of the research, all of the information that's out there, there's no clear consensus about how to motivate, operationalize, and really implement change in the DDI space. People have ideas. There are some sort of well-known pathways that people think about. There's some best practices, but there's no consensus. This is not settled. And again, leadership is integral to any change initiative, especially at the organizational level because of that top-down approach that we've talked about. And so now we may be thinking about introducing some sort of change initiative, okay? Change in general must be tied to addressing a problem or a challenge for us to really be able to create an organizational consensus around it. People have to agree that this is a problem or that this is something that we want to engage with. And then again, the challenges of the problem must be clearly defined and agreed upon because in an organization, you may have individuals that see the problem differently or see the level of importance differently. And so we want to have some agreement. And that gives you a little bit more of a bottom-up approach to organizational change that would actually make it more sustainable. And then how does the current culture help or hinder our ability to address these challenges? So we have to think about like, okay, so we agree that these things are problems. We want more diversity. We need to have transparency in what we're doing. Maybe we need more leadership equity, whatever the sort of agreement is. But does the current culture allow us to really address them? If the culture doesn't allow us to address them, then we have to do some cultural work. And we'll talk a little bit about what that looks like. So usually there needs to be some intentional exploration of the challenges. So this is when we talk about like no clear consensus. Here are some of the best practice things that people have been doing. So people do climate surveys. They solicit feedback. Some people have talked about safe space conversations. Reviewing past challenges that relate to the current issues that we identify. Some people do SWOT analyses, needs assessments. But in the DEI space, what you do with this information is critical. Because a lot of times we've done these surveys. We've given the feedback. We've shared what the problems are. We've agreed and then nothing happens. And so experienced leadership is actually necessary to direct the exploration and help to move an organization forward. And this is why in that top-down approach leaders really need to understand can you do this? Are you experienced enough to do this? Do you have senior leaders who can do this? Or do you need to bring in new people to help the organization to move forward? So I want to talk a little bit about the stages of change. And so before we get into that, I want you to see that in organizations these changes are ongoing and forever sort of rotating. That's why it's a circle. So all of the different stages lead into each other and we have to go back and forth and around and around sometimes when we're trying to create change in an organizational level. So the first thing is awareness, right? We've talked about this. People need to know that something is a problem. What are the issues? What's our intention about addressing this issue? Why are we doing this? That has to be clear to everybody in the organization. Otherwise it's a non-starter. Then you need people to be interested. So we can be aware but in order to really change something people have to be interested. So how do we get people to be interested? We have to encourage people to be curious about these problems like remember the questions that we were thinking about earlier? What are the gaps between what we say we value and what we're actually doing? But we also have to discourage people from being silent or shaming people who speak up or have people be just sort of apathetic. I'm here in this organization. I'm just doing my part. I don't care about these other diversity, equity, inclusivity issues, social justice issues. I'm just here for my core job. So apathy is also a deterrent to change. So get people aware. Maybe some people are interested. Now you got to engage people. So part of the engagement from the organization level is to be transparent. To really be transparent about this is what we've been doing that no longer works for us or this is what we've been doing that needs to be improved. We need to be accountable for that and we need to be have some humility that you know what this is a large organization maybe we're quite successful in our some of our core initiatives but in the DEI and social justice space we haven't done well. Engagement naturally leads into action and in order to have action that is meaningful we have to be honest. We have to self-reflect. We have to go back to our intention, back to that awareness phase. Why are we doing this so that every action that we implement makes sense and is aligned with that initial agreement and consensus and then things have to be sustained so that they can grow. What does that look like? The organization must invest right so time, the leadership involvement, and actual resources. A lot of times resources means financial but not always and a lot of times we need to make opportunities and make room for others to rise. Again if the organization is not prepared, doesn't have the right ability in the leadership, do we need to create spaces for other people to join us or to rise that already exist in an organization so that the things that we've decided to implement can really be sustained and can actually grow. And again at different phases we may need to go back into some of these