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Young, Crazy, and Of Color: Why Schools and Doctors Get It Wrong [ColorLines]

Editor’s note: This is the first part of a 2-day series on people of color and mental health.

Earlier this month, news surfaced of a Louisiana school psychologist who posted racially charged messages on Twitter. Mark Traina, who later resigned, worked as a psychologist at an alternative school in Jefferson Parish Public School System, a district that’s been under intense scrutiny in recent months. According to a court complaint filed by the Southern Poverty Law Center, Jefferson County has been sending a disproportionate number of black and special education kids to “languish for months” in the district’s alternative schools.

Traina had already taken to Twitter to post his support of George Zimmerman, the former neighborhood watch captain charged with murdering Trayvon Martin. But back in January, Traina went on a rant against “young black thugs.” Traina, a self-proclaimed ‘American Civil Rights Activist who unlike Jessie Jackson and Al Sharpton presents all Americas”, tweeted that “Young black thugs who won’t follow the law need to be put down not incarcerated. Put down like the Dogs they are!”

While black children aren’t often ceremoniously “put down like dogs”, they do face harsh school punishment at much higher rates than their white counterparts. Jefferson Parish’s problems are symptomatic of a disease that’s already been diagnosed nationally: the  tendency to dole out harsher than average treatment for people of color. From the classroom to the clinician’s office, there’s a long and troubling relationship between racism and the mental health field.

Research has also shown the black students are disciplined more severely than white students, even when they commit offenses that are less serious. The National Education Policy Center at the University of Colorado reported (PDF) that more than 30 percent of black students caught using, or in possession of, a cell phone for the first time were suspended. The rate for white students who committed the same infraction was just 17 percent. 

The disparity lead Education Secretary Arne Duncan to lament that “the everyday educational experience for too many students of color violates the principle of equity at the heart of the American promise.”

Data released this year by the U.S. Department of education showed that black students are three times more likely to be suspended than their white classmates. Even though black students make up just 18 percent of students nationally, they comprise 35 percent of suspensions and 39 percent of expulsions. Additionally, as Liz Dywer points out at GOOD, 70 percent of students arrested or referred to police are black or Latino.

Yet many contend that the problem extends far beyond the classroom. When it comes to mental illness, people of color are more likely to be given more severe diagnoses than their white counterparts. In 2005, the Washington Post reported that even though schizophrenia has been shown to affect all ethnic groups at the same rate, black people in the U.S. were more than four times as likely to be diagnosed with the disorder than whites. Latinos were more than three times as likely to be diagnosed as whites.

“The way we define mental illness is slanted toward pathologizing basically angry black men,” said Jonathan Metzl, a psychiatrist at Vanderbilt University and author of the book “The Protest Psychosis: How Schizophrenia Became a Black Disease.”

There’s a deep mistrust between communities of color and the mental health field. The National Alliance on Mental Health notes (PDF) that African Americans are more likely to be misdiagnosed and, in turn, receive inadequate treatment often due to a “lack of cultural understanding.”

In 2005, the Washington Post published a wide-ranging series on the role of culture in mental illness and told the story of a case encountered by Dr. Roberto Lewis-Fernandez. While completing his psychiatry training at a hospital in Massachusetts, Fernandez encountered a suicidal 49-year-old Puerto Rican woman who begged for help to resolve a conflict with her son. The woman also said she was hearing voices, seeing shadows, and felt invisible presences. At first, the Harvard-affiliated doctors diagnosed the woman as depressed and psychotic. She was given medication and sent home.

“I wasn’t sure if she was psychotic, but I treated her as if she was,” Lewis-Fernandez told the Post.

But Lewis Fernandez, who’s also Puerto Rican, found the diagnosis unsettling and thought the hospital had misjudged the situation. He knew that at a certain level, seeing shadows and sensing presences was considered normal in some Latino communities. After another argument with her son, the woman nearly overdosed on the medication. She was taken back to the hospital where she was re-evaluated, given a less severe diagnosis, and given help to reconcile with her son.

Race and institutional definitions of insanity share a long and troubling history. Metzl outlines in his book that in the 1850’s, American psychiatrists believed that runaway slaves suffered from an acute mental illness called “drapetomania.” The era was also littered with references to “dysaesthesia aethiopis”, a form of madness characterized by disrespect for the slaver owners’ property and best treated with extensive whipping.

In the early twentieth century, American psychiatrists thought that schizophrenia patients were largely white, middle class and harmless to society. The disease was misunderstood as one that was deeply emotional and, in turn, associated with melancholy housewives, novelists, and poets. In 1935, Metzl notes that the New York Times speculated that many white writers demonstrated a symptom called “grandiloquence”, a propensity toward flowery prose then thought to be “one of the telltale phrases of schizophrenia, the mild form of insanity known as split personality.”

It wasn’t until the 1960’s that societal attitudes toward the disease dramatically shifted. Schizophrenia was no longer seen as harmless, but was instead a dangerous disease defined by rage and associated with the Civil Rights and Black Power movements. In 1968, while protest movements became more radical — particularly those in poor black neighborhoods, the field  of psychiatry introduced a radically new definition of the disease. That year, the Diagnostic and Statistical Manual (DSM) updated its definition. “The patient’s attitude is frequently hostile and aggressive and his behavior tends to be consistent with his delusions.” 

Metzl makes the argument in his book that the change on societal attitudes was the unintended consequence of growing white anxiety about cultural and social change. And while obvious bias can’t be easily discounted, sometimes misdiagnoses are the unintended side effects of persistent cultural misunderstandings. Metzal argues that racial tensions are structured into clinical interactions long before doctors and patients meet in the exam room. 

