Psychiatric diagnoses and racial bias: An empirical investigation.

Using data from a random sample of 313 severely mentally ill individuals, we assessed the relation between race and schizophrenic diagnoses among those hospitalized at four Chicago metropolitan state mental hospitals. After we controlled for psychiatric diagnosis with an independent SADS diagnosis and other relevant variables, the logistic regression analysis reveals that being Black is predictive of a diagnosis of schizophrenia. These results suggest that significant problems may exist with regard to the treatment and diagnosis of minority groups within the mental health system and the need for culturally appropriate services for minorities, especially within large urban areas. Recently, an association between race and hospitalization in state-operated mental institutions across the United States has emerged. Data collected by the National Institute of Mental Health (NIMH; 1980; Manderscheid & Barrett, 1987) suggest startling disparities in the types of diagnosis attributed to racial groups, indicating that the diagnosis of schizophrenia has increased among Blacks in comparison with Whites in state-operated facilities. Concurrently, literature that has accumulated over the last 20 years suggests that racial bias occurs within the institutions that treat the severely mentally ill. Given this context, we examined the issue of race and diagnosis in an urban mental health system. We asked, more specifically, to what extent being Black is predictive of a diagnosis of schizophrenia, independently of other clinical and social variables thought to influence clinical decision making.