“It was argued that the medical diagnoses of people of non-European origin, particularly with schizophrenia, were frequently inappropriate or even ‘wrong,’ biased by British psychiatric stereotypes of what constitutes ‘normality’ in different groups. Many West Indian immigrant patients who had been hospitalized with a diagnosis of schizophrenia were found in research studies to lack the symptoms of schizophrenia commonly regarded as of a primary diagnostic significance in such studies as the World Health Organization’s cross-national project on schizophrenia, itself modeled on British descriptive psychiatry. An earlier study which had showed that alcoholism was preferentially diagnosed among Irish people independently of actual symptomatology was cited to suggest that popular ethnic stereotypes carried over into medical practice. Increased salience was given to these issues by repeated findings that non-White patients of quite diverse linguistic and cultural backgrounds were two to three times more likely to be involuntary patients under the Mental Health Act than were comparable groups of Whites, whether these were native Britons or non-English speaking European immigrants. There was some evidence of differences in treatment. In one study Black patients were more likely to be given physical treatment and it has become generally recognized that access to psychotherapy is easier for Whites.”

“The shift from ‘cultural’ explanations to explanations based on race…. was supported by a study which showed that the British-born children of West Indian immigrants were likely to have even higher rates of diagnosed schizophrenia than their migrant parents.”

Patterns of Explanation include:

“(d) Misdiagnosis
Psychiatric diagnosis is less consciously racist than ethnocentric, and White Europeans are simply not very good at understanding the experiences of people rather different than themselves. These are often ‘misdiagnosed.’ The category of ‘abnormal personality’ is seldom recognized among minority patients, suggesting that medical perception of cultural baselines is uncertain: if in doubt doctors diagnose illness.”

“(f) The historical association between ‘the Black’ and ‘the Other’
      (i) Once in contact with psychiatrists, non-European patients are more likely to be diagnosed as schizophrenic, because of certain specific associations between the medical perception of ‘the Black’ and the insane as some sort of undifferentiated ‘Other,’ rooted in psychiatric theory albeit unofficially….
      (ii) Or else, more generally in Western society, ethnic stereotypes embody notions of irrationality, violence, and inability to communicate which are close to those which characterize mental illness and which are thus perceived clinically in the Black patient.”

“Lewis’ study found that, diagnosis apart, Black patients were perceived as more violent and in need of treatment with medical drugs, a finding which corresponds with previous perceptions of actual patients.”