Injustices in Mental Health Diagnoses and Treatment
Mental health diagnoses are not equally distributed across the population, let alone across different countries and cultures.
For example, in the UK there is a higher rate of psychosis diagnoses in young black men than in white men, a higher suicide risk among older South East Asian women, and young white women are most likely to be diagnosed with an eating disorder.
In this project, you'll explore how ethnic minorities can suffer stigmatisation both for their race and for their mental health condition.
Summary
There is increasing recognition that race and ethnicity can affect the diagnosis and treatment of mental health conditions, and whether people seek out and are able to access treatment. On the one hand, stereotypes, stigmatisation, and lack of cultural understanding can lead to misdiagnosis, lack of understanding, or non-recognition of a mental health condition. On the other hand, cultural factors can shape how a mental health condition is experienced and expressed. In this way, race, ethnicity, and culture play a role in who is diagnosed with a mental health condition and what diagnosis and treatment they receive.
The 5th Diagnostic and Statistical Manual of Mental Health’s Text Revision now explicitly points to the importance of avoiding any misdiagnosis which may result from lack of sensitivity to the way cultural factors affect both the expression of mental health issues and how behaviour is categorised by clinicians. While this is an important corrective that acknowledges the challenges and biases that affect diagnosis and treatment, we are left with a host of questions regarding the underlying reasons for diagnostic differences, the impact of such differences on individuals and communities, and how they might be addressed.
In this philosophical project, you’ll investigate how cultural, class, and systemic factors shape, influence, and even mask how mental health conditions manifest, are experienced, diagnosed, and treated.
Aims
The aims of this project are to:
- investigate the role cultural, class, and systemic factors play in mental health diagnosis and healthcare
- explore how stereotypes and stigmatisation linked to ethnicity and race impact diagnosis
- show how cultural factors influence how symptoms of mental health conditions manifest and are expressed
- analyse how perceptions and preconceptions concerning mental health that are prevalent within a community can affect an individual’s willingness and ability to seek medical help
- improve our understanding of how diagnostic differences arise out of and result in injustice
- consider the impact of injustices in mental health condition diagnosis both for individuals and communities
Based on your research interests, you could pursue these aims through the lens of a specific issue (e.g., misdiagnosis), a specific group (e.g, young Black men in the UK), and/or a specific mental health condition (e.g., schizophrenia, anorexia nervosa), or take a broader, more general approach.
Research questions
The project could include addressing some of the following questions, though there is scope for tailoring them to your own research interests within the overall remit of the project.
- How does the perception of mental ill health within an ethnic group affect the presentation of mental health problems?
- How do cultural factors and preconceptions about specific mental health interact to create situations of epistemic injustice?
- What are the cultural factors that lead to the high incidence of psychosis diagnosis in young black men?
- When does being diagnosed more commonly constitute an injustice and when do less frequent diagnoses constitute the injustice?
Sources and materials
This project is primarily philosophical and will involve drawing on philosophical work on topics such as mental health, stigma and recognition, and epistemic injustice, as well as work from psychiatry and sociology. You’ll also be encouraged and supported in engaging with relevant mental health charities and providers.
