Structural Competency Series

Our structural competency curriculum is designed to foster a deeper understanding of the ways in which the structural elements of society (e.g. poverty, racism, community development, access to institutions and services) impact the development, and overall wellness of individuals and communities. We recognize that individuals exist within the larger context of the society around them and therefore, in order to successfully work with children and families, we must understand and engage with the structural elements of society that impact their lives. As members of the medical community as well as the larger community that exists outside the doors of our clinic, we believe that it is our duty to examine not only the ways in which we can work with individuals to improve their health and wellness, but also the ways in which we can understand and interact with the societal structures that surround those individuals and their communities.

There are two major goals for this series:

  1. Residents will develop and understanding of the ways in which the outside world, and the structural elements of society, affect presentation of mental health concerns and therefore have implications for treatment and care. In other words, the world “outside” an individual affects the world “inside” the individual.
  2. Residents will become more comfortable and competent engaging with the structural determinants of health that affect the lives of the children and families that they work with.

In order to accomplish these goals, we ask ourselves three essential questions:

  1. How does the world “outside” affect the world “inside”? In other words, how do the structures and workings of society impact an individual’s social-emotional health and development?
  2. How can we bring an awareness of the structural determinants of health into our clinical practice?
  3. What examples of successful structural interventions can we find around us, and how can we be involved in working toward structural changes that promote the health and wellness of individuals and communities?

Throughout the two years of child and adolescent psychiatry training, fellows participate in several different types of learning experiences aimed at achieving the goals and addressing the questions above. As part of our didactic curriculum, fellows participate in a structural competency didactic seminar series, visit local community organizations working to address structural barriers to the health and wellness of our community and its members, and complete a group quality improvement project that addresses a structural barrier impacting the care of patients in our Children’s Psychiatry Clinic. Clinically, our fellows participate in community visits with our CAMPS mobile team and work with individual rotation supervisors to bring elements of structural competency into clinical care.

This series partners with several local organizations working to promote health equity and support meaningful social change.