10/05/2026
Psychiatry sits at the intersection of medicine, public health, education, social policy, and human experience. Few clinicians embody that intersection more fully than Sarah Vinson, MD, Chair of the Department of Psychiatry and Behavioral Sciences at Morehouse School of Medicine.
A child and adolescent psychiatrist, forensic psychiatrist, educator, entrepreneur, and nationally recognized expert on trauma and social determinants of mental health, Dr. Vinson has built a career focused on understanding not only psychiatric symptoms, but also the environments, systems, and life experiences that shape them.
Raised in rural Northwest Florida, Dr. Vinson trained at Harvard, completed fellowships in child and adolescent psychiatry and forensic psychiatry at Emory University, and has spent her career serving historically marginalized communities. Her work spans clinical care, forensic consultation, academic leadership, and scholarship, including her co-edited book Social (In)Justice and Mental Health.
In this conversation on The Gold Standard Podcastwith Dr. Mark S. Gold, Dr. Vinson discusses her professional journey, the importance of trauma-informed and culturally informed psychiatric care, disparities in diagnosis and treatment, the role of social determinants of health, and what psychiatry must do to better serve diverse communities.
From Rural Florida to Academic Psychiatry Leadership
Dr. Gold: You originally entered medical school planning to become a pediatrician. What led you to psychiatry?
Dr. Vinson: I came into medical school expecting to pursue pediatrics. Growing up in rural Northwest Florida, addiction was something I associated primarily with the criminal justice system. I didn't really understand addiction treatment or addiction medicine as medical disciplines.
During medical school, I was exposed to the neurobiology of addiction, and that completely changed my perspective. It helped me understand how profoundly these issues affected the community where I grew up and how urgently we needed better access to care and education. That experience ultimately led me toward psychiatry.
Although I didn't complete an addiction psychiatry fellowship, I pursued fellowships in child and adolescent psychiatry and forensic psychiatry, and many of the issues surrounding addiction, trauma, and access to care have remained central to my work throughout my career.
Dr. Gold: After medical school, you chose to leave the Southeast and train at Harvard. What motivated that decision?
Dr. Vinson: I always intended to return to the Southeast because it's an underserved region, but I also believed that I should get the strongest training possible before coming back.
I often tell students something I was told early in my own career: you only train once. I wanted to learn in an environment that would challenge me and give me the best possible foundation.
One of the most formative experiences of my training was working with Dr. Judith Herman and learning about complex trauma. That experience influenced my clinical care, my writing, my teaching, and my consulting work. It shaped how I think about psychiatric illness and how life experiences affect mental health across the lifespan.
Building a Career at Morehouse School of Medicine
Dr. Gold: What drew you to Morehouse School of Medicine?
Dr. Vinson: My undergraduate experience at Florida A&M University had a tremendous impact on me. Because of that experience, I always hoped to become faculty at a Historically Black College or University medical school.
Morehouse School of Medicine offered that opportunity. I came to Atlanta with that goal in mind and have remained affiliated with Morehouse throughout my career.
Before becoming chair, I was involved part-time while also pursuing clinical, forensic, and entrepreneurial work. That allowed me to gain experience in multiple sectors before stepping into academic leadership.
Dr. Gold: Tell us about the Department of Psychiatry and Behavioral Sciences at Morehouse.
Dr. Vinson: We're a community-based medical school, which means our work is deeply connected to community partners.
We don't operate our own hospital. Our primary clinical affiliate is Grady Memorial Hospital, Atlanta's safety-net hospital. We also work closely with community health centers, the Department of Juvenile Justice, the Georgia Department of Behavioral Health and Developmental Disabilities, and other organizations throughout the region.
Our department includes child psychiatrists, adult psychiatrists, consultation-liaison psychiatrists, addiction specialists, and an expanding forensic psychiatry presence. Over the past several years, we've grown significantly while maintaining our focus on serving underserved populations.
Forensic Psychiatry Through a Trauma-Informed Lens
Dr. Gold: You also founded a forensic mental health consulting practice. What prompted that effort?
Dr. Vinson: I recognized a significant lack of diversity within forensic mental health. At the same time, I was receiving more requests for consultation than I could handle personally.
Part of what was driving that demand was my approach. I bring a culturally informed and structurally informed perspective to forensic evaluation. Attorneys and courts increasingly wanted that perspective represented in their cases.
The practice allowed me to recruit and mentor clinicians who share that commitment. We've assembled an interdisciplinary team of Black and Brown mental health professionals who perform forensic work nationwide.
Dr. Gold: What types of cases do you evaluate?
Dr. Vinson: The cases vary widely.
On the child side, we evaluate issues involving child custody, parental fitness, educational discrimination, and the impact of trauma on children.
In criminal cases, we work with youth being considered for adult prosecution, individuals facing capital punishment, and people involved in post-conviction appeals.
