The Intersection Between Psychiatric Misdiagnoses of Schizophrenia and anti-Black Racism
By Salma Metwally
A split mind
Before delving into this topic, it would be useful and arguably necessary to provide a diagnostic summary of schizophrenia and its more unfamiliar criteria, since understanding these and their context is crucial for providing context for the topic we’re discussing today.
Drapetomania: justice becomes insanity
In 1851, Samuel Cartwright, a psychologist in the southern states, claimed to have discovered an explanation for why slaves desired freedom from their masters: a mental illness called “drapetomania” that was unique to Black individuals. At the time, especially in the South, slaveowners were genuinely perplexed by slaves’ desires to be free and independent. Although seeing the absurdity of slavery is comically easy now, it wasn’t as easy before the Civil War, which is why so many slaveowners turned to psychology for an explanation. To them, slaves were meant to be subserving property that did as it was told without question or resistance.
When schizophrenia became a Black man’s disease
It was in the 1960s, during the Civil Rights Movement, when the cultural notions around schizophrenia shifted, from the benign and pitiful illness that afflicted helpless and overworked White women to the terrifying disease of the enraged and dangerous Black man’s mind. With the publication of the second edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM) came the transformation of the image of the White woman and the Black man. The White woman was now agitated or depressed and the Black man was no longer antisocial.53
During the 1960s, different medications were marketed specifically for the “angry Black male” who experienced delusions of victimization and persecution that caused him to “irrationally” attack the establishment. The most prominent neuroleptic (antipsychotic) to be marketed at this time was Haldol, a typical antipsychotic that was particularly infamous for its extreme sedating effects and significant role in causing tardive dyskinesia (an antipsychotic-induced movement disorder that occurs more commonly with older antipsychotics).
Healthy paranoia and cultural differences
Years of medical mistreatment have understandably led the Black community to be very suspicious of White authority figures.40 And while this is obviously a result of generations of racial trauma, many Black psychiatrists believe that this “healthy paranoia” towards the medical system is a legitimate clinical concern, especially since a significant number of patients with schizophrenia experience persecutory delusions surrounding the belief of malevolent psychiatrists or poisoned medications; Black patients have every right to be mistrustful.41 Not only are they more likely to be incarcerated for the same symptoms that White patients would instead be hospitalized for, but Black individuals are also more likely to be involuntarily sectioned or treated with hostility by both law enforcement and medical professionals.49, 52, 57
About the Author
Salma Metwally is a high school student from California. She enjoys researching political affairs, history, psychiatry, and neuroscience. In her free time, she likes to crochet and do Taekwondo. A fun fact about her is that she speaks four languages.