different phases, the awareness, interest, engagement, and action. Everything feeds into each other. All of these will then over time lead to change. What we're seeing when it comes to DEI and social justice is that people want immediate change but they don't want to deal with these steps. They're tired of it, it's been a long time, the organization hasn't responded well enough and so we just want you to change it. Change it now but without paying attention to what is required in an organizational level what we'll see is what we have seen in the past. Initiatives that really don't go anywhere that just involve a small group of people and don't affect the larger organization. So what if you're a leader that is managing organizational change? What do you need to know? So number one you got to be informed and remember the beginning of this talk we talked about some of the foundational concepts that people really need to take some time and educate themselves about. I think we're in a sort of a fast-paced society where people will just want the quick answer. A lot of these questions though are more complicated and nuanced and you need to take time to educate yourself. Once you get informed and educated you have to think about how we can act strategically. You also have to be willing to break away from historical norms. Sort of the way we've always done things. If your leadership group is organized a certain way and it's always been organized a certain way does it need to change? Do you need to invite new leaders? Do you need to really have a hard talk with some of the current leaders and say hey things aren't working well and we need to do something different? And leaders actually must be able to inspire, mentor, and learn from individuals and also other organizations in order to really in the DEI space make this a possibility. The other things that leaders have to do is form a coalition of what we call early adopters. In the DEI space there's a lot of people that are already engaged that already have a lot of the foundational knowledge that we are talking about and you can leverage their enthusiasm to really spread the message of change. You have to be able to identify and confront change resistors. There's a lot of people in organizations that are not interested in changing. They feel comfortable with the status quo. This is what we've done. DEI and social justice issues are sort of irrelevant to the core mission of the organization and so we have to be able to talk about that and how we sort of have a dialogue about why these things are important and why they're not irrelevant to the core mission of the organization. We also have to be willing to transform our daily practices. So sometimes that includes developing new policies that really specifically address DEI and social justice needs and we have to be able to reflect and change course whenever that's necessary. At the organizational level a lot of people want to create all these new policies, do all these new things, and then not be able to respond if some of the things aren't working or they need to be adjusted and so that's a part of this and that's why leaders are so important here. You need people who have experience who can actually do this and help the organizations to do this as well. Whenever we're preparing for change or thinking about some of the things we want to do, again what I have seen and what is sort of the most common in the DEI and social justice space is that a lot of organizations are focusing on recruitment and retention. Again, we want to have people that are traditionally underrepresented in our organization to join us. What does that actually look like? Join us how? Join us in what capacity? Do these goals actually coincide with the mission of the organization and its leadership? Again, questions here are welcome. That's why I'm asking the questions because I think people don't really consider these or sometimes these questions get lost. What action steps do we need to take to create accountability to make sure that our organizational culture can support diverse members and perspectives? Remember, we can't recruit and retain people who are diverse or underrepresented if the culture can't support them. Do we have policies and procedures to provide us with the data and the responsibility really so that we can understand how effective these initiatives are? If we don't, we need to get these in place. We can't just recruit and retain people and then not have any information about how you're doing with that. Then how do we include fairness and the attention to the key concerns of individuals within the organization who are not in the power or the leadership positions? Because what happens is that, again, you'll have the early adopters, the people that are ready, that have the information, that want to go. You have people that are maybe sort of more neutral. Some people can be apathetic or really resisting change. We need to be able to balance that and we need to think about, in some ways, fairness to all three groups. Because what happens is we only attend to sort of one of your key groups. The other groups get burned out, they're apathetic, and we cannot implement change at the organizational level. So I want to think about some do's and don'ts. When we're thinking about creating an organizational level change, we have to think about, like, you can't set a deadline. You can't say by July 1. July is like a pretty, very interesting time of year in medicine because you always have new people entering organizations. You have new trainees, usually. That's a time where new faculty will join. And so we said, July 1, we're going to do all these things. But in the initial phases of