Our role is often to help courts understand not simply what happened, but why. We examine developmental history, trauma exposure, intellectual disability, untreated psychiatric illness, and other factors that may have influenced behavior.
Very often, trauma and adverse life experiences are essential parts of the story.
Trauma as a Foundation for Psychiatric Understanding
Dr. Gold: Trauma appears repeatedly throughout your work. Why is it so central?
Dr. Vinson: Trauma frequently shapes how people experience the world, how they cope, and how symptoms emerge.
Being trained in child psychiatry and developmental psychiatry reinforces the importance of understanding what happened during a person's formative years. Even when I'm evaluating adults in forensic settings, childhood experiences are often critically important.
Development matters. Context matters. Understanding those experiences helps us understand later mental health challenges in a much richer and more accurate way.
Cannabis, Self-Medication, and Barriers to Care
Dr. Gold: You've spoken about cannabis use among youth as a reflection of broader access-to-care challenges. What do clinicians often miss?
Dr. Vinson: What many clinicians underestimate is how difficult it is for families to access timely, trauma-informed, culturally informed mental healthcare.
When young people are struggling emotionally and professional help is unavailable, many begin self-medicating long before they ever enter a psychiatric office.
In many communities, cannabis is viewed as relatively benign. Youth often know adults who use it regularly and appear functional. In some families, ma*****na is far more accessible than therapy, antidepressants, or psychiatric consultation.
When clinicians speak only about potential harms without acknowledging lived experience, those messages may not resonate. Effective care requires integrating research evidence with an understanding of what patients actually see in their daily lives.
When Trauma Looks Like ADHD
Dr. Gold: One area you've written and spoken about extensively is ADHD diagnosis. What concerns you most?
Dr. Vinson: ADHD is very real, but it's often what I think of as a gateway diagnosis. It's familiar, widely recognized, and generally less stigmatized than some other psychiatric conditions.
What I frequently see is trauma-related symptoms being labeled as ADHD.
Children exposed to violence, chronic stress, family instability, race-based trauma, or neighborhood adversity may develop concentration problems, hypervigilance, impulsivity, and emotional dysregulation. Those symptoms can resemble ADHD, but the underlying issue may actually be trauma.
Teachers are familiar with ADHD. Families are familiar with ADHD. As a result, that label can become a default explanation.
The challenge is that when trauma gets mislabeled as ADHD, the root causes remain untreated.
Dr. Gold: Is this a problem of overdiagnosis or underdiagnosis?
Dr. Vinson: It's both.
In some settings, ADHD may be overdiagnosed because trauma and anxiety aren't fully recognized. In other settings, children with genuine ADHD may go undiagnosed because of inadequate access to evaluation and care.
Those realities can coexist, particularly in marginalized communities.
Race, Trauma, and Psychiatric Diagnosis
Dr. Gold: You've also raised concerns about how trauma can affect psychiatric diagnosis, particularly in black patients.
Dr. Vinson: Trauma, substance use, psychosis, and racial disparities intersect in complicated ways.
During my work in juvenile justice, I frequently encountered young people diagnosed with bipolar disorder or psychotic disorders when what I saw was profound trauma.
Re-experiencing symptoms were sometimes mistaken for psychosis. Emotional numbing was sometimes interpreted as negative symptoms.
If clinicians are not actively exploring trauma, particularly race-based trauma or chronic adversity, it's easy to focus on symptoms and fit them into diagnostic categories without recognizing the experiences that produced them.
Our diagnostic systems don't always provide adequate frameworks for understanding those experiences.
As a result, trauma can be overlooked, and individuals may receive diagnoses that don't fully capture what's happening.
Caring for Patients Across Differences
Dr. Gold: What advice would you give psychiatrists who want to provide more culturally informed care?
Dr. Vinson: First, learn about the communities where your patients live.
You don't have to rely exclusively on what patients disclose. Information about neighborhood violence, housing instability, educational inequality, and community stressors is often publicly available.
Understanding those realities gives important context for the patient's experience.
Second, appreciate that trust develops over time.
Patients may not share deeply personal experiences during the first appointment. Sometimes they'll offer small pieces of information to see how you respond.
If a patient mentions a traumatic experience and the response minimizes it, that may discourage further disclosure.
Clinicians need the ability to sit with difficult experiences without dismissing or rushing past them.
Dr. Gold: Any additional guidance?
Dr. Vinson: Always be mindful of the gap between your lived experiences and those of your patients.
Most physicians occupy positions of privilege in some way. It is important to recognize how differently institutions and systems may respond to your patients.
Also, remain curious and committed to learning. There are books, podcasts, and educational resources available. Don't rely entirely on colleagues from marginalized backgrounds to do that work for you.
Finally, think beyond patient encounters. Consider the composition of your care teams, departments, and leadership structures. Diverse perspectives improve decision-making and ultimately improve patient care.
Identity as a Protective Factor
Dr. Gold: You've emphasized the importance of racial identity in mental health. Why is that topic often overlooked?
