How schizophrenia became a “Black man’s” disease

by Alan Bean

In the late 1960s, schizophrenia became a Black man’s disease.

In late 1963, Malcolm X was asked to comment on the assassination of President John Kennedy.  He called it a case of “America’s chickens coming home to roost.”  Outraged by this comment, the Nation of Islam prohibited their rising star from speaking publicly for 90 days.  When that period expired, Malcolm announced that he was severing ties with the nation.

In August of 1965, rioting broke out in the Los Angeles neighborhood of Watts.  Before order was restored, 34 people were dead, 1,032 were injured, and 3,438 had been arrested.

At a civil rights rally in Greenwood, Mississippi on June 17, 1966, Stokely Carmichael, the chairman of the Student Nonviolent Coordinating Committee (SNCC), introduced the term “Black power” into the American lexicon.

Four months later, Bobby Seale and Huey P. Newton organized the Black Panthers in Oakland.

The mainstream civil rights movement, though seemingly triumphant, hadn’t addressed the economic misery and building anger within the Black urban ghetto.  While Dr. Martin Luther King, Jr. achieved unparalleled success by adapting his protest language around the perceptions of middle class White moderates, the Black Power movement got up in the face of White America, demanding radical and immediate change.

How did White folks respond to this challenge?   Not well.  Richard Nixon was elected in 1968 on the strength of a “law and order” message.  Everybody knew what the Republican candidate was talking about.

In a new book, The Protest Diagnosis, psychiatrist Jonathan Metzl describes how, in the late 1960s, “schizophrenia became a Black man’s disease.”  The Haldol ad featured above right is from  1974.

Beside a picture of a stereotypical angry Black activist we find the words, ‘Cooperation often begins with Haldol.’ The Black Power movement was calling for a revolution in economic policy but White America couldn’t listen.

Black people had already received the vote, access to public schools and the elimination of Jim Crow laws.  Surely that was enough.  If Black dissidents were raging in the streets, the problem had to lie in their faulty emotional wiring.

By 1974, the vagaries of Freudian analysis had been trashed in favor of biological diagnostic schemes.  When I worked as a psychiatric social worker in the geriatric ward of Louisville’s Central State Hospital in the late 1970s, I could see the change in approach in the medical records of my clients.  Many of them had been in and out of the mental hospital for decades.  Early psychiatric evaluations linked early childhood trauma with a variety of Freudian syndromes.  By the late 1960s all you got was a diagnosis and the prescription of the appropriate drug. In an article summarizing his book, Metzl demonstrates that paranoid schizophrenia went from being a relatively benign malady afflicting White women and men with an artistic temperament to being a “Black man’s disease.”  Here’s an excerpt (I urge you to read the entire article):

“A series of transformations occurred during the American civil rights era of the 1960s and 1970s. During this vital period, new clinical ways of defining mental illness unintentionally combined with growing cultural anxieties about social change. Meanwhile, reports about new ‘psychochemical’ technologies of control merged with concerns about the ‘uncontrolled’ nature of urban unrest. As these historical contingencies evolved, the American public, and at times members of the scientific community, increasingly described schizophrenia as a violent social disease—even as psychiatry took its first steps toward defining schizophrenia as a disorder of biological brain function.

“As but one example, in 1968, psychiatry published the second edition of the ‘Diagnostic and Statistical Manual’ (DSM)—the ‘official’ source of psychiatric diagnoses. That text recast the paranoid subtype of schizophrenia as a disorder of masculinized belligerence. ‘The patient’s attitude is frequently hostile and aggressive,’ the DSM-II claimed, ‘and his behavior tends to be consistent with his delusions.’ My evidence shows that growing numbers of research articles used this language to cast schizophrenia as a disorder of racialized aggression. In the worst cases, psychiatric authors conflated the schizophrenic symptoms of African-American patients with the perceived schizophrenia of civil rights protests, particularly those organized by Black Power, Black Panthers, Nation of Islam, or other activist groups.” I also recommend this helpful evaluation of Metzl’s research, “Psychiatry, the DSM, and the Black Power movement.”

Metzl argues persuasively that the perceived link between Black protest and mental illness was driven by perceptions rooted deeply in cultural trends that influenced the American academy to a shocking extent.  The folks who produced the 1968 edition of the “DSM” were not aware of the institutional racism at work in their midst.  The bias was unintentional and therefore unacknowledged.  This is precisely the kind of “color blind” racism we confront in the new Jim Crow that Michelle Alexander dissects in her ground breaking book.

Read a brief interview with Jonathan Metzl, Associate Professor of Psychiatry, University of Michigan

video via Big Think
article via African-American News and Issues

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