when race and gender determine the diagnosis of schizophrenia

Delivered. Jonathan M. Metzl recounts a detailed investigation in Stifle the revolt. Psychiatry versus Civil Rights, a history of social control (Other). For four years, the American psychiatrist has plunged into the heart of some 624 archive boxes of the State Hospital of Ionia (Michigan) for criminally irresponsible criminals, but also millions of pieces of popular music, novels, d newspaper articles, advertisements, films… The result is surprising. In great detail, it traces the evolution of the diagnosis of schizophrenia within the medical profession in the XXe century – and its popular perception. He shows how the racial history of the United States has strongly influenced the medical institution to the point that it made schizophrenia a disease particularly affecting black men during the struggle for civil rights.

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Going through the files of the criminals sent to this specific asylum and examining the medical reports and the patient-doctor exchanges of files stamped “White” and “Negro”, Jonathan Metzl noted that, in the years 1920-1930, the majority of schizophrenics were white women from the rural middle class, arrested for disturbing public order, attempted suicide or shoplifting. They are considered harmless but failing in that they are not model wives. The case of Alice Wilson is striking. Her admission sheet reveals that she is incarcerated for “S ‘[être] put to ramble and embarrass her husband “. She was showing signs of confusion and was speaking too loudly. On others, we can read “This patient was not able to take care of her family with dignity” or “Not able to do housework”.

“Psychosis of the revolt”

Everything changed in the 1960s when Detroit, 130 km from Ionia, was one of the epicenters of the struggle for civil rights. At that time, prestigious medical journals and many psychiatrists, like Walter Bromberg and Franck Simon, “Describe schizophrenia as a ‘rebellious psychosis’ whereby black men develop ‘hostile and aggressive feelings’ and “anti-white delusions” after hearing Malcolm X’s speeches, joining the Muslim Brotherhood or rallying groups preaching militant resistance to white society. “

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At the end of the 1960s, more than 60% of patients at Ionia hospital were “Black, schizophrenic, ‘dangerous and paranoid’ men, mostly from the working-class neighborhoods of Detroit” against barely 12% on average between 1920 and 1950. In fact, “Some patients, notes Jonathan Metzl, became schizophrenic, no longer because of their clinical symptoms but because the diagnostic criteria had changed. “

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