cultural change or the shifts that we're doing, we cannot have a deadline. Because, again, there's so much work that needs to be done to get people on board. And not every group or individual within the organization will view the need in the same way. So that consensus building does take some time. And I think people really need to allow some space for that and really understand that it's critical to being able to sustain the larger change initiative. And then people need to feel safe, especially those who have been underrepresented or marginalized. So we should never really make assumptions, like, oh, we're nice people, everybody hangs out after work, or the organization pays for conference time or does different things. So people are safe to talk about what they want to talk about. We can never assume that. We can also, we also need to make sure that people who do share their experiences or share viewpoints that are typically divergent or go against the core values of the mission thinks, the organization thinks the mission is, will not face retribution or other consequences within the organization for sharing. And a lot of organizations have come up with grievance reporting systems as a way to sort of deal with this. But again, you have to take care with these if the psychological safety of the people in the organization has not been established. Because grievance systems can be used as a way to retaliate against people. So how do you make people safe? And how do you create a sense of safety within an organization? Number one, you have to collaborate people with people that don't share your location, that are responsible for different things in the organization, that are just not the people that you see every day. Communicate and empathize with people who have different perspectives. Thinking about curating and creating content that's relevant to the real-world issues that the organization is facing. Reflect on and take responsibility for individual learning and the learning of others within the organization. Thinking about doing some of that independently and then also leveraging our digital tools, using the internet to help support the learning. These are ways to help people see that the organization is committed to creating the change and that it's safe to speak up. And we have to do this all the time. And again, we want to make sure that the organization understands that everybody's not going to agree. The other thing that's been happening is that many organizations want like a formal diversity training. They want to hire consultants to come in and train people at various levels within the organization. And it's sort of like, come in and train us and after the training we'll be fine. I think people are really starting to realize that that does not work. But targeted trainings with specific goals, especially when we're talking about our change diagram, can really actually be useful to creating that awareness, building the consensus. So organizations kind of need to think about, if we're going to do a training, what is the training supposed to help us with or to understand? And really create an avenue so that people understand that and then they can engage with it. One of the things that I discourage organizations from doing is creating like a checklist. So here's the 10 items. Here are the three core things that we're going to be doing. Because if you operate from a checklist, it provides an assumption that like once you address these items, that we're finished and we don't need to do anything else. And so there's no room for that re-evaluation process that does need to happen, especially at the organizational level. And what organizations really fail to realize is that this kind of change is really rooted in self-reflection. So what the organization needs to provide is a clear understanding of what our values and goals are. And a sort of clear understanding of what needs to change about those values and goals if they do not support DEI and social justice the way that the organization wants to support those. And so when we think about these initiatives and what's going to be transformative, is that really it needs to be integrated into the daily work and not seen as something that's irrelevant to the sort of established daily work of the organization. So it won't be viewed as an additional sort of burdensome activity and it can help promote people's individual self-efficacy. Thinking about having people commit to things that are already important to them. Again, we want to go back to that discouraging of the silence inactivity apathy and thinking about embracing uncertainty and really having open discourse. That's what helps to move an organization forward. Change can't be forced though. And I think organizations are used to mandates where we say we are doing this new initiative. This is what the organization has said we need to do. But when it comes to DEI and social justice, this is very very sensitive and we have to really be and pay attention to what are we doing here? And how are we going to make people go along with this? Because we can't really do that. Change does occur gradually. How gradually really depends on the flexibility of the organization. It requires guidance, transparency, accountability, and safeguards for the expected setbacks and resistance. And I think a lot of us understand that as, and we talked about the before 2020 and after 2020, as things have become a little bit more progressive in talking about DEI related issues, there should be expected setbacks and resistance against that. And that should be accounted for. And again, it must be supported at the highest levels of leadership. What I have seen organizations