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An effort to increase the number of psychiatrists of color

After 35 years in law and advocacy, Rawle Andrews Jr. returns to his roots

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Rawle Andrews, Jr. is executive director of the American Psychiatric Association Foundation. (Courtesy photo)

Rawle Andrews Jr. took an indirect path to become executive director of the American Psychiatric Association Foundation (APAF). 

From a psychology major in college to becoming a lawyer, the passion for equity and inclusion that fueled him during his years at AARP and as a professor at Howard and Georgetown universities serves as the foundation for his career in mental health.

Andrews has made it his mission at APAF to prioritize youth mental health — including in schools in D.C. and across the country — and to reduce stigma around mental illness and increase the number of psychiatrists of color practicing in the U.S. 

Andrews, who began his educational career studying psychology, said he felt out of place in college when his classmates were pursuing medical careers and he was more interested in law.

“I was the only person in my cohort who was going to law school,” he said. “Everybody else wanted to be a doctor and go to medical school.” 

Everything changed for Andrews during the COVID-19 pandemic and after George Floyd was killed by police in Missouri: Those pivotal moments reshaped national conversations about health, race, and inequality, and pushed Andrews to rethink his career.  

“I saw people deathly afraid of some disease, but also mortified by the fact that they witnessed somebody die on TV,” he said. 

After nearly 16 years working as a lawyer in private practice and 15 years at AARP, Andrews found himself pulled back to mental and “whole body” health. 

“My goal in law school was to be a courtroom lawyer all the time. If you had told me in 1990 that I would be a practicing lawyer going to court every day, I would have laughed you out of this room. If you had told me in 2010 that I wouldn’t be an in-house lawyer every day … I would have laughed you out of this room,” he said. “Everybody thinks you’re going to go straight from A to B. Life doesn’t work A to B.” 

Now, Andrews says, he has the “ability to serve the whole house.” He can help “the eight-year-old who’s struggling in middle school … the parent who’s trying to get that child through, but also caring for an older loved one … who might have some cognitive decline or mobility challenges.” 

Building a pipeline of Black mental health professionals  

In his role at APAF, Andrews has his sights set on increasing the number of psychiatrists nationwide by reducing barriers to study and success, particularly for practitioners of color, who are vastly underrepresented. 

Only about 5% of physicians are Black, and the number for Black psychiatrists is even lower at just 2%, according to the American Psychiatric Association. Widespread stigma around mental illness in communities of color, combined with “systemic barriers that keep persons of color from getting into medical school and matching for residency with teaching hospitals after graduating,” have contributed to the low numbers, Andrews says. 

Financial pressures, limited residency slots, and a lack of exposure to psychiatry as a viable career all play important roles in limiting Black representation in the field. At the same time, stigma surrounding mental health — especially in Black communities — can discourage both patients and future physicians, according to Andrews. 

He explains that this stigma is rooted in underlying fear, shame, and historic discrimination, and the only way to deal with those issues is directly. If you break those down, Andrews said, you can actually address them.

There are signs of change, though. “In the digital world, more and more people are seeing and talking about mental health all the time,” Andrews said. “And I believe more and more young doctors of all colors are deciding, ‘we need more psychiatrists, and I want to be a part of that solution.’”

Not having enough psychiatrists of color has far-reaching consequences. If you are a “non-diverse” physician or a physician practicing without humility or cultural competency, you may over-diagnose or misdiagnose a patient, said Andrews. You might assume a patient has symptoms due to your own cognitive biases.

A 2024 study in the Journal of General Internal Medicine revealed that mistrust and suspicion were high among dozens of Black patients with serious mental illness, who said they felt doctors did not take their concerns seriously or took a condescending tone with them during appointments.

This type of treatment does not promote trust or disclosure, Andrews said. “What is my advantage to be vulnerable with people who don’t think much of me, because you already thought I was broken?”  

To combat medical racism and bias, APAF runs one of the largest psychiatry pipeline programs in the world. It provides more than 1,000 medical students from underrepresented and marginalized communities with training and professional development. Programs like the Diversity Leadership Fellowship emphasize cultural competency and evidence-based practices to better serve diverse groups and at-risk populations. 

