Mind and Culture

This article, in Tuesday's Washington Post, was the last in a series of three, discusses how there are racial disparities in how mental illnesses are diagnosed.

I thought it was disheartening, but very interesting. When I looked back on my 2nd Grade year w/ Ms. Seggio, I spoke of how there is a problem in the educational system that sees young black students held back at the drop of a dime and it sets them on a path toward underacheivement for the remainder of their school careers -- wasted talent due to incompetence, negligence or ignorance on the schools part.

Well shows another way that discrimination and prejudice can rear its head...and what's telling about both the educational system and psychiatric diagnoses is that the discrimination is not always done with harmful intent. Check the following exert from the story....

Because we have no lab test, the only way we can test if someone is psychotic is, we use ourselves as the measure," said Michael Smith, a psychiatrist at the University of California at Los Angeles who studies the effects of culture and ethnicity on psychiatry. "If it sounds unusual to us, we call it psychotic."

Zeber and a team of other researchers said they do not know why doctors were more likely to diagnose schizophrenia among blacks and Hispanics. Perhaps diagnostic measures developed primarily with white patients in mind do not automatically apply to other groups, said Zeber, who published his results in the journal Social Psychiatry and Psychiatric Epidemiology.

"Race appears to matter and still appears to adversely pervade the clinical encounter, whether consciously or not," Zeber and his colleagues wrote in their October 2004 report.

Darrel Regier, director of the division of research at the American Psychiatric Association and U.S. editor of the journal, said the study had been carefully conducted. He agreed that cultural differences between patients and doctors could result in misdiagnosis.

"I believe bias exists, and there is a risk a psychiatrist with a different cultural experience than a patient can misinterpret the expression of a psychiatric symptom," he said. "If you have a very religious group of patients and a very secular psychiatrist who thinks beliefs in spirits or hearing the voice of God is not normal, you are going to have misses."

Sometimes that's just it. A psychiatrist, no matter how many degrees, may not be culturally aware of certain things and tend to misdiagnose their patients.

When a jury wrongfully convicts or sentences a minority defendant, is always because of evil racism? I don't think so. Sometimes, preconceived notions can taint what someone may think about criminal intent, the likelihood they'll commit future crimes, etc...there's so much subconscious prejudice in this world, and America in particular.

Read the following and tell me if you think the diagnosing psychiatrist hates people of color...

She added, "Because the people who work on our unit are sensitive to the issues of African Americans, we are much more likely to look at our patients with eyes that aren't clouded by preconceived notions."

The psychiatrist recalled another case of a black man diagnosed as delusional. The man had talked about going to another city and getting revenge on people who had killed his son.

"The treatment plan was filled out by someone who was not part of our focus unit," she said. "She assumed it was a delusion -- she said, 'This man has a delusion that his son was killed in a hate crime.' " Hall checked out the man's account. It turned out to be true.

If it weren't for Hall, this potentially useful man (who definitely needs help, but was not expressing anything other than human thirst for revenge, unfortunately a common quality when someone's son dies from a hate crime) would've been medicated, maybe put on disability and marginalized.

I mean, when my father was in his late teens he was an angry black youth. He was a poli-sci major at Canisius and if he didn't become a Jehovah's Witness, he could've been anything from a civil right lawyer to a black extremist...who knows. His last two years in HS he quit the basketball team and stopped going to class because he was tired of the rhetoric and the conditions. He got the Canisis scholarsip because his academic advisors didn't want to lose young black dude like him to frustration and anger, so they pulled some strings. But during those years (16-19), Pops used to tell me that he used to talk about getting a sniper rifle, going to the top of City Hall and picking off white people during the lunch hour.

The man was fiercely intelligent and aware of what was going on, so he had misguided judgement about how and where to find catharsis. But he wasnt CRAZY. This man wasnt schizophrenic or delusional. he didn't need to be medicated...at least I don't think. But what if he went to a psychiatrist and said these things. Instead of marrying Linda Frazier and creating a productive, close-knit, god-fearing family...he could be some medicated hobo. Naa mean?!

This stuff has consequences.

I offer social conditions like these to the Americans that insist people of color use racism and prejudice too much as reasons or causes for the socio-economic dispairty in this country.

We're not making this up and people need to realize when these points are brought up, it's not always an indictment. Viewed in its proper, and maybe less judgmental light, its a factual observation.

But I don't know the solution -- at least I don't know a human solution. Being a Christian dude, I tend think God is the only personage that can right a whole world of wrongs, things inherent to imperfection.

But I do know that steps need to be taken in the right direction. You can't ask for anything other than a willingness to learn and accept.

I have white friends from Osh-Kosh, WI; Fairhope, AL; Alberquerque, NM; Boston; NC and other places. They teach me some things and I teach them some things.

Before they met me they probably didn't know too much a the black plight, before I met them I didn;t really have a fair view of affirmative action or fear.

Rodney King?