do is sort of either put somebody in charge of the DEI work, create a committee to help with our organizational equity, but then the leaders have limited engagement in that process and really want a report or an update. And my suggestion is that leadership really needs to be active, engaged, and energized about this to create the sense that this is something that's important to the organization and it's critical to our daily work. The other thing we need to think about is that immediate action affects our understanding about how much we might not know about the organization and how it's currently functioning. So again, that's that immediate push. We need to fix this. We need to put a statement out there. We need to create this committee or name somebody to run this. But I think it sort of leaves us a little bit in a place of misunderstanding because we don't know exactly what the daily values look like currently. Establishing an infrastructure allows for partnerships. We talked a little bit about working with people that are not the people that you work with every day. And it also allows you to identify talented potentials. But we need to seek these people out. These are the people that really could rise within the organization that have a sense of how the organization works and can help to lead some of the DEI related work. And again, whatever we do with DEI and social justice must be aligned with the broader values of the organization. And so when we think about this, like one person can spread the message, but the vision needs to be shared by the group. Like everybody needs to kind of say, yes, this is why I work for this organization. This is why I'm here. This makes sense to me that we're doing this. And that's how you create that engaged coalition. Again, an engaged coalition can help to communicate progress, updates, really talk about the vision for the organization. So it moves away from that top down approach that we were describing earlier and really create something that's dynamic and involves all levels of people in the organization. I wanna just say that leading organizational change is very difficult. Wycliffe and Sutliff in 2007, there's a quote here from a paper that they wrote. Says you wanna modify people's practices, like their behavior patterns, their habits, because at the organizational level, people act their way into new beliefs and values. So it's not something that you just tell people, this is what we're thinking now, this is what we're doing now. You have to really get people to start behaving differently, to shake things up, to change their habits, especially when we're talking about DEI and social justice. If they're not doing that, then they can't sort of like start to embody the new beliefs and the values that the organization is trying to embody. And so that's why we have to get people and so that's why we have to get away from the way we've always done this, this is how it was set up 20 years ago, 30 years ago, that's why we have to understand how it was set up that way. But we need to be a little bit more flexible so that we can change that to help people really act their way into these new beliefs and values that the organization is trying to uphold. So just thinking about the future when it comes to what a lot of organizations are doing and remember that we're sort of in this new phase of understanding what DEI means, especially at this level, is that sort of this work doesn't end. And so people need to commit to continuous learning. And so the individuals and groups within organizations have to evaluate their openness and willingness to continue this journey. We can't wait for societal events to spark us to adapt or change what organizations are doing. We have to be able to do that every single day so that we can actually be prepared when something does happen and our organization doesn't suffer from some of these sort of really bad examples that we've seen recently. Thinking about not becoming complacent and feel like we were done, we got this committee together, we have these people in place now, so we're good, right? No, we're not. And I think that that's something that's a very, very difficult thing for people to understand, but it's necessary to get it like this is the process that we're all gonna keep doing as long as this organization exists, we're gonna keep working on this. And then we need to create systems that help us to reevaluate what we've done. Sometimes you gotta take a break and re-engage so that again, we're trying to limit this apathy, this burnout. But again, that commitment to the continuous learning is critical and the organization has to create pathways and mechanisms for this to really occur. So I wanna just remind everybody about the steps that we were talking about, getting people aware that the organization is making a change, getting people interested in doing it, engaging them into some sort of measurable actions, and then things need to be sustained and grow. All of these will lead eventually to organizational change. And then there's some critical changes that some organizations need to put in place to support this process. Again, we need to sort of think about the way that we've always done things may not be the way that we want to do them. So I wanna transition to a video to kind of show us a little bit of what this might look like the Unilever Corporation. The Unilever is a mega corporation. When you think about an organization, it's pretty big. And they create a lot of the household products that we use every day. They have decided that they're changing their organizational model and their strategy for marketing to make it more inclusive. And this video will show us in real