These programs have had tangible success in producing leadership in the field of psychiatry: APA’s CEO Dr. Marketa Wills, the first CEO of color and first female CEO in the APA organization’s 180-year history, was a trainee with the APAF nearly three decades ago. 

Despite efforts to make healthcare more equitable for patients of color and members of the LGBTQ+ community, many experts believe that racism and biases are more deeply ingrained in the system than many realize. For example, a 2019 study found that Black patients suffering from depression are often misdiagnosed with schizophrenia, and a 2016 study revealed that many doctors wrongly believe that Black patients have higher thresholds for pain tolerance.

“If you don’t have cultural humility or cultural competency, you could over-diagnose somebody because you’re looking for them to be ADHD, you’re looking for them to be bipolar, you’re looking for them to be schizophrenic,” said Andrews. “And then, because of the fears, the stigmas, the shame, people don’t want to go and get tested either.”  

Youth mental health focus

Andrews says many fear that telling someone else about their struggles will cause that person to look down on them. That unwillingness to share about mental health challenges can start at a young age. 

That’s why the APAF has partnered with local organizations in the Washington, D.C., area to help young people address mental health concerns. One of the programs, Our Minds Matter, operates in D.C.-area schools and other states to educate students on signs of emotional distress and how to address it. APAF also runs the Notice.Talk.Act. at School program, which helps train school staff to recognize and address student mental health issues and connect them to resources. The program was recently adopted at Jefferson Middle School Academy. 

The program is “the ‘stop, drop and roll’ of mental health,” Andrews said. “How do I notice signs and symptoms of distress in a student? How do I create an open space to talk and be a better active listener with a student who wants to share their mental health concerns and then act?” 

APAF’s program, funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) and free to schools, trained about 890 school staff members across the country in 2024, and boasts a 70% reduction in truancy and 89% reduction in disciplinary referrals, according to the foundation. 

Notice.Talk.Act. is not just in schools — there are versions for home, for college, for the workplace.

Andrews hopes that this work with the APAF will reduce the stigma surrounding mental health struggles and improve access to culturally competent care. But he acknowledges there’s still a long way to go. 

“We are planting and sowing seeds now and fertilizing the soil and tilling the soil,” he said. “We know that the next generation of doctors is going to look closer to the way the population looks. But ultimately, we still haven’t done enough.”  

(This work is part of a partnership between the Washington Blade Foundation and Youthcast Media Group, funded through the FY26 Community Development Grant from the Office of D.C. Mayor Muriel Bowser. Jebeh Pajibo is a senior at Bard High School Early College DC, one of Youthcast Media Group’s journalism class partners. Sarah Gandluri, a UNC-Chapel Hill sophomore, is an intern and former high school participant with YMG. YMG founder, former USA Today health policy reporter Jayne O’Donnell, contributed to this report.)

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Federal Government

Republicans attach five anti-LGBTQ riders to State Department funding bill

Spending package would restrict Pride flags on federal buildings, trans healthcare, LGBTQ envoys

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(Washington Blade photo by Michael Key)

As Congress finalizes its funding for fiscal year 2027, Republicans are attempting to include five anti-LGBTQ riders in the National Security and Department of State Appropriations Act.

A rider is an unrelated provision tacked onto a bill that must pass — in this instance, the bill provides funding for national security policy and for the State Department.

The riders range from restricting Pride flags in federal buildings to banning transgender healthcare, but all aim to limit the visibility and rights of LGBTQ Americans.

The five riders are:

Section 7067(a) prohibits Pride flags from being flown over federal buildings.

Section 7067(c) restricts the United States’ ability to appoint special envoys, representatives, or coordinators unless expressly authorized by Congress. These roles have historically been used to promote U.S. interests in international forums — including advancing human and LGBTQ and intersex rights and other policy priorities. The change would halt what the Congressional Equality Caucus describes as providing “critical expertise to U.S. foreign policy and leadership abroad.”

Section 7067(d) reinforces multiple anti-equality executive orders signed by President Donald Trump, effectively requiring that foreign assistance funded by the United States comply with those orders. This includes rescinding federal contractor nondiscrimination protections, including for LGBTQ people.