In the early 1970’s a series of influential studies established the fact that people of color were often over-diagnosed with much more severe mental illnesses than their white counterparts. When psychiatrist miss the mark so consistently, one obvious side effect is that persistent — though perhaps less severe — mental illnesses often go untreated.

Metzl notes that black men are historically underdiagnosed with illnesses like depression, anxiety, and attention deficit disorder.

“There’s a mistrust of psychiatry that I think is very well-founded. In the 1960’s we see very clearly that psychiatric experts were pathologizing civil rights protests and particularly black power protests as being insane. And it’s very hard to turn around from that and say, ‘Oh no, we made a mistake, please trust us.’ If you have a history of pathologizing legitimate political protests as mental illness, you set conditions for mistrust on both sides.”



Forty-eight percent of African American boys drop out of the public schools in Hennepin County, and only one of every four African American boys in the Minneapolis Public Schools graduates on time.

“By fourth grade, many African American boys are already falling behind in the classroom. It [is]especially noticeable among students from low-income families,” according to Dr. James Comer, director of the Yale Child Studies Center in an April 1997 Parenting Magazine article. Cromer is an educator who has been in the forefront of Black child development reform for nearly 30 years.

Why is this fourth grade floundering especially apparent in young Black males? In the lower grades, the classroom atmosphere is more of a companionable social interaction, and mixing-type learning environment. Whereas by fourth grade, the approach to teaching transforms into a static, sit-in-your-seat, listen, and lecture-type surrounding.

Harry Morgan, an early childhood development professor, believes that “this change in teaching method from a casual, relaxed hands-on instruction to a formal sit-at-attention-and-listen styleis toughest on male students, who tend to be more active than girls in the elementary grades. And for Black boys, a teacher’s reaction to these high energy levels may be compounded by racism.” Morgan states that even Black teachers may share this undercurrent of fear or tension toward young Black males.

This alarm may be set off by something as simple “as a Black boy walking around the room.” The teacher may feel that if a Black child is allowed even the slightest infraction, his behavior will escalate out of control. This teacher could be faced with a baffling situation — how can I solve this problem of an unruly child, yet maintain order for the other students?

A White sixth grade teacher in Minneapolis answers, “If four or five kids are always causing problems in your class, it’s not fair to the remaining 20 studentsso the troublemakers are frequently referred to Special Ed. What else are you going to do? You can either be their teacher or their therapist. You can’t be both.”

In 2000, African American boys accounted for 23 percent of the Minneapolis Public Schools student body; however, they made up 37 percent of all students in Special Ed programs, and 55 percent of all students in programs for emotional/behavioral disorders.

Special Ed programs often provide a place to discard Black and/or low-income children who have behavior issues rather than lack of abilities.

Research by authors of The Reading Crisis reveals that one third of the low-income and low-achieving readers were reading below their intelligence level by a year or more.

Data from the “Minneapolis Research Valuation and Assessment of 2002” exposes the reading achievement gap that exists between African American students and White students: 85 percent of White students passed the Minnesota MBST reading assessment, while only 39 percent of African American students passed. What is the reason for this?

The author of Conspiracy of Ignorance, Martin L. Gross, writes that “more than likely the failure is due to the incompetence of the establishment. [The school system] has relegated poor children to the academic scrap heap [of Special Ed], blaming [the student,] their parents and the community instead of placing the blame where it belongs — on the school system, its principals and its teachers.”

Gross contends that “it’s not because of racism, or less attention to African American and Hispanic children Much of the real reasonis that the establishment’s theories on how to teach reading are ineffective.”

From other research studies, we find that if the child is not reading well by the fourth grade, he is often feeling embarrassed, and he would rather be labeled bad rather than dumb. He acts out these aggressive behaviors to detract from his lack of reading skills.

Seed Academy Harvest Prepartory School (HPS), a Minneapolis charter school with over 95 percent African American students, substantiates Gross’s conclusions. HPS is just one example of several schools that successfully educate poor and minority students. They use a core learning curriculum that emphasizes the basics: “multiplication tables, spelling, phonics, rote learning.”

And, in March 2003, third graders at HPS surpassed the state in reading. State scores were 76.3 percent at or above grade level. HPS scores were 95.7 percent at or above grade level. The state scored 17.3 percent superior performance beyond grade level, and HPS scored 23.4 percent superior performance beyond grade level.

Another successful approach was uncovered by Durkin. He used the research strategy of comparing “low-income above-average readers with low-income below-average readers. The findings were that Black children who were highly successful at reading had books at home, had help with their homework from a parent or someone else” and that they were expected to go to college.

Many of these children were already reading prior to entering kindergarten. Obviously, some older sibling or adult had spent quality time with the child during the critical period of zero to five years, according to Durkin.

One of the critical causes of educational trouble for African American boys is low parental involvement. In Parents magazine, September 1997, Mitchell Trockmen, former associate superintendent for elementary and secondary education for Minneapolis Public Schools proclaims “Parents who act as advocates [for their child] aren’t being pushy or meddling, they are appropriately concerned.”

The bottom line here is that to prevent failure of Black boys in the public schools, we must forge a strong teacher/parent relationship.

*sigh* I’m still fighting my youngest son’s incorrect IEP & my oldest son’s teacher just politely asked me to take him out of her room because he knows everything she’s covering. We are asking teachers to build houses out of baling wire & chewing gum & penalizing them for failing. Meanwhile parents who are struggling aren’t getting any support & are busy trying to keep the wolf from the door. And kids who are hungry, tired, in ill-health, or misdiagnosed are getting lost in the cracks. Society is currently failing everybody.

(via bad-dominicana)