Charlayne Hayling-Williams: Dismantling structural racism, disrupting DC mental health care
Dr. Charlayne Hayling-Williams wasn’t born into poverty, but it surrounds her in the area around her office at Community Wellness Ventures in Southeast Washington. She's the psychologist daughter of a mother who was one of just two Blacks to graduate from her pharmacy school. Her great-grandparents graduated from college. She could have settled comfortably in Georgetown with a busy clinical practice.
Hayling-Williams said she could have ended up at a think tank or in academia after she spent 2010 to 2014 working in local, federal and congressional offices in the nation's capital. But that's when she decided to work on the problems caused by structural racism from the inside out: Moving from the government offices into the community that most needed the solutions.
She opened CWV in 2015 in the city's lowest-income ward and started heading in the direction health policy leaders say mental health has to go: Fully integrated into health care systems. And when it gets there, it needs cultural competence in a one-stop-shop for all the social and health challenges racism has wrought.
Her initial attempts to incorporate primary medical care into this "human service agency" were stymied by the pandemic and the broken mostly-Medicaid-covered system in which she's trying to integrate.
But she remains undaunted, focusing on her successful integration of services including housing, employment and disability services into a center that offers mental health and addiction treatment. CWV programs have reduced the impact of trauma, racism, and poverty, she said. The center also has a contract to run the Pathways to Wellness program for citizens reentering the community after incarceration - part of Mayor Muriel Bowser's Office of Neighborhood Safety and Engagement.
Here, she answers Five Questions from USA TODAY health policy reporter Jayne O'Donnell and Caitlyn Taylor, an intern with the Urban Health Media Project, which O'Donnell co-founded.
When and why did you decide you'd do more good if you did more than practice psychology?
The proverbial light bulb went on for me in college when I began to understand more fully the role of oppression and systemic racism in America. I knew at that time I was going to be a psychologist but there was a shift that made me realize I needed to focus on systems and that fully top down or bottom up approaches alone weren't going to be effective. I also knew i could accomplish more by integrating policy and practice than i could as a practicing psychologist. There is a tremendous amount of responsibility to train and supervise and help develop the next generation of behavioral health practitioners in a way that leading Community Wellness Ventures allows me to do as well.
It has long been abundantly clear that people in poverty are often found at the intersection of the worst of the healthcare, education, public safety, justice, and housing systems. As such, I knew relatively early on that my most significant contribution would be interrupting the intended course of oppression at the systems level. In college, I really developed a deeper understanding of the role of oppression and systemic racism in America. From that point on, I have consistently sought to promote systems change by integrating policy and practice in ways that allow me to impact the Black community on a larger scale. Building CWV as a system for transformational change that promotes equity in public health and is a training ground for the next generation of behavioral health change agents is my life’s work.
Health care delivery in America needs to be overhauled, just as most systems in America need to be overhauled. Structural racism and oppression are as American as anything else in the U.S. and are part of the tapestry of our country.
We're seeking to address the many problems differently beginning with the human behavior responses to the maladapted circumstances. The way people are responding to conditions is really indicative of the multiple needs we have in this country to change the way that we interact and the way engage all people, not just people of privilege, not just people in any one racial group, particularly the majority group. We need to provide that same level of care, if not more, to make up for all of the years of oppression for Black people and other people of color.
Who was your most influential mentor and what did you learn from that person?
It sounds cliche when people say their most influential person is their mother. But I have to say my mother, because she is a revolutionary in her own right. Growing up in the Jim Crow South in Louisiana in the Civil Rights era, she was a member of the class that integrated her high school. She always spoke truth to power around racism and my responsbility to elevate the conditions of our community. She created space for me to innovate, think and be an individual. She encouraged me to follow my passion when I said in eighth grade I wanted to be a psychologist. That gave me the fire to pursue my goals and dreams even to this day with the confidence that I will be able to contribute in meaningful ways to leave the world a better place than I found it. I can attribute a lot of my passion and purpose to her.
What are the typical obstacles that stand in the way of good health for your clients?
Quite often, we're encouraged to identify the most significant problem or challenge our clients face and I regularly shift that narrative to encourage people to realize our clients' issues are as complex as the multiple challenges they face in everyday life. There's no one thing that is the source of the problem.
For example, a client needed support throughout her pregnancy and wanted to seek behavioral health care due to conflict with her partner at the time. She lost her job because she was constantly on her feet. Then she needed housing and didn’t have adequate resources for her child, so our team helped out with that. Both of her parents had issues with substance misuse and challenges she witnessed growing up. Even though she was able to head off to college, she was taken advantage of, reportedly, by an older man who sexually abused her, causing her to come home and develop depression.
Over the course of treatment, our team has served her partner - individually and in couples counseling - mother, and sister. We have assisted her with securing stable housing, employment, and childcare. She and her family have full teams working daily to address systemic barriers beyond what is traditionally viewed as behavioral health. Again, this is an illustration of the direct outcomes of systemic oppression at work. The outcomes are a mere reflection. The system is nothing if not effective. The necessary work is dismantling it.
What’s your advice for young Black Americans who want to make a big difference in the lives of their contemporaries?
My advice is three-fold.
First, the most powerful thing you can do as a young Black American is equip yourself with the knowledge of who you are and the resilience and brilliant history of Black people in America and throughout the diaspora. And that's regardless of what messages are perpetuated in the mainstream. That knowledge alone is very powerful and strengthening in a number of ways as we work collectively toward a more equitable world.
Purpose. Work early and often to identify why you're here and what particular talents you have that will improve the human condition. When we focus specifically on our purpose, we are so much more likely to be impactful and to feel a sense of accomplishment and pride in the life that we live.
And legacy. That is realizing that time and tomorrow is not promised and we're building our legacies as we speak. What we do at 15, 20, 25 and 30 is as much a part of our legacy as what we do at 40, 50 and 60. Having a true sense of who we are, and why we are here, and what we’d like to leave behind is the essence of consciousness.
The combination of those three factors are quite likely to yield a passion-driven, thoughtful and impactful life.
What do you want your own legacy to be?
CWV is my legacy in a lot of ways. It represents my husband and I building upon the dreams of our ancestors that our daughters can be proud of and continue. I hope to leave a replicable system of care that elevates the conditions of Black people in poverty in every way that counts. We empower people, engage families, and enrich communities…that is my legacy.
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This article originally appeared on USA TODAY: Dismantling structural racism by disrupting mental health care in D.C.
