“Nonpsychotic African-American patients had shorter lengths of stay than white patients with similar disorders. White patients were more likely to be on one-to-one observational status. Clinicians were more likely to order urine drug screens for African American patients with high socioeconomic status than for comparable white patients. African American patients with schizophrenic disorders received higher neuroleptic dosages than white patients with similar diagnoses.”

“The 1980 study by Flaherty and Meagher concluded that treatment differences between American-American were most likely a result of racial bias and clinicians’ unfamiliarity with African-American patients.”

“First, we did not find most of the previously cited differences in treatment between African-American and white patients with psychotic disorders….However, in the subsample of patients with schizophrenia or schizophrenic disorder, we found that African-American patients had a higher average daily neuroleptic dose, a finding that is consistent with more recent studies.
The possibility that African American patients with schizophrenic disorders might be less responsive to neuroleptic medication must be considered. Higher neuroleptic dosages among African Americans has generally been attributed to the effects of clinicians’ racial bias on diagnosis and treatment. This explanation is only one of several possibilities as biologic, diagnostic, cultural, and environmental factors must also be considered…. The difference between racial groups in rates between personality disorder diagnoses raises the question of whether substance abuse diagnoses were appropriately considered for white patients.”

“Our finding of a difference between racial groups in the use of a rigorously defined one-to-one observation status raises the concern that African Americans may be less forthcoming than whites about suicidal thoughts because they may experience “cultural distance” or feelings of distrust in a hospital setting staffed predominantly by whites.

“In our sample, African Americans were more likely to receive a discharge diagnosis of psychotic disorder not otherwise specified (9.2 percent) compared with whites (1.1 percent)…
Racial differences in treatment can be real and meaningful. However, overreliance on racial bias as the primary explanatory factor can inadvertently decrease further scientific inquiry into such differences… Given the history of differential psychiatric treatment of racial and ethnic groups and the current debate on access to health care in future reforms, more studies are needed to determine the quality and efficacy of treatment in these groups and to establish the need for culturally specific interventions that are substantiated by differences in diagnosis and treatment.”