Is there racial bias in clinicians' perceptions of the dangerousness of psychiatric patients? A review of the literature

Spector, Rachel E.

doi:10.1080/09638230124205

Cited by 14 publications

(18 citation statements)

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“…Firstly, despite government initiatives to deliver race equality in mental health (DH 2005), Black Caribbeans in the UK continue to report poorer access to and experiences of mental health services (CHAI 2007). Institutional racism and the use of racial stereotyping have been shown to negatively influence clinical encounters and outcomes and to contribute to the over-representation of Black Caribbeans in secondary and tertiary care (Ahmad 1999, Hickling and Hutchinson 1999, Littlewood et al 2001, Spector 2001. As illustrations, commentators highlight the emergence of 'racialized' psychiatric categories such as 'cannabis psychosis' and 'rastaphrenia' in the last decades of the twentieth century (Sashidharan 1993, Hickling and Hutchinson 1999, Takei et al 1998).…”

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confidence: 99%

Ethnicity and mental health encounters in primary care: help-seeking and help-giving for perinatal depression among Black Caribbean women in the UK

Edge¹,

MacKian²

2010

Ethnicity & Health

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Perinatal depression among Black Caribbean women in the UK remains an intriguingly under-researched topic. Despite high levels of known psychosocial risks, Black Caribbeans remain relatively invisible among those seeking/receiving help for depression during and after pregnancy.In-depth interviews were undertaken with a purposive sample of twelve Black Caribbean women selected from a lager sample (n=101) to examine prevalence and psychosocial risks for perinatal depression among this ethnic group. The study also sought to explore women's models of help-seeking. During analysis, the context in which help-seeking/giving is mediated emerged as a key issue. We explore the nature of these encounters thereby opening up the possibility of finding common ground between service users and providers for enabling women to receive the care and support they need.Whether or not women configure depressive feelings as 'symptoms' requiring external validation and intervention is a reflection both of the social embeddedness of those individuals and of how 'help-givers' perceive them and their particular needs. We suggest that the ways in which helpseeking/giving are commonly conceptualised might offer at least a partial explanation for apparently low levels of diagnosed perinatal depression among Black Caribbean women. Popular approaches to health seeking behaviours within health promotion and practice focus on individuals as the fulcrum for change, tending to overlook their embeddedness within 'reflexive communities'. This might serve to reinforce the invisibility of Black Caribbean women both in mainstream mental health services and associated research. Alternative approaches may be required to achieve government targets to reduce inequalities in access, care, and treatment and to deliver more responsive and culturally-appropriate mental health services.

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confidence: 99%

Ethnicity and mental health encounters in primary care: help-seeking and help-giving for perinatal depression among Black Caribbean women in the UK

Edge¹,

MacKian²

2010

Ethnicity & Health

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“…It is unclear why ethnicity should be associated with this form of aggressive behaviour. While this study cannot rule out differences in the management of ethnic minority patients by staff (Spector 2001), previously observed ethnic differences in the use of coercion have been explained by geographical region rather than evidence of institutional racism: hospitals in areas with a relatively high ethnic minority population are likely to be more coercive (Bennewith et al . 2010).…”

Section: Discussionmentioning

confidence: 72%

Inpatient verbal aggression: content, targets and patient characteristics

Stewart¹,

Bowers

2012

Psychiatric Ment Health Nurs

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Verbally aggressive behaviour on psychiatric wards is more common than physical violence and can have distressing consequences for the staff and patients who are subjected to it. Previous research has tended to examine incidents of verbal aggression in little detail, instead combining different types of aggressive behaviour into a single measure. This study recruited 522 adult psychiatric inpatients from 84 acute wards. Data were collected from nursing and medical records for the first 2 weeks of admission. Incidents of verbal aggression were categorized and associations with patient characteristics examined. There were 1398 incidents of verbal aggression in total, reported for half the sample. Types of verbal aggression were, in order of prevalence: abusive language, shouting, threats, expressions of anger and racist comments. There were also a large number of entries in the notes which did not specify the form of verbal aggression. Staff members were the most frequent target of aggression. A history of violence and previous drug use were consistently associated with verbal aggression. However, there were also some notable differences in patient variables associated with specific types of verbal aggression. Future studies should consider using multidimensional measures of verbal aggression.

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“…Doctors who expected to see paranoid schizophrenia in young Black men interpreted hostile behavior as symptoms, ignoring the social factors underlying their behavior. Studies are mixed about the prevalence of Black stereotyping among clinicians today, with some studies suggesting that White clinicians are still affected by negative stereotypes of Black men (Abreu 1999; Loring and Powel 1988;Spector 2001) and other studies suggesting that attitudes among White clinicians toward Black men have shifted away from negative stereotypes (Woods 1999). 12 While the 12 One study shows that British psychiatrists are less likely to view Black psychiatric patients as more violent than White patients (Minnis et al 2001), though a study from a previous decade suggested that British psychiatrists did hold negative stereotypes toward Black men (Lewis, Croft-Jeffreys, and David 1990).…”

Section: Injustices In Diagnosismentioning

confidence: 99%

“Clinician Knows Best”? Injustices in the Medicalization of Mental Illness

Gosselin

2019

fpq

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This paper uses a non-ideal theory approach advocated for by Alison Jaggar to show that practices involved with the medicalization of serious mental disorders can subject people who have these disorders to a cycle of vulnerability that keeps them trapped within systems of injustice. When medicalization locates mental disorders solely as problems of individual biology, without regard to social factors, and when it treats mental disorders as personal defects, it perpetuates injustice in several ways: by enabling biased diagnoses through stereotyping, by exploiting and coercing people who are seen as insufficiently competent, and by perpetuating idealized conceptions of choice and control that do not take into account people’s real limitations and the social context of health. Through practices of diagnosis, treatment, and recovery, medicalization can perpetuate injustices toward people who have serious mental disorders.

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Is there racial bias in clinicians' perceptions of the dangerousness of psychiatric patients? A review of the literature

Cited by 14 publications

References 0 publications

Ethnicity and mental health encounters in primary care: help-seeking and help-giving for perinatal depression among Black Caribbean women in the UK

Ethnicity and mental health encounters in primary care: help-seeking and help-giving for perinatal depression among Black Caribbean women in the UK

Inpatient verbal aggression: content, targets and patient characteristics

“Clinician Knows Best”? Injustices in the Medicalization of Mental Illness

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