‘Schizophrenia’ Is Not Color Blind

Psychiatry’s Achilles heel is the relationship between race and diagnosis. According to the rhetoric of mental health professionals, mental illness strikes indiscriminately, and there is no such relationship. In reality doctors are more likely to label people of color seriously mentally ill than they are people of northern European descent.

Three years ago, in the third part of a three part story from the Washington Post, Racial Disparities Found in The Pinpointing Mental Illness, we get this mention of John Zeber’s examination of one the largest databases of psychiatric cases to evaluate how doctors diagnose schizophrenia:

Although schizophrenia has been shown to affect all ethnic groups at the same rate, the scientist found that blacks in the United States were more than four times as likely to be diagnosed with the disorder as whites. Hispanics were more than three times as likely to be diagnosed as whites.

Zeber, who studies quality, cost and access issues for the U.S. Department of Veterans Affairs, found that differences in wealth, drug addiction and other variables could not explain the disparity in diagnoses: “The only factor that was truly important was race.”

Over-diagnosis is not a myth according to Jonathan Metzl, author of the recently published The Protest Psychosis: How Schizophrenia Became A Black Disease, whose book was recently covered in a review for Science Daily.

Black men are over-diagnosed with schizophrenia at least five times higher than any other group — a trend that dates back to the 1960s, according to new University of Michigan research.

Studying the archives of the Ionia State Hospital for the Criminally Insane, Metzl learned that black people from Detroit were often misdiagnosed schizophrenic, and sent there, during the civil rights era.

How the psychiatric profession defined schizophrenia also changed during this period [’60s and ’70s]. In the 1920s-1940s, doctors considered the illness as affecting non-violent white individuals (mainly women), but later changed the language to violent, hostile, angry and aggressive as a way to label black men, he added.

Pathologizing violent behavior has become a trend of late, hasn’t it? Perhaps the genesis of this trend was not such an innocent one as a unwary observer might at first think.

Too many people have been labeled mentally ill, and too many of those people so labeled are non-white. I am not at all surprised by these results, and I hope that in the future further research will be applied to this matter of racial bias in the diagnosis of mental illness.

4 Responses

  1. You might have meant to say ONE of psychiatry’s MANY Achillles heels.

    Sometimes I amuse myself by arguing in favour of psychiatry. It’s even funnier if I later find that my piss take is actually used as a serious argument.

    I’ll see if I can do it here. It could be said that Africans taken as slaves were less fit due to mental illness and less able to resist being captured and transported. Once landed in America their symptoms resurfaced as drapetomania, a psychotic obsessive disorder which manifests as running away behavior.

    Doesn’t sound any sillier than the stuff Torrey comes up with.

    • I recently responded on this blog to a woman’s editorial making the argument, a bad one in my opinion, that because Seroquel was being sold as a street drug charges of over-prescription were exaggerated or unfounded.

      The stigma argument, used ostensibly to drum up funding for mental health services, is essentially an under-diagnosis argument.

      I think the under-diagnosis position is mostly baloney, and that this problem
      of over-diagnosis is bigger than most people realise. A couple of doctors are being investigated for over-prescribing psychiatric drugs now, but these are doctors who have been ‘caught’ so to speak, and they’ve been found out only because somebody cared enough about the matter to launch a rare investigation into their prescribing practices.

      Robert Whitaker, author of Mad In America, in research and interviews has shown how mental illness rates have risen dramatically to epidemic proportions since the introduction of psychiatric drugs.

      In 1903 1 in 500 people were being treated for mental illness.
      In 1955 1 in 300 people were labeled in mentally ill.
      In 1987 1 in 75 people were said to suffer from a psychiatric disability.
      In 2005 1 in 50 people are so psychiatrically labeled.

      The New York Times has reported on poor children on Medicaid being prescribed psychiatric drugs at a much higher rate than children in general. In many places the rates of drugging children in foster care has been found to be higher than that of other children.

      When black and Hispanic people are being over-diagnosed, obviously there is something very fishy about this stigma argument.

  2. Metzls right my brother was wrongly diagnosed in the late 70’s which led to all kinds of problems for him throughout his 20’s.

    • This kind of thing happens more often than is acknowledged. I hardly think your brother alone in being wrongly diagnosed. If he managed to get out of the system, that’s great. More power to him!

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