Other aspects of modern medicine and health care are inseparable from race are mental health diagnoses and treatment. Several racial elements affect the science and background of mental health more than you might initially imagine.
Misdiagnosis: The Case of Schizophrenia
As we’ve come to establish in several other articles, there exist great disparities in treatment of people of color, and mental health--unfortunately--is no exception.
Non-white Americans are not only far more likely to receive poor care that they tend to cease prematurely, but also not seek those services in the first place. Not to mention issues of accessibility.
A primary example of this inequity is the rate of misdiagnosis: black men are four times more likely to be diagnosed with schizophrenia than their white counterparts. Interestingly enough, before the Civil Rights Movement, schizophrenia was widely known as a harmless condition of the middle-class, only acquiring a negative connotation when researchers unduly concluded that schizophrenic aggression was correlated with African Americans.
This relationship is also intimately related to the disproportionate incarceration of people of color in America, wherein mental illnesses are often amplified without quality treatment. Disparities are also exacerbated by the fact that most of the physicians qualified to provide mental health treatment are white, which of course is not inherently discriminatory, but increases the likelihood of racial biases in health care.
Mental Health and Mass Incarceration
Indeed, psychiatric explanations of harmfully generalized behavior attributed with black people contributed to the rhetoric of criminality that bolstered mass incarceration.
The untold story of mass incarceration, however, is the relocation of many prisoners to mental hospitals wherein horrific shock therapies were used against patients. The alternative to such state-based mental health treatment proved to have an even uglier legacy, with the closing of state wards and long-term lack of mental health care for the people of color more likely to be dispossessed by racism and therefore seeking mental health treatment.
These modern-day issues are only evolutions of historical forms of racism. For instance, the father of American psychiatry--Benjamin Rush--penned the term “Negritude,” a mental illness only able to be cured by becoming white. Much later in American history, psychiatric justifications were used to substantiate segregation. Reports and studies claimed that African Americans had mental illnesses attributed with their tendencies to attempt escape or resist authority.
The mindset of psychological science as a means for justifying slavery and racism only persisted into the 20th century: many psychiatrists believed that African Americans were psychologically incapable and unfit for true freedom. Even when slavery was abolished, new forms of mental health disparities formed as black Americans experienced powerful displays of bigotry and racism.
Why is this history so important?
It’s all necessary context to help us conceptualize the legacy of racism in mental health and how it may impact people of color uniquely.
Racism in mental health does not solely exist at the modern-day level of treatment and bias, but is also structurally encoded into institutions that exist today. Understanding these systemic issues may help us gain clearer insight into how we may dismantle these structures at the surface and root causal level.
Resources:
Comentarios