The civil rights psychosis

The latest All in the Mind from ABC Radio National has a fascinating discussion about how the definition of schizophrenia shifted throughout the 20th century in the USA as it morphed from being a disease of the withdrawn middle class female to being the affliction of the aggressive black man.

The program is an interview with psychiatrist Jonathan Metzl who discusses his new book The Protest Psychosis: How Schizophrenia Became a Black Disease.

Unfortunately, discussions about mental illness and race can quickly starting going round in circles. As we’ve discussed previously, the fact that an ethnic minority has higher rates of mental illness, does not, in itself, provide strong evidence that the mental health system is racist – as this could easily be a reflection of poverty or immigration, both of which have been shown to have been linked to mental illness independently of the skin colour of the peoples concerned.

However, Metzl’s critique is somewhat more subtle and he suggests that in mid-20th century America there were attempts, implicit or otherwise, to pathologise the civil rights movement by shifting the diagnosis for certain conditions – most notably, schizophrenia.

In fact, in 1968, an article in the Archives of General Psychiatry even proposed what was called ‘protest psychosis’, “a special type of reactive psychosis” that affected “American Negroes” which was caused by “the stress of asserting civil rights in the United States”.

At the time, the excessive and ad hoc use of the diagnosis of schizophrenia in the USA led to the famous ‘US-UK Diagnostic Study‘ where the States was brought in line with the standards and definitions used in Europe.

By the way, if you’re a regular All in the Mind listener don’t miss the extra audio that turns up on the blog. Sadly, you can’t download the extra audio directly because it is embedded in a playing widget, but if you mouseover or ‘View source’ you can see the whole URL for the extra mp3s and download by pasting this into your browser.

Link to AITM on ‘protest psychosis’.

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