Mental Health Equity Champion – Dr. Sheryl Kataoka

Sheryl Kataoka, M.D., M.S.H.S., is a child psychiatrist and health services researcher who has focused her career on improving mental health care for youth and families living in under-resourced communities. She is professor emeritus in the UCLA Department of Psychiatry, where she had served as program director for the child and adolescent psychiatry fellowship and chaired school committees for both the American Academy of Child and Adolescent Psychiatry and the National Child Traumatic Stress Network. As a senior faculty member in school mental health research at UCLA, Dr. Kataoka is currently a co-primary investigator for a National Institute of Mental Health-funded grant, Right Care at Right Time: Digital Supported Peer Navigation for Addressing Child Mental Health Inequities, which aims to create an app-based well-being tool to improve access to care for diverse youth living in under-resourced communities.
Thank you for speaking with us and for your leadership in the field. When did you realize you wanted to pursue a career in child psychiatry?
Back when I was in medical school, psychiatry was quite stigmatized even within the medical profession. It wasn’t even on my radar to consider as a specialty. In my fourth year, all my residency interviews were set for pediatrics. But early that year, I did an in-patient child psychiatry elective, and the light bulb went off. I loved getting to know the children and families so in depth and all their psychosocial complexity. Also, at that time, I was grieving the loss of my sister and got connected with my own psychiatrist, a psychiatry resident. That was very profound. As someone who grew up in a Japanese American household, I would never have thought to see a psychiatrist myself. I cannot help but think that was critical to my going into psychiatry.
You shared that you were raised by three generations of family members who emigrated from Japan. How has your heritage shaped your perspective as a psychiatrist?
I was born and raised in a family of immigrants, where our cultural heritage was greatly valued. We celebrated. We gathered together. We ate amazing food made by my grandmother and great-grandmother. I have seen through my own family how mental health and well-being were foreign concepts, and how the journey of immigration can bring both strengths and challenges to a family. My family’s history of internment has also affected the way I view the world and what is going on around us. And why it is important for us as psychiatrists to also advocate for those who are not always able to advocate for themselves. My background has undoubtedly played a role in the work that I have done in trying to better understand how we, as psychiatrists, can support children and their families, those who have acculturative stress, those who experience racism and discrimination and those who don’t seek care because of stigma about their mental health condition or lack of available and acceptable resources.
In what ways do cultural and community contexts impact mental health?
Our cultural background is integral to our mental health. The beauty of psychiatry is that we value learning about how each person is unique, with their generational history, their family’s customs and beliefs, their neighborhood, who surrounds them, what school they attend, and how institutions and systems treat them. The cultural factors that we carry with us play a role in our mental health and well-being, and in our life trajectory – the ways we learn, how we make friends, develop self-esteem and move forward from life’s challenges. Part of our role as psychiatrists is to understand each individual in front of us and how we can support them within their cultural and community contexts.
I was trained in a traditional medical model. But my research has been embedded in community participatory work. That approach to research has helped shape my approach as a clinician in learning to partner with children and families, understanding their perspectives, honoring their lived experiences, and working together with them to find a solution. It has been an intentional shift, where I am constantly learning from the communities with which I get to collaborate.
Can you tell us more about what it means to engage in community-partnered participatory research?
The community-partnered participatory research approach was born out of a community partnership model developed by Loretta Jones, who founded Healthy African American Families in Los Angeles. She helped create this model of thinking about research in partnership with communities, in which equity is at the center of the research project and all voices are welcomed to the table. It means that community and academic partners work together in defining the research question, deciding on outcome measures, interpreting results, and contributing to scientific papers and presentations as well as community reports and meetings. For so long, researchers counted on community partners volunteering their time. We, as researchers, are paid to be at the table – why shouldn't the community partners? Ms. Loretta taught us that this is a partnership. We should honor the community's time, their experience, and their contribution to research.
You have extensive experience in partnering with schools. How can psychiatrists help promote mental health in school settings?
Psychiatrists can start by partnering with school leaders, listening to what their needs are and opportunities for psychiatrists to be more involved with the prevention of illness alongside school staff. Psychiatrists can provide education to parents, students, and staff, consult administrators about what mental health support might be helpful, as well as see patients directly in places such as school-based health centers. Seeing children and families in the natural environments of schools, where they spend their everyday lives, is an amazing way to support children and really gain insight into what they are experiencing. We as psychiatrists need to get out of our offices more and into community settings such as schools, into the places where kids and families spend so much of their lives. I have also partnered with schools on a research level. Working with schools and districts to evaluate what they are doing and helping them to improve the quality of the mental health care they are providing can also be an important role.
From your perspective as a clinician and a researcher, how can trauma- and resilience-informed mental health care be incorporated into schools?
There has been a lot of research now on ACEs, or adverse childhood events, which can impact a child's development, their ability to do well in school, and their social relationships. Trauma is so pervasive that we really have to understand its impact on a child. It often masks as other disorders. We need to make sure that we are taking all of the experiences a child has had into consideration when we are doing an assessment. And not only understanding the adverse experiences but also how to build on the strengths of each child. And not just thinking about resilience at an individual child level, but the importance of strengthening the family, the community, the school. There is a growing literature now on positive childhood experiences, or PCEs, that speaks to building resilience-informed communities and systems, including our schools.
Mentoring is also one of your passions. How did your own experiences as an APA Minority Fellow and an APA Program for Minority Research Training in Psychiatry Fellow impact your professional journey?
Both of those opportunities opened my eyes to what was out there. We often live in our own bubble and only see what is directly in front of us, what we are exposed to. I had never seen myself as a leader, or even as a researcher. I only knew my clinical bubble, and my love for medicine, psychiatry, and working with my patients. During residency, I was exposed to the APA Minority Fellowship, which helped me see so many roles of a psychiatrist and the immense impact we can have on our communities, policy, our profession, and the broader world. The APA Program for Minority Research Training in Psychiatry really launched my research career, enabled me to have protected time to learn how to do research, conduct studies, and most importantly find research mentors who helped guide my career.
As a speaker for the current fellows at the APA Spring Leadership Summit, it was so great to see all of those fresh faces excited about their next steps, pushing our field forward, and learning how they can make an impact. I feel like mentorship really gives back to the mentors too. I am constantly rethinking and challenging my own assumptions each time I am in conversation with our next generation of leaders.