race and Protest psychosis
“[Racism] is a mass psychosis … the racist is a man crazed by hysteria at the idea of coming into equal human contact with Negroes. And this mass mental illness called racist is very much a part of the ‘American Way of Life’” – Robert Williams
The peak of the civil rights movement featured many African-American people vehemently opposing the rampant racism and racial discrimination that had been plaguing the United States since its inception. In order to invalidate and negate the demands of the African-American people, psychiatrists (all being white) began diagnosing black people with schizophrenia at an alarmingly high rate. Schizophrenia had started becoming associated with “the perceived hostility, rebellion, mistrust, and violence of Black men during the civil rights movement”1. This psychiatric shift is described by American psychiatrist Jonathan Metzl as protest psychosis in his book:
“The Protest Psychosis: How Schizophrenia Became a Black Disease“
Results from this rise of misdiagnosing affects psychiatry even today: African-American men are still being diagnosed with schizophrenia 2.4 times more than their white counterparts2. Not only that, but black patients in psychiatric hospitals are also more likely to receive both more antipsychotic medications and at higher doses than white patients3.
“Diagnosis is an inherently political interaction because diagnostic terminology is inherently politicized … even a correct diagnosis is always already a misdiagnosis.”
Jonathan Metzl
racial trauma and psychosis
It is known that black people are grossly misdiagnosed with psychotic disorders due to the stereotypes outlined above. However, factors that are often associated with the development of unusual behaviors are also extremely present in racial minorities in America.
Racial discrimination is associated with anxiety, depression, distrust of systems, and severe psychological distress4. A study conducted by Anglin, et al. (2014) interviewing 650 young adults and immigrants in America revealed that racial discrimination and trauma was “significantly associated” with the development of psychotic-like behaviors5.
Structural racism also features a strong association with negative health outcomes due to the fact that it is maintained through many different pathways in society. This can look like a reduction in flexible and non-discriminatory resources in segregated communities, and the interrelated loss of individual freedom and choice6.
"Structural Racism and Social Determinants of Psychosis" Video
Dr. Deirde Anglin conducts specialized research training in psychiatric epidemiology at Columbia University’s School of Public Health, and co-leads the Racial Inequities and Social Determinance unit at the school. In this video, she discusses the impact of structural racism and social determinants on the development of psychosis.