Section 7067(e) prohibits funding for any organization that provides or promotes medically necessary healthcare for trans people or “promotes transgenderism” — effectively banning funds for organizations that recognize trans people exist. This is despite the practice of gender-affirming care being supported by nearly every major medical association.

Section 7067(g) reinforces two global gag rules put forward by the Trump-Vance administration. One is the Trans Global Gag Rule, which prohibits foreign assistance funding for organizations that acknowledge the existence of trans people or advocate for nondiscrimination protections for them, among other activities. The second is the DEI Global Gag Rule, which prohibits foreign assistance funding for organizations that engage in efforts to address the ongoing effects of racism, sexism, and other forms of bigotry outside the United States.

The global gag rule has its roots in anti-abortion policy introduced by President Ronald Reagan in 1984, when the 40th president barred foreign organizations receiving U.S. global health assistance from providing information, referrals, or services for legal abortion, or from advocating for access to abortion services in their own countries. Planned Parenthood notes that the policy also affects programs beyond abortion, including efforts to expand access to contraception, prevent and treat HIV/AIDS, combat malaria, and improve maternal and child health.

If organizations funded by the State Department engage in these activities, they could lose funding.

This anti-LGBTQ push aligns with broader actions from the Trump-Vance administration since the start of Trump’s second term, which have focused on restricting human rights — particularly those of trans Americans.

The House Appropriations Committee is responsible for drafting the appropriations legislation. U.S. Rep. Tom Cole (R-Okla.) serves as chair, with U.S. Rep. Rosa DeLauro (D-Conn.) as ranking member. The committee includes 34 Republicans and 27 Democrats.

For FY27 appropriations, Congress is supposed to pass and have the president sign the funding bills by Sept. 30, 2026.

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Noticias en Español

The university that refuses to let go

Joanna Cifredo is a trans woman participating in University of Puerto Rico strike

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Joanna Cifredo outside the University of Puerto Rico campus in Mayagüez, Puerto Rico. (Washington Blade photo by Ignacio Estrada Cepero)

Over the past days, I have been walking with a question that refuses to leave me. Not the kind of question you answer from a desk or from a distance, but one that grows out of what you witness in real time, at the gates, in the faces of those who remain there without knowing how any of this will end. What is truly happening inside the University of Puerto Rico, and why have so many students decided to risk everything at a moment when they can least afford to lose anything.

I write as someone who lives just steps away from the Río Piedras campus. These days, the silence has replaced the constant movement that once defined this space. The absence is felt in every corner where students used to pass at all hours. Since arriving in Puerto Rico three years ago, I have come to know firsthand stories that rarely make it into reports or official statements. One of the reasons I chose to stay was precisely this, to serve the university community, to help create a space where students could find something as basic as a safe meal at night and, in some way, ease burdens that are often carried in silence.

I have listened, asked questions, and tried to understand without imposing answers. What I have found is not a collective outburst or a generational whim. What exists is a fracture, a deep break between those making decisions and those living with their consequences every single day.

There has been an effort to reduce this strike to an issue of order, scheduling, or academic disruption. Conversations revolve around missed classes, delayed semesters, and students supposedly unaware of the consequences of their actions. What is rarely addressed are the conditions that lead an entire student body to pause its own future to sustain a protest that offers no guarantees.

Because that is the reality. These are students who fully understand what they are risking, and yet they remain. When someone reaches that point, the least they deserve is not judgment, but to be heard.

From the outside, there have also been attempts to discredit what is happening. Familiar narratives are repeated, legitimacy is questioned, and doubt is cast over intentions. It is easier to do that than to acknowledge that this did not begin at the gates, but long before, in decisions made without building trust.

And something must be said clearly. This is not limited to the gates of Río Piedras. What we are witnessing extends across every unit of the University of Puerto Rico system. Mayagüez, Ponce, Arecibo, Bayamón, Cayey, Humacao, Carolina, Aguadilla, Utuado, and the Medical Sciences Campus. This is not an isolated reaction. It is a movement that runs through the entire institution. Río Piedras may be more visible, but it is not alone. What is happening there reflects a broader unrest felt across the system.

Within that context, one demand has grown increasingly present, the call for the resignation of University of Puerto Rico President Zayira Jordán Conde. This is not the voice of a small group. It reflects a deeper level of mistrust that has spread across multiple campuses.

