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

Spector, Rachel E.

doi:10.1080/09638230020023570

Cited by 39 publications

(14 citation statements)

References 40 publications

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“…Colonial psychiatrists described violent outbursts of madness in African patients which Collomb termed "bouffée délirante" (1975, p. 96). It has been argued that the greater use of coercion in the psychiatric treatment of Black males in the UK and the USA may be linked to racial stereotypes of dangerousness among clinicians (Spector, 2001). This suggests a two-way traffic of perceptions of Black dangerousness (as of sexuality) with long roots in colonialism and the slave trade (Fanon, 1986;Gilman, 1985).…”

Section: Resultsmentioning

confidence: 97%

“I want the one that will heal me completely so it won’t come back again”: The limits of antipsychotic medication in rural Ghana

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2012

Transcult Psychiatry

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Campaigns to scale up mental health services in low-income countries emphasise the need to improve access to psychotropic medication as part of effective treatment yet there is little acknowledgement of the limitations of psychotropic drugs as perceived by those who use them. This paper considers responses to treatment with antipsychotics by people with mental illness and their families in rural Ghana, drawing on an anthropological study of family experiences and help seeking for mental illness. Despite a perception among health workers that there was little popular awareness of biomedical treatment for mental disorders, psychiatric services had been used by almost all informants. However, in many cases antipsychotic treatment had been discontinued, even where it had been recognised to have beneficial effects such as controlling aggression or inducing sleep. Unpleasant side effects such as feelings of weakness and prolonged drowsiness conflicted with notions of health as strength and were seen to reduce the ability to work. The reduction of perceptual experiences such as visions was less valued than a return to social functioning. The failure of antipsychotics to achieve a permanent cure also cast doubt on their efficacy and strengthened suspicions of a spiritual illness which would resist medical treatment. These findings suggest that efforts to improve the treatment of mental disorders in low-income countries should take into account the limitations of antipsychotic drugs for those who use them and consider how local resources and concepts of recovery can be used to maximise treatment and support families.

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Section: Resultsmentioning

confidence: 97%

“I want the one that will heal me completely so it won’t come back again”: The limits of antipsychotic medication in rural Ghana

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2012

Transcult Psychiatry

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“…For example, not a single study (to our knowledge) has varied the race of the defendant. This is a particularly important point when there is mounting evidence of racial bias in everyday judgments of various types (Pager, Bonikowski, & Western, 2009; Pletcher, Kertesz, Kohn, & Gonzales, 2008), whereby African-Americans are judged, for example, as less trustworthy (Stanley, Sokol-Hessner, Banaji, & Phelps, 2011) or more dangerous (Spector, 2001). Furthermore, there is evidence for racial bias in legal decisions specifically (Demuth, 2003; Hart, 2017; Hetey & Eberhardt, 2014; Johnson & Betsinger, 2009; Mitchell, Haw, Pfeifer, & Meissner, 2005; Mustard, 2001; Rachlinski, Johnson, Wistrich, & Guthrie, 2008; Sweeney & Haney, 1992).…”

Section: Discussionmentioning

confidence: 99%

Neuroscientific evidence in the courtroom: a review

2019

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The use of neuroscience in the courtroom can be traced back to the early twentieth century. However, the use of neuroscientific evidence in criminal proceedings has increased significantly over the last two decades. This rapid increase has raised questions, among the media as well as the legal and scientific communities, regarding the effects that such evidence could have on legal decision makers. In this article, we first outline the history of neuroscientific evidence in courtrooms and then we provide a review of recent research investigating the effects of neuroscientific evidence on decision-making broadly, and on legal decisions specifically. In the latter case, we review studies that measure the effect of neuroscientific evidence (both imaging and nonimaging) on verdicts, sentencing recommendations, and beliefs of mock jurors and judges presented with a criminal case. Overall, the reviewed studies suggest mitigating effects of neuroscientific evidence on some legal decisions (e.g., the death penalty). Furthermore, factors such as mental disorder diagnoses and perceived dangerousness might moderate the mitigating effect of such evidence. Importantly, neuroscientific evidence that includes images of the brain does not appear to have an especially persuasive effect (compared with other neuroscientific evidence that does not include an image). Future directions for research are discussed, with a specific call for studies that vary defendant characteristics, the nature of the crime, and a juror's perception of the defendant, in order to better understand the roles of moderating factors and cognitive mediators of persuasion.

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“…(2002) highlighted the growing concern with violence in MH settings, and strategies for its prevention and management. Staff are rightly concerned about violence, but it would appear that racial biases in perceptions of dangerousness influence patient management (Barnes & Bowl 2001, Spector 2001). This is borne out by the fact that, in a study comparing black and white patients, despite having lower scores on aggressive behaviour, black patients were perceived as being more dangerous (Bhui 2001).…”

Section: Discussionmentioning

confidence: 99%

Fear, black people and mental illness: A vicious circle?

Keating

Robertson

2004

Health Soc Care Community

123

103

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The relationships between black communities and the mental health (MH) services are fraught. Paradoxically, black communities receive the MH services they don't want, but not the ones they do or might want. Black people mistrust and often fear services, and staff are often wary of the black community, fearing criticism, and not knowing how to respond, are fearful of black people, in particular, young black men. The situation is fueled by prejudice, misunderstanding, misconceptions and sometimes racism. The present paper describes the findings of a study to explore the issues in greater depth. The study was premised on a belief that there are 'circles of fear' which lead to poorer treatment of black communities. A purposive sampling approach was used to seek out groups and individuals in whom the 'circles of fear' were likely to be evident. The findings suggest that there are fears which impact negatively on the interaction between black communities and MH services. Two major themes emerged in this study, i.e. the sources of fear and the consequences of fear. Sources of fear included perceptions of MH services, attitudes to mental illness and diagnosis, and experiences of hospital care. The impact of fear included limited trust, limited engagement and delayed help-seeking behaviour. The study concludes that these fears mar the interactions between these communities and MH services, affect help-seeking behaviour adversely, and lead to restrictive and punitive interventions. Progress will only be made in breaking the 'circles of fear' if there is a systematic change in the experience of black services users at each point in the care pathway.

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

Cited by 39 publications

References 40 publications

“I want the one that will heal me completely so it won’t come back again”: The limits of antipsychotic medication in rural Ghana

“I want the one that will heal me completely so it won’t come back again”: The limits of antipsychotic medication in rural Ghana

Neuroscientific evidence in the courtroom: a review

Fear, black people and mental illness: A vicious circle?

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