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Schizophrenia: are Blacks particularly at risk?

C. Alexander Haywood | 5/25/2011, 5:33 p.m.

"The statistics on sanity are that one out of every four Americans is suffering from some form of mental illness. Think of your three best friends. If they're okay, then it's you."-- Rita Mae Brown (American Writer, b.1944)

What are we to make of the multitude of published studies that say African Americans are two to three times more likely than Whites to be diagnosed with schizophrenia, and that Black immigrants from war-torn Africa and the Caribbean are six to nine times more likely to be pronounced schizophrenic, than other residents of the United States?

Some say there is a xenophobic or, at the very least, biased-element in diagnoses of schizophrenia.

According to Websters dictionary online, to be sane is to be devoid of mental derangement.

With the American economy still in disrepair, even after an extended government crusade to provide various public services and subsidies, the mere mention of sanity might seem folly to some, and blatantly offensive to others who have yet to secure gainful employment in these harsh financial times. Specifically, the rate of joblessness among African Americans has reached 15.8 percent, according to the latest report from the United States Department of Labor, nearly double the rate of Whites.

Predominant among the psychological effects sustained by Blacks throughout the recession have been severe cases of chronic stress and depression, exacerbated by ongoing social, economic and medical inequities, reports the National Institute of Mental Health.

Until recently, schizophrenia, which is a mental disorder characterized by the disintegration of sound judgment and emotional responsiveness, was purported to be a conclusively problematic disease for people of color, Black men especially.

Originally considered a fairly harmless condition that primarily affected Caucasian patients, from the 1920s to the 1940s, schizophrenia was associated with what leading psychiatrists of yesteryear described as "emotional disharmony," and the suggested treatment for those affected was that they be nurtured, rather than feared.

The next two decades would usher in a dramatic shift in the meaning of the illness, however, where advertisements for advanced schizophrenia medication proliferated, and featured physically imposing Black men under the tagline "Assaultive and Belligerent." Apparently, "cooperation" could be achieved with balanced doses Haldol, one of several anti-psychotic drugs on the market.

According to Dr. Rahn Bailey, chairman of psychiatry and behavioral sciences at Meharry Medical College in Nashville, Tenn., some earlier mental health professionals tried to assert that having mental illness was an issue more prevalent in certain communities (people of color). "But with the advent of structured testing, we have found that the actual percentages of persons diagnosed with schizophrenia are essentially the same [across all ethnicities].

"In the not so distant past, there were less than objective measures used to diagnose the disease," Bailey continued, "As a psychiatrist, it would be hard for me not to make an argument that bias, discrimination, or even racism didn't play a role in this. But I think that there are a variety of other influences that should also be considered."

In his book "The Protest Psychosis," Jonathan Metzl, an associate professor of psychiatry at the University of Michigan (Beacon Press, 2009), delves into the tumultuous history of schizophrenia.

"Protest psychosis is a term used in psychiatric literature in the 1960s by White doctors in New York ," he told The Root in an interview. "It basically categorized Black men who were participating in civil rights as insane. It was a way to pathologize the civil rights protests."

Throughout the remainder of 2010, an abundance of subsequent reports and studies surfaced from various portions of the U.S., particularly out of Michigan, that Black men had been over-diagnosed with schizophrenia at a rate at least five times higher than other groups up to that point in time.