The Puerto Rican Association of University Professors has also made it clear that this is not solely a student issue. There is real concern among faculty, and a shared recognition of the conditions currently shaping the university. When students and professors arrive at the same conclusion, the problem can no longer be minimized.

Meanwhile, the administration continues to speak in the language of dialogue. But dialogue is not a word, it is a practice. And when trust has been broken, it cannot be restored through statements alone, but through decisions that prove a willingness to truly listen.

In the midst of all of this, there are voices that cannot be ignored. Voices grounded not in theory, but in lived experience. One of them is Joanna Cifredo, a student at the Mayagüez campus, a young Puerto Rican trans woman, and someone widely recognized for her advocacy.

I spoke with her in recent days. What follows is her voice, exactly as it is.

How would you describe what is happening inside the University of Puerto Rico right now, beyond what people see from the outside?

Estamos viviendo momentos muy difíciles, en el sentido de que hay mucha incertidumbre y una presión constante por parte de la administración para reabrir el recinto, pero, entre todo el caos e inestabilidad provocado por las decisiones de esta administración, también hemos vivido momentos muy poderosos. Esta lucha ha sacado lo mejor de nuestra comunidad.

Lo vimos en las asambleas y plenos, donde 1,500, 1,700, hasta 1,800 estudiantes llegaron —bajo lluvia, bajo advertencias de inundaciones— y aun así se quedaron, participaron y votaron a favor de una manifestación indefinida hasta que se atiendan nuestros reclamos.

He conocido a tantas personas en los diferentes portones, estudiantes graduados, aletas, estudiantes de intercambio, estudiantes de todo tipo de concentraciones y se unieron para apoyar el movimiento estudiantil. Estudiantes que vienen a los portones después del trabajo o antes de trabajar. Estudiantes que vienen a dejar agua y suministros entre turnos de trabajo. Viejitos que vienen a los portones con desayuno, almuerzo o cena.

Más allá de lo que se ve desde afuera, lo que estamos viviendo es una mezcla de tensión y resistencia, pero también de comunidad, solidaridad y compromiso colectivo.

Much of what is discussed remains at the level of headlines or social media. From your direct experience, what specific decisions or actions from the administration have led to this level of mobilization?

Desde el inicio, la designación de la Dra. Zayira Jordán Conde careció de respaldo dentro de la comunidad universitaria. No contaba con experiencia administrativa en la UPR ni con un conocimiento básico de nuestros procesos, cultura y reglamentos. Por eso, en asamblea, el estudiantado votó para solicitarle a la Junta de Gobierno que no considerara su candidatura, y múltiples organizaciones docentes hicieron lo mismo. Existía un consenso amplio de que no tenía la experiencia necesaria para liderar una institución como la nuestra.

A pesar de ese rechazo claro, la Junta de Gobierno decidió ignorar los reclamos de la comunidad universitaria e imponer su nombramiento.

Una vez en el cargo, su estilo de gobernanza ha sido poco transparente y poco colaborativo. Sin embargo, el detonante principal de la movilización en el Recinto Universitario de Mayagüez fue su decisión de destituir, de manera unilateral y en medio del semestre, a cinco rectores, incluyendo al nuestro, el Dr. Agustín Rullán Toro, para reemplazarlo por un rector interino, el Dr. Miguel Muñoz Muñoz.

Esta acción, tomada de forma abrupta, provocó de inmediato un clima de caos e inestabilidad dentro de la institución. Y deja una pregunta inevitable: ¿no anticipó el impacto de esa decisión, lo que evidenciaría una falta de experiencia? ¿O lo anticipó y aun así decidió proceder? No está claro cuál de las dos es más preocupante.

Además, esta decisión tuvo consecuencias concretas para el estudiantado, incluyendo el retiro de becas educativas para nuevos integrantes del RUM por parte de la Fundación Ceiba, que calificó la movida como “sorprendente” y “preocupante”. Decisiones impulsivas como la que tomó la presidenta ponen en peligro la estabilidad de nuestra institución y la acreditación de la universidad.

As a trans woman within this movement, how does your identity intersect with what is happening, and why does this also shape the future of people like you?

Soy una de varias chicas trans que formamos parte activa de este movimiento estudiantil.

