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February 2018

Structural Competency and Psychiatry

Author Affiliations
  • 1Center for Medicine, Health, and Society, Department of Sociology, Vanderbilt University, Nashville, Tennessee
  • 2Department of Psychiatry, New York University, New York
  • 3Department of Anthropology, New York University, New York
  • 4Nathan Kline Institute for Psychiatric Research, Orangeburg, New York
JAMA Psychiatry. 2018;75(2):115-116. doi:10.1001/jamapsychiatry.2017.3891

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.