Dr. Vinson: A strong and positive racial identity can be profoundly protective for people from marginalized groups.
That was true for me growing up, and I've seen it repeatedly in clinical work.
Psychiatry often talks about symptoms and pathology, but we don't spend enough time discussing identity as a source of resilience.
Many therapeutic breakthroughs emerge from helping patients explore who they are, how they understand themselves, and how they navigate society.
Those conversations can be deeply healing and deserve greater attention within psychiatric practice.
The Social Determinants of Mental Health
Why Policy Matters to Psychiatry
Dr. Gold: What emerging issues concern you most?
Dr. Vinson: One major concern is the impact of policy decisions on social determinants of health.
Psychiatrists often see people after problems have already existed for years. Looking backward, we can frequently identify disruptions in housing, education, employment, healthcare access, and economic opportunity that contributed to the challenges people face.
When resources are reduced, marginalized communities are usually affected first and most severely.
As a child psychiatrist, I pay close attention to education and Medicaid because they affect large numbers of children and families.
Fundamentally, people need to feel safe. When they don't feel safe, it becomes much harder to learn, work, care for their families, or engage fully in treatment.
Predictability and stability matter. Without them, people experience diminished control over their lives, and that has significant mental health consequences.
Fear, Anxiety, and the Current Moment
Dr. Gold: How should psychiatry think about fear and anxiety in today's environment?
Dr. Vinson: We need to be thoughtful about distinguishing psychiatric disorders from reasonable responses to circumstances.
There are situations where people from historically marginalized groups are reacting to genuine threats or uncertainty. Those responses may look like anxiety, but they may actually be adaptive reactions to real concerns.
My hope is that we avoid reflexively labeling those experiences as anxiety disorders and immediately reaching for medication as the only intervention.
We should also be thinking about how communities can be supported and protected when their fears are grounded in lived reality.
Scholarship and Social Justice
Dr. Gold: Your book Social (In)Justice and Mental Health has received substantial attention. What was your goal?
Dr. Vinson: My co-editor, Dr. Ruth Shim, and I wanted to explore how systems of inequality influence mental health and mental healthcare.
The book examines institutions such as education and the criminal legal system, alongside diagnostic categories including schizophrenia and personality disorders. We look at how social injustice shapes both mental health outcomes and the ways systems respond to individuals experiencing distress.
Importantly, each chapter concludes with reflection questions. We wanted readers not only to absorb information but also to critically examine their assumptions and practices.
It's been gratifying to see the book used not only in academic settings but also by policymakers and community leaders.
Dr. Gold: Are you planning another book?
Dr. Vinson: Yes. I'm interested in developing a work focused on forensic mental health that applies the same culturally informed, structurally informed, and social justice-oriented framework to forensic practice.
Leadership, Sustainability, and Self-Care
Dr. Gold: You wear many hats: department chair, educator, forensic psychiatrist, author, consultant, and mentor. How do you sustain that pace?
Dr. Vinson: I believe strongly in modeling wellness.
I sleep seven hours a night. I vacation every quarter. I exercise five days a week. I get massages twice a month.
I genuinely love what I do, but I want to do it sustainably.
Too often in healthcare we talk about self-care without practicing it. For me, maintaining those habits is essential to remaining effective as a clinician, leader, and mentor.
Finding Hope in Psychiatry
Dr. Gold: Despite the challenges you describe, you remain remarkably optimistic. Where does that optimism come from?
Dr. Vinson: I get energy from the people I work with.
At our departmental retreat, we ask new faculty members to talk about their "why"—what brought them into this work. Hearing those stories is incredibly inspiring.
The people who choose careers in mental health are often deeply committed to improving lives and strengthening communities. Being able to support them and help create an environment where they can thrive is a privilege.
Yes, there are enormous challenges. But we also get to see the difference this work makes. We see lives change. We see healing happen. We see communities benefit.
That's what keeps me hopeful.
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Sarah Y. Vinson, MD is Chair of the Department of Psychiatry and Behavioral Sciences at Morehouse School of Medicine. She is a board-certified child and adolescent psychiatrist and forensic psychiatrist whose clinical, academic, and consulting work focuses on trauma, social determinants of health, cultural psychiatry, forensic mental health, and mental health equity.
Dr. Vinson completed medical school at the University of Florida, psychiatry residency training at Harvard, and fellowships in child and adolescent psychiatry and forensic psychiatry at Emory University. In addition to her academic leadership, she founded a forensic mental health consulting practice that provides culturally informed evaluations and expert services nationwide.
A nationally recognized speaker, educator, and scholar, Dr. Vinson is co-editor of Social (In)Justice and Mental Health, a widely used text examining the intersections of structural inequity, public systems, and psychiatric outcomes. Her work continues to influence clinicians, policymakers, researchers, and educators seeking to advance equitable, trauma-informed mental healthcare.
