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Is there discrimination in the psychiatric treatment of African Americans that has ill-effects on patients and on the practice of mental health care in the United States? At the outset of our work to answer these questions, we conducted a literature review search from the 1850s to the present day. Studies eligible for inclusion are peer-reviewed literature reviews related to race and diagnosis. We searched for articles using the key terms "African American," "research or study," "health disparities," "cultural competency," and all types of mental illness including but not limited to "schizophrenia," "bipolar disorder," "depression," and "psychosis." We did not consider studies before 1850s or those that focused on non-African American populations. The articles were chosen on the basis of their impact on race and ethnicity in the diagnosis and treatment of all mental illnesses.
Given the extremely wide time scope that we consider, not all the literature that our searches yielded is discussed here; rather, we draw on the literature to support the thread woven throughout the paper: from overt doctrines of White supremacy to implicit biases that are widespread in our own day, the social disorder of racism gives rise to inequitable psychiatric treatment of African Americans in comparison with non-Hispanic Whites. Secondly, deeply substantive training in cultural competence as part of medical education for all, and increasing the numbers of physicians of color (graduates of both U.S. medical schools and international medical schools) are two central strategies for changing the status quo into one of equity in mental health care.
Today's Problem with Racism
They say crisis reveals true character. The current COVID-19 pandemic has exposed the discriminatory character of the United States (U.S.) health care system. African Americans are dying at alarmingly high rates from the coronavirus and the root cause is racism. Blacks represent a third of hospitalized COVID-19 patients, yet they are only 13% of the U.S. population.1
As of July 2, 2020, the Centers for Disease Control and Prevention (CDC) reported a total of 2,624,873 new cases of COVID-19 and 127,299 deaths.2 In New York, Black people made up 28% of COVID-19 deaths despite representing only 18% of the population, while non-Hispanic White people accounted for 27% of deaths although they represent 55% of the...