Discrimination, Ethnicity and Psychosis
Discrimination, Ethnicity and Psychosis
Issue 02 – May 2008
Author: Steven Coles (email@example.com)
- Evidence points to environmental factors rather than genetic / biological factors as the reason for the increased rate of psychosis in some ethnic minority groups. Social factors in particular have been put forward as likely.
- Encountering discrimination seems to be related to people experiencing ‘delusional ideation’ at a later time.
- Individual discrimination can be subtle as well as blatant. Subtle forms can be as psychologically damaging as more obvious forms.
Implications for practice
- Service users should be sensitively asked about their experiences of discrimination. How and when this is done should be thought about carefully.
- In understanding and making sense of a service user’s distress, it will be important to consider their experience of different forms of discrimination and the reality of the social worlds they live in.
- Staff should have adequate awareness and knowledge of their own stereotypes and prejudices, so to be able to work effectively with service users who experience discrimination and racism.
Racism and practiceResearch into discrimination and racism has also highlighted that individual acts of racism can be blatant (e.g. verbal abuse) as well as subtle (e.g. body language, tone of voice etc). Subtle forms can also be outside the awareness of the person acting in a racist manner. However, subtle forms of racism that a person themselves is unaware of, does in fact effect how they interact with others, biases decision making and it is noticeable to others (see Dovidio & Gaertner, 20046 for an introduction to this research). Further, witnessing subtle, minor and day-to-day forms of discrimination can have as great a negative effect on people as more blatant and obvious forms of discrimination8. Given all of the above, it seems important for mental health professionals to be able to discuss issues of discrimination and racism with service users. However, the fact that racism can be subtle also suggests that this needs to done sensitively, for example it has been argued that staff who lack awareness of their own prejudices are likely to continue the oppression that service users have already faced (see Patel et al. 20009 for further discussion). Many clinical and academic writers have also strongly argued against staff seeing service users’ perception of discrimination as ‘hypersensitivity’, particularly as ‘hypervigilance’ in an hostile social environment can be seen as adaptive.
SummaryResearch concerning the higher rates of psychosis in some ethnic groups points to the importance of social factors in the causation of psychotic symptoms, including discrimination. It is also suggested that mental health professionals need to ask about service users’ experiences of discrimination and the realities of the social worlds they live in.
- Sharpley, M., Hutchinson, G., McKenzie, K., & Murray, R. M. (2001). Understanding the excess of psychosis among the African-Caribbean population in England: Review of current hypotheses. British Journal of Psychiatry Supplement, 40, s60-80.
- Boydell, J., van Os, J., McKenzie, K., Allardyce, J., Goel, R., McCreadie, R. G. & Murray, R.M. (2001). Incidence of schizophrenia in ethnic minorities in London: Ecological study into interactions with environment. BMJ, 323, 1-4.
- Karlsen, S. & Nazroo, J. Y. (2002). Relationship between racial discrimination, social class and health among ethnic minority groups. American Journal of Public Health, 92, 624 – 631.
- Karlsen, S., Nazroo, J. Y., McKenzie, K., Bhui, K. & Weich, S. (2005). Racism, psychosis and common mental disorder among ethnic minority groups in England. Psychological Medicine, 35, 1 – 9.
- Janssen, I., Hanssen, M., Bak, M., Bijl, R. V., De Graad, R., Vollebergh, W., McKenzie, K. & Van Os, J. (2003). Discrimination and delusional ideation. British Journal of Psychiatry, 182, 71 -76.
- Dovidio, J. F. & Gaertner, S. L. (2004). Aversive racism. Advances in experimental social psychology, 35, 1 – 52. San Diego, CA: Academic Press.
- Bentall, R.P.(Ed.) (1990). Reconstructing schizophrenia. London: Routledge.
- Essed, P. (1991). Understanding everyday racism: An interdisciplinary theory. London: Sage.
- Patel, N., Bennett, E., Dennis, M., Dosanjh, N., Mahtani, A., Miller, A. & Nadirshaw, Z. (Eds.) (2000) Clinical psychology, ‘race’ and culture: A training manual. Leicester: BPS Books.
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