time, what would that look like in a large corporation with a lot of branches, a multinational corporation that has offices and footholds all over the world. How are they doing this? So that those of us in small organizations can think about how we wanna do this here. So I think we have the link to the video. Okay, so I wanted to see if there were any questions from the audience or comments that people had just about what you all have experienced as of now when it comes to your organization. How are they managing these change initiatives? Does it sort of align with some of the things that you've heard today? And are there sort of different ways that we can engage with this at such a large level? Well, let me say, thank you, Dr. Forrester. I can't speak for everyone, but I will still do. This is probably the most, not only the most realistic and grounded presentation I've heard, but it literally is a call to action and how to go about doing it and the right steps to make sure that we get to where we wanna be, regardless of what organization that we're in and always to the benefit of the people that we're here to serve. Of the people that we're here to serve. So this was a wonderful, wonderful presentation, and I'm so glad I printed the slides because I'm gonna just keep going through them. So thank you. Absolutely. And as Dr. Forrester said, I know there's a few of you out there. Please don't be shy. If you have any questions, please use the chat or you can just do the questions and I will make sure that I pass your question along. Otherwise that means that, so I see a thank you, Dr. Forrester. That's good. Otherwise I will be asking questions that are just selfish for my own personal gain. So I'll ask a question as individuals are thinking about them. So as you think about the landscape of whether it's academia and higher ed, are you seeing more of a change going in where they're putting more of an emphasis on diversity when they're hiring people? What it means to actually work and have proof that you've done work in the diversity, inclusion, equity phase? Because I see a lot of times they hire people then all of a sudden it's like, well, you should know this. But nowhere in the recruitment process did you actually vet them correctly to see if you actually have those values and how have you implemented those values? So I think that that's why going back to the point about what are the core values of the organization? Because if I am applying to work in your organization and I'm coming in and I don't know anything about it, the first thing the organization has to do is tell me what they value. They have to tell me and then they have to ask, they have to say, now that you know that this is what we value, what's been your experience with this so far? I think organizations need to advertise their values. Again, we've seen a lot of here's our diversity statement, here it is, but it's not incorporated into anything else that the organization is doing. And so here in the Department of Psychiatry at University of Maryland, what we have done as an example is like we have agreed, here are some questions. So we say, you wanna work here, diversity, equity, inclusion is important to us. Can you tell us how you've engaged with this in your prior career, either in your training, if you're just finishing your residency training or fellowship training, or in your other work as a psychiatrist, or as a social worker, or as an occupational therapist. These are the things that if you're coming in, if you're asked about this, then it's made clear to you that this is important. If you can't answer it, maybe you're not a great fit for this organization because you have no experience, you haven't dealt with it, but are you open to it? Is this something that because of your lived experience, you're excited to see that these are questions that are being asked of you on your interview day. And then the organization needs to provide resources. So if I don't have a lot of experience, but I'm open to it, how are you gonna teach me? How does this sort of equate to this job that I'm here to take? So you have to provide resources. And that we've talked about, let's use our technologies, let's create resources that are accessible and shareable throughout the organization that anybody can access. And then it needs to be part of how we evaluate your performance. And so again, organizations really have to think about, you have to sit and think about how does this actually look for us and create the processes, create the protocols so that somebody coming in can be successful and know that sort of DEI and social justice is critical to us. I agree. And I think because for so long, the standard has been, you focus on service, research and teaching and nowhere do you actually embed all those values on how it means and there's room for growth there and how you evolve what all three of those mean. And we do have a question from the audience. What is your experience with addressing white fragility in this work? Do you call out, let me scroll here, sorry. Do you call out the resistance when you see it? So let me say this. So give an example. So here, our chair actually purchased the book, White Fragility for every faculty member in our department in 2020. And she's reflected since that time that almost nobody read the book or sort of came back and said, this is what I thought about it or wanted to discuss it in any way. And so what has happened since then is that there's been, of the people that are resistant to some of the changes that we're doing, there's been that apathy and that sort of disengagement from the process. And what I've said is that it's not my job to call it out because then