There has been has been a major focus on incorrectly diagnosing African Americans with Schizophrenia. This has caused several negative reactions such as, becoming dependent on the incorrect medicines that have been prescribed, unresolved mental health diagnoses, and negative well-being of the individual. This article goes on to suggest that clinicians often are from different cultures and ethnicities, and tend to develop a prejudice when seeing these African American clients. It is very well needed in counseling to be aware of cultural and contextual characteristics of an individual. This literature states that African Americans are less likely to be diagnosed with a mood disorder, and more likely to be diagnosed with Schizophrenia as their Caucasian counterparts. This article further discusses how an individual’s race, social class, salary, ethnicity, and sex play a role in incorrectly diagnosing blacks with Schizophrenia. There are several other factors besides race and gender that aid in the correct diagnosis of Schizophrenia in African American individuals.
Data for the study were obtained from the Management Information Services Division of the Indiana Family and Social Services Administration, which coordinates health services, maintains databases with medical, demographic, and treatment information for all clients admitted to state psychiatric hospitals (IFSSA, 2004). The study sample included all individuals 18 years and older with single admissions to state psychiatric hospitals in Indiana with diagnosis of schizophrenia or mood disorder s from January 1, 1988, to October 15, 1996 (Lawson, 1994). Race was categorized as white, African American and other (Arnold, Keck, Collins, Wilson, Fleck, Corey, Amicone, Adebimpe, & Strakowski, 2004).The other category, which consisted of American Indians, Asian Americans, and Hispanics, was less than two percent of the sample and was not included in the study analysis (Malgady & Zayas, 2001).
Other mental health diagnoses did not participate in this study. Homogeneous subgroups included schizophrenia-paranoia subtype, major depressive disorder, and bipolar disorder (Arnold, Keck, Collins, Wilson, Fleck, Corey, Amicone, Adebimpe, & Strakowski, 2004). The two residual subgroups consisted of other schizophrenia subtypes (Whaley, 1997). Chi-square tests were used to compare the overall distribution of the six diagnostic subgroups among blacks and whites, and compare the racial distribution of each homogeneous diagnostic subgroup with all other admission diagnosis (Whaley, 1997). Cross-tabulation was used to examine therelationships between race, principle admission diagnoses, and comorbidity (Whaley, 1997). Logistic regression was used to examine the relationship betweens between admission diagnoses of schizophrenia or mood disorders and their variables of race, age, gender, education, income, health insurance, and prior hospital admission (Whaley,1997).
As a result of this study, it was shown that African Americans are most likely to be diagnosed with schizophrenia when the abuse of substances is present. Demographic information played a role in the diagnosis of Schizophrenia. The demographic factors of color, and a limited educational level were very important variables in the diagnosis of schizophrenia. This study showed not diagnosing African Americans with a significant mood disorder increases a greater diagnosis of Schizophrenia in African Americans. This literature supported the hypothesis with the fact that more African Americans are not diagnosed with mood disorders, and are more speedily diagnosed with Schizophrenia.The demographic information of race and education level also played a great role in the diagnosis of Schizophrenia in blacks.
As a clinician, I am careful about passing judgment, bias, or providing a misdiagnosis with clients who have mental illnesses.There is a myriad of background information that should be readily available during the assessment process to avoid unethical practices while treating behavioral health clients. Culturalism and awareness is of utmost importance when "meeting your clients where they are."
References
Arnold, L. M., Keck, P. E., Collins, J., Wilson, R., Fleck, D. E.,
Corey, K. B., Amicone, J., Adebimpe, V. R., & Strakowski, S. M. (2004).
Ethnicity and first-rank symptoms in patients with psychosis.
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Indiana Family and Social Services Administration. (2004). Biennial
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Lawson, W. B., Hepler, N., Holladay, J., & Cuffel, B. (1994). Race as a
factor in inpatient and outpatient admissions and diagnosis. Hospital
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Malgady, R. G., & Zayas, L. H. (2001). Cultural and linguistic
considerations in psychodiagnosis with Hispanics: The need for an
empirically informed process model. Social Work, 46, 39-49.
Whaley, A. L. (1997). Ethnicity/race, paranoia, and psychiatric
diagnoses: Clinician bias versus sociocultural differences. Journal of
Psychopathology and Behavioral Assessment, 19(1), 1-21.
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