For those outside the UPR who believe this does not affect them, what are the real consequences of this crisis?

La Universidad de Puerto Rico se fundó para servir al pueblo.

It is impossible to overstate the role the University of Puerto Rico and its students have played in shaping the social, cultural, and economic life of this country. Its impact extends into science, medicine, and every profession that has sustained Puerto Rico over time. No other educational institution has contributed more.

After listening to her, one thing becomes undeniable. This is not just another protest, but a generation refusing to let go of what little remains within its reach. And when a generation reaches that point, the issue is no longer the strike, the issue becomes the country itself.

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District of Columbia

Judge issues revised order in Capital Pride stalking case

Defendant Darren Pasha agreed to accept less restrictive directive

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Darren Pasha (Washington Blade photo by Lou Chibbaro, Jr.)

A D.C. Superior Court judge on April 30 reinstated an anti-stalking order requested by the Capital Pride Alliance against local gay activist Darren Pasha based on allegations that Pasha engaged in a year-long effort to harass, intimidate, and stalk the organization’s staff, board members, and volunteers.

The reinstated order by Judge Robert D. Okun followed an April 17 court hearing in which he rescinded a similar order he initially approved in February on grounds that more evidence was needed to substantiate the need for the order.   

At the time he rescinded the earlier order he scheduled an evidentiary hearing for April 29 at which three Capital Pride staff members testified in support of the anti-stalking order. But Okun discontinued the hearing after Pasha, who was representing himself without an attorney, announced he was willing to accept a revised, less restrictive temporary restraining order.

The judge said Pasha’s decision to accept a restraining order made it no longer necessary to continue the evidentiary hearing. He then asked Capital Pride and Pasha to submit their suggested revisions for the order which they submitted a short time later.

The case began when Capital Pride Alliance, the D.C.-based LGBTQ group that organizes the city’s annual Pride events, filed a civil complaint on Oct. 27, 2025, against Pasha, accusing him of engaging in a year-long effort to harass, intimidate, and stalk Capital Pride staff, board members, and volunteers. It includes a 167-page addendum of “supporting exhibits” that includes multiple statements by unidentified witnesses.

Pasha, who has represented himself without an attorney, has argued in multiple court filings and motions that the stalking allegations are untrue. In his initial court response to the complaint, he said it appears to be a form of retaliation against him for a dispute he has had with Capital Pride and its former board president, Ashley Smith, who has since resigned from the board.

Similar to his earlier anti-stalking order against Pasha, Okun’s reissued order on April 30 states, a “Temporary Anti-Stalking Order is GRANTED, effective immediately and remaining in effect until further order of the Court or final disposition of this matter.”

It adds, “The defendant shall not contact, attempt to contact, harass, threaten, or otherwise communicate with any protected person, directly or indirectly, including through third parties, social media, electronic communication, or any other means.”

Unlike the earlier order, which did not identify the “protected persons” by name, the latest order includes a list of 34 people, 13 of whom are Capital Pride staff members or volunteers, including CEO Ryan Bos and Chief Operating Officer June Crenshaw. The other 21 people listed are identified as Capital Pride board members, including board chair Anna Jinkerson.

Possibly because Pasha addressed this in his suggested version of the order, the judge’s revised order says Pasha is allowed to visit the D.C. LGBTQ+ Community Center, where the Capital Pride office is located, if he gives the community center a 24 hour advance notice that he will be visiting the center, which hosts many events unrelated to Capital Pride. The earlier order required him to stay at least 100 feet away from the Capital Pride office.

The new order also prohibits Pasha from attending 21 named events that Capital Pride Alliance either organizes itself or with partner organizations that were scheduled to take place from April 30 through June 21. The order says he is allowed to attend the two largest events, the June 20 Pride Parade and the June 21 Pride Festival and Concert, in which 500,000 or more people are expected to attend.

It says Pasha is also allowed to attend the June 15 Pride At The Pier event organized by the Washington Blade.

But for those three events the order says he is restricted from entering “ticketed and controlled access areas.”

At the April 29 court hearing, Okun also scheduled a mandatory remote mediation session for July 23, in which efforts would be made to resolve the civil complaint case brought by Capital Pride without going to trial. 

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