it becomes about me. So I'm the chief of diversity. So yes, I'm like the diversity police. You're not doing what you're supposed to do so I'm gonna call you out. But DEI related things are very charged, especially when we're talking about racialized things, discrimination and bias. And doctors and medical providers, they don't wanna feel like that's something that you're saying about them. And we've talked a little bit, I think Ibram X. Kendi really talks about anti-racism as an action. So when you call people out individually like that, especially somebody in my position, then it becomes you are racist or you're biased or you're not doing things because you're resisting the changes that we're making. Really, that's not my job. That should really come from the chair or people at leadership levels that said, well, we said that this is core to the mission and I have noticed that you have not engaged with this. Can you tell me why? And that shouldn't be done in a public forum. That really is your main leader coming to you and saying, I'm noticing this. In the DEI space, people tend to like sort of actively not notice when people aren't engaging. Have the individual conversation, talk about it and say, but this is critical and you are my leader. You run this program or you are in charge of this thing and I need you to demonstrate that this is a thing. And the same way, like if I'm the CL fellowship director, one of my fellows is not engaged with what's happening here, I can go to that fellow and say, hey, I'm your training director and I don't see you engaging in this, what's going on? And then you can establish the safety of the conversation to find out what's going on. And if the person really says, well, I'm not interested, again, we go back to, well, this is core to the mission of what we're doing. So if you're not interested, are you really the right fit for this organization? But that can only come from the leadership. Well said, well said. We have time for possibly one more question if there's anyone there that would like to ask the last question. Let's see, I'm scrolling, scrolling, I don't see anything yet. I will ask this question then, I'm gonna try and skip anyone. So I know you, part of the presentation, you did highlight historical norms as far as, well, we've always done this. I think one of the things we sometimes forget is that even ourselves as people of color, sometimes we fall victim to that too. Absolutely. So how can we really have an awakening and break out of that and realize that just what we've been led to believe was the norm is not necessarily the case? That's why you need the ability to have diverse input and have people who have different perspectives, perspectives that may be divergent and sort of what the core of the organization thinks to really be able to share their experience and have it be shared in such a way that it's safe for them to do that without facing some recrimination and also that they're empowered that there's a process now that we will reflect on this and that we are really committed to understanding how we're gonna incorporate your perspective into what we think is our norm. And usually when that happens and happens successfully, we are able to sort of break out of, maybe this doesn't work. Maybe this actually really does not work. But it requires that conversation that us acting our way into new beliefs and it requires us to be able to really utilize diverse perspectives and input in such a way that we're not sort of defensive about it. We're good people and we've always been trying to do this and we're taking care of the patients and it's not about that. It's about, is this core to who we are? And are we really incorporating the matters that are central and relevant to the society that we live in right now? And I think people need to sort of be aware of that, that not everybody has that same experience and we can all get caught up in it because you're not just one identity. I think that's the other thing. Intersectionality is key here that people are different things. And that's why I said earlier, I can't tell what your perspective is or what you think about DEI and social justice related issues based on how you look. Can't tell that because there's so much that is reliant upon your lived experience and sort of your outlook. So I think we just have to really be intentional about that and organizations need to be able to self reflect critically. Are we really doing what we say we're doing? And would everybody agree to that? Would the most marginalized people in this organization really agree that we're on the right page? I agree. Once you're honest with yourself, you can live your own truth. So thank you once again, Dr. Forrester. I know I have some last minute slides. I believe we're gonna go through. Sure. All right, so how to claim credit. Please go ahead and follow the instructions below. If you have any issues, please go to the learning center at psych.org with any questions. Next, okay. And then the references. Thank you for that. In case anyone is interested, do remember you can download the slides from today's presentation. And once again, thank you on behalf of the American Psychiatric Association, Dr. Forrester. It's been a pleasure just hearing your presentation and learning from you and getting an insight into just a wonderful work that you're doing. Thank you so much. I really appreciated being here today. And thank you to everyone for attending. And have a great afternoon or morning, depending where you're coming from. Take care. ♪♪

diversity

equity

inclusion

sustainable change

leadership involvement

cultural intelligence

challenges in implementation

safe space

accountability