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SOME EVIDENCE OF RACE BIAS IN THE DIAGNOSIS AND TREATMENT OF THE JUVENILE OFFENDER

NCJ Number
53990
Journal
American Journal of Orthopsychiatry Volume: 49 Issue: 1 Dated: (JANUARY 1979) Pages: 53-61
Author(s)
D O LEWIS; D A BALLA; S S SHANOK
Date Published
1979
Length
9 pages
Annotation
CLINICAL AND EPIDEMIOLOGICAL EVIDENCE OF RACIAL BIAS IN THE DIAGNOSIS AND TREATMENT OF BLACK JUVENILE OFFENDERS AND THEIR FAMILIES ARE EXAMINED.
Abstract
THE POSSIBILITY EXISTS THAT BLACK DELINQUENT CHILDREN ARE DENIED ACCESS TO PSYCHIATRIC TREATMENT BECAUSE OF THE RELUCTANCE OR INABILITY OF MENTAL HEALTH PROFESSIONALS TO DIAGNOSE SEVERE PSYCHOPATHOLOGY IN THIS POPULATION. ABUSE AND NEGLECT CONSEQUENTLY MAY GO UNRECOGNIZED AND UNTREATED. CLINICAL DATA WERE OBTAINED FROM PSYCHIATRIC AND SOCIAL EVALUATIONS OF A JUVENILE COURT CLINIC POPULATION. EPIDEMIOLOGICAL DATA WERE DERIVED FROM ONGOING STUDIES OF THE MEDICAL HISTORIES OF DELINQUENT CHILDREN. MANY BLACK DELINQUENT CHILDREN REFERRED FOR PSYCHIATRIC EVALUATION TO CLINICS, PRIVATE PSYCHIATRISTS AND PSYCHOLOGISTS, AND MENTAL HOSPITALS WERE DISMISSED AS CHARACTEROLOGICALLY IMPAIRED EVEN THOUGH THERE APPEARED TO BE CLEAR EVIDENCE OF PSYCHOTIC OR ORGANIC DISORDERS. THERE WAS A TENDENCY TO DISMISS RECURRENT HALLUCINATIONS AS CULTURALLY APPROPRIATE, TO SEE DANGEROUSLY PARANOID IDEATION AND BEHAVIOR AS ADAPTIVE TO THREATENING SOCIAL CONDITIONS, TO TAKE EXTREME GRANDIOSITY FOR STREET BRAVADO, AND TO INTERPRET BIZARRE BEHAVIOR AS MANIPULATION. SERIOUSLY DISTURBED BLACK DELINQUENTS HAD TROUBLE GAINING ADMISSION TO THERAPEUTIC FACILITIES, AND THOSE ADMITTED WERE QUICK TO BE DISCHARGED AND TRANSFERRED TO CORRECTIONAL SETTINGS IF THEIR PSYCHOPATHOLOGY MANIFESTED ITSELF IN AGGRESSIVE WAYS. THE PATHOLOGICAL BEHAVIOR OF PSYCHIATRICALLY IMPAIRED BLACK PARENTS OF DELINQUENTS TENDED TO BE DISMISSED AS DUE TO ETHNIC CHARACTERISTICS. IN THE COURSE OF CONDUCTING EPIDEMIOLOGICAL STUDIES ON DELINQUENCY AND PHYSICAL AND MENTAL HEALTH, SUPPORT FOR CLINICAL OBSERVATIONS EMERGED. WHILE THE PROPORTION OF CHILDREN EVER HAVING BEEN TREATED FOR ACCIDENTS AND INJURIES IN HOSPITALS WAS APPROXIMATELY EQUAL FOR BLACK AND WHITE DELINQUENTS, THE PREVALENCE OF SERIOUS HEAD TRAUMA WAS CONSIDERABLY GREATER AMONG BLACK THAN AMONG WHITE DELINQUENTS. ABUSE AND NEGLECT WERE UNRECOGNIZED AND UNDERREPORTED. THE IMPLICATIONS OF THE FINDINGS ON RACIAL BIAS ARE DISCUSSED IN LIGHT OF THE RECOGNITION OF PSYCHOPATHOLOGY BY MENTAL HEALTH PROFESSIONALS. SUPPORTING DATA ARE TABULATED, AND REFERENCES ARE CITED. (DEP)