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Medicalizing Ethnicity: The Construction of Latino Identity in a Psychiatric Setting. Vilma Santiago-Irizarry. Ithaca, NY: Cornell University Press, 2001. 178 pp.
Medicalizing Ethnicity is a provocative book: Its author, Vilma Santiago-Irizarry, is not afraid to reach difficult conclusions concerning the well-meaning attempt to include "culture" in the therapeutic practices of psychiatric counseling. Her conclusion is that despite the best of intentions, the Latino mental health practitioners she studied ultimately essentialize and stereotype "Latino culture" in their interactions with Latino patients. Moreover, she shows that the use of culture in the psychiatric setting actually reproduces the existing hierarchies that privilege "the rationality of medical science over the complex, elusive, and messy construct that is 'culture'" (p. 3).
Santiago-Irizarry was hired in 1989 as a senior research assistant to help evaluate three bilingual, bicultural psychiatric programs for Latino patients in New York City. These programs were the product of efforts by Latino mental health practitioners who sought to establish "culturally sensitive" psychiatric care for Latino patients. Although Santiago-Irizarry's research consisted mainly of ethnographic evaluations of these programs, Medicalizing Ethnicity is not an ethnography in the usual sense of the term. As the author notes: "This book is not an ethnography as such but an ethnographic study of the paradoxes involved in using notions of culture to validate entitlement in the United States" (p. 7). The introduction is a rich and detailed interrogation of the concepts of "ethnicity" and "culture" and their incorporation into mental health care programs. At the core of this discussion is the medicalization of ethnicity: the incorporation of an essentialized ethnicity into medical discourses and practices as a constitutive element of diagnosis and treatment.
Chapters 1 and 2 present the author's relationship to the evaluation research team for the three psychiatric programs. They also detail the history of the creation of special psychiatric facilities for Latinos...