Social Class and Psychiatric Treatment

Hollingshead and Redlich1have reported that patients in the upper social classes*who seek psychiatric treatment for any type of psychiatric disorder are more apt to receive intensive, insight-producing psychotherapy, while patients in the lower social classes are more apt to receive short-term supportive psychotherapy, pharmacologic, or other somatotherapy and if hospitalized, simple custodial care. It has been emphasized that this differential treatment or discrimination is in part the result of the inability of patients from lower social classes to afford the more costly and therefore presumably preferred intensive psychotherapy. If the economic factors were of primary importance, it would be expected that this difference would not exist in a public clinic which excludes patients who are able to afford private psychiatric treatment. With the economic factor eliminated, intensive individual psychotherapy would be equally available to all patients regardless of their social class. Schaffer