Some have argued that diagnosis may be affected by factors, such as gender, ethnicity and social class. This means that the label attached by the psychiatrist may have been influenced by things other than the symptoms presented.
Ethnicity: The Case of Calvin
Littlewood and Lipsedge (1997) have suggested that the reason why black and Irish people in Britain are more likely than others to receive a diagnosis of serious mental disorder has more to do with bias in the system than a genuine greater vulnerability in those groups. They describe the case of Calvin, a Jamaican man arrested following an argument with the police when a post office clerk believed he was cashing a stolen postal order (an accusation which later proved to be false). The following was recorded by a British prison psychiatrist:
“This man belongs to Rastafarian – a mystical, Jamaican cult, the members of which think they are God-like. The man has ringlet hair, a straggly goatee beard and a type of turban. He appears very eccentric in his appearance and very vague in answering questions. He is an irritable character and has got arrogant behaviour.”
The aforementioned shows the ignorance within psychiatry; the suggestion is that anyone who appears different MUST have something wrong with them.
Fernando (1992) also provides an insight into diagnosis and bias:
– Over-diagnosis of schizophrenia among West Indian and Asian British. This means for the same symptoms, disproportionately more individuals from these groups were diagnosed as schizophrenic rather than any other illness.
– Excessive admission of ‘offender patients’ among West Indian British. Individuals in this group were more likely to be put into prison than in hospital.
– Excessive use of compulsory admission for West Indian British. Research in South London found that Black patients were three times more likely to be institutionalised than Whites.
It is important to emphasise that the differences are not due to differences in the prevalence of mental illness among the ethnic groups – it is a product of the bias in the mental health system.
Gender:
Similarly, this argument links to the second type of bias in the mental health system – women. Lloyd (1991) noted that women made up 4% of the prison population, but 20% of the population of the Special Psychiatric Hospitals. Women who are aggressive, addicts or living rough are more likely to be diagnosed as anti-social personality disorder than men in the same situation.
that psychology blog 