Implications of the EDUCATE Act on Graduate Student Externship Experiences in Psychology: Threats to Diversity, Inclusion, and Equitable Mental Health Care
The Embracing anti-Discrimination, Unbiased Curricula, and Advancing Truth in Education (EDUCATE) Act, introduced by Congressman Greg Murphy, M.D., raises significant concerns regarding the future of medical education and healthcare in America, particularly impacting graduate student externship experiences in psychology at medical and health education centers. These externships serve as critical learning environments for future psychologists, offering hands-on training and valuable exposure to various healthcare settings. Psychology graduate student externship experiences would be profoundly affected by the EDUCATE Act. The Act threatens to cut off critical federal funding to medical schools and healthcare centers that prioritize diversity and inclusiveness. In the 2023 APPIC Match Survey of Internship Applicants, it was found that 36% of applicants were matched to federally funded healthcare centers, and 12% were matched to medical schools. This indicates a substantial number of psychology graduate students rely on these federally funded centers for their externship experiences (APPIC, 2023).
The EDUCATE Act's potential impact on these externships is concerning, as it could severely limit opportunities for psychology students to gain diverse and inclusive training experiences. Applicants already express worries about disclosure of their identities to externship sites, with the average response indicating a “slight agreement” that such disclosure could result in bias or discrimination by the sites (APPIC, 2023). These fears are not unfounded, as research consistently shows that individuals from systematically marginalized identities, including racial, ethnic, sexual, and gender identities, face significant barriers to accessing quality healthcare due to systemic biases and disparities (Flores et al., 2020; Odonkor et al., 2021; Chauhan et al., 2020). Members of the LGBTQ+ community, in particular, often encounter discrimination and stigma in healthcare settings, leading to disparities in access to care and health outcomes (Green et al., 2023; Ahyan et al., 2020; Brown & Veinot, 2021).
Psychology graduate students, who are training to provide mental health services and support, require exposure to diverse patient populations and settings to develop cultural competence and sensitivity. Externships at federally funded healthcare centers and medical schools offer invaluable opportunities for this type of training. However, the EDUCATE Act's potential impact on funding could limit the availability of these externships, hindering the development of psychology students' abilities to provide equitable and culturally competent care. Furthermore, the Act's threat to cut funding for diversity and inclusion initiatives in medical education exacerbates concerns about colorblindness and systemic biases in patient care (West & Schoenthaler, 2017). Colorblindness in healthcare systems can result in differential treatment based on race or ethnicity from providers, compromising patient care and trust (Okah et al., 2022; Penner et al., 2016).
The Act's disregard for the impact of multiple systematically marginalized identities on health, particularly in psychology and mental health services, is troubling. Intersectionality theory suggests that individuals experience unique biases due to their multiple and intersecting marginalized identities, highlighting the importance of addressing these intersections in healthcare (Crenshaw, 1989; 1991). For example, LGBTQ+ individuals of color may face compounded challenges related to both their sexual and racial identity, leading to heightened experiences of discrimination and barriers to healthcare access (Macapagal et al., 2016). Addressing health disparities and providing equitable mental health services require a comprehensive understanding of how intersecting identities contribute to differential health outcomes. Psychology graduate students rely on externship experiences to develop these understandings and skills. Further, psychology graduate students who hold systematically marginalized identities could be at risk for bias and discrimination at such sites without DEIA initiatives in place, thus leaving their placements altogether. The EDUCATE Act, by potentially limiting funding for these crucial externship opportunities, threatens to hinder the development of psychology students' abilities to provide inclusive and equitable mental health care, and exacerbate fears of bias and discrimination among psychology graduate students, thus impeding progress towards addressing systemic biases in healthcare.
In conclusion, the EDUCATE Act's potential impact on federally funded healthcare centers and medical schools could have profound effects on graduate student externship experiences in psychology. Psychology students rely on these externships to develop cultural competence, sensitivity, and skills to provide equitable mental health care. The Act's threat to funding for diversity and inclusion initiatives further raises concerns about systemic biases in patient care. It is imperative that all stakeholders consider the far-reaching consequences of this legislation on the future of mental health services, the development of competent and inclusive psychology professionals, and the health and wellbeing of underrepresented psychology graduate students during critical externship placement.
A note from the Author: It is imperative that we highlight and consider the implications of the EDUCATE Act as psychology graduate students in order to shift the future towards equitable mental health care provision. We can start doing this by registering to vote and letting our voices be heard in response to policies threatening our education and future work to achieve equity for all. https://www.usa.gov/register-to-vote
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