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Racism in Psychiatry Necessitates Reappraisal of General Procedures and Eurocentric Theories Author(s): S. P. Sashidharan and Errol Francis Source: BMJ: British Medical Journal, Vol. 319, No. 7204 (Jul. 24, 1999), p. 254 Published by: BMJ Publishing Group Stable URL: http://www.jstor.org/stable/25185340 . Accessed: 29/10/2013 22:46
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Letters

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Racism procedures

in

necessitates psychiatry reappraisal and Eurocentric theories

of general

diet

and

nutritional

25-hydroxycholecalciferol was the same assayed with equilibrium

serum survey,4 concentration kit (which uses an

Editor?We Editor's effects the Choice of the

agree

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(in issue of 6 March) Lawrence Stephen

that the and

are are to who they applied people socially or excluded Black culturally marginalised. in the United communities will Kingdom continue sional bias to bear as the brunt of such a long chiatric practice remain sufficient Obviously, tional racism our must to examine attitudes. this In exhortations change attempt a rate function alignment the larger as the coordinates culturally profes of psy

into it will be far and inquiry reaching that no public institution will be exempt. We that the soul searching that doubt, though, has followed the publication of the inquiry action against report will result in corrective institutional editorial marshals tional is an racism in the NHS. McKenzie's indication of this1: although he to argue that institu

although differences the two studies. between ological To see whether these differences in might seen in in values the difference part explain a number were the two studies of samples in the Leicester both analysed laboratory that analysed the samples for our study and in the Dunn in which Cambridge, laboratory for the national analysed samples study. two sets of values The correlated well, and the values from the Cam although were (mean bridge laboratory slightly higher 1.59 nmol/1), difference the difference did not reach The that significance. suggestion the low concentrations found in our Asian be a function of the study may analytical not substantiated. is therefore method Senior lecturer inpaediatric Margaret Lawson nutrition Childhood Nutrition Research Centre, Institute of Child Health, London WC1N 1EH 1 Correspondence. Vitamin D concentrations inAsian chil dren living inEngland. BMJ 1999;318:1417. (22May.) 2 Lawson MS, Thomas M. Vitamin D concentrations in Asian children aged 2 years living in England: population survey.?A4/1999;318:28. 3 Farrerons J, Barnadas M, Rodriguez J, Renau A, Yoldi B, Lopez-Navidad A, et al.Clinically prescribed sunscreen does not decrease serum vitamin D concentration sufficiently either to induce changes inparathyroid function or inmeta bolic markers. BrJDermatol 1998;139:422. 4 Gregory JR, Collins DL, Davies PSW,Hughes JM, Clarke PC.National diet and nutritional survey:childrenaged 1.5-4.5 years.London: HMSO, 1995.

radioimmunoassay procedure), some minor there were method

fixed.

to institu challenge more include than our practice and

the evidence racism

to address

is very much part of the struc and culture in the NHS, he ture, procedures, offers few and political professional to strategies challenge discriminatory tices in the health services. As McKenzie discrimination prac

of reappraisal of professional of critical struggle commitment be

any psychiatry, issue must incorpo the purpose and practices The and voices an with home a use inquiry

professional racism. against to extend

of racial says, allegations are not new in the NHS. But the most

secretary's Relations Act ful start would into race

the Race

to the NHS

is welcome;

of example glaring in service in the provision inequality in It is often NHS?that psychiatry. ignored ignored racial in debates to deal with praisal of not but such as this because would racism any necessitate attempt a reap of of

he has

to set up a national and mental health.

S P Sashidharan Professor of community psychiatry Errol Francis Director, Frantz Fanon Centre for Mental Health Northern Birmingham Mental Health (NHS) Trust, Academic Unit, Birmingham B23 6AL 1 McKenzie K. Something borrowed from the blues? BMJ 1999;318:616-7. (6 March.) 2 Moodley P,Thornicroft G. Ethnic groups and compulsory detention. Med SeiLaw 1988;28:324-8. 3 Fernando S.Mental health,raceand culture. London: MIND, 1991. 4 McGovern D, Hemmings P.A follow up of second genera tion Afro-Caribbeans and white British with a first admis sion diagnosis of schizophrenia: attitudes tomental illness and psychiatric services of patients and relatives. Soc Sei Med 1994;38:117-27. 5 Sashidharan SP.Afro-Caribbeans and schizophrenia: the ethnic vulnerability hypothesis re-examined. Int Rev Psychiatry 1993;5:129-44.

psychiatry our theories the

only the general procedures also the Eurocentric bias a commitment culture differences. comes that to

and

professional

change on is based

pathologising Psychiatry among medical tices nate United numbers

to the closest police in pursuing prac specialties and procedures that explicitly discrimi in the ethnic groups against minority Kingdom. of black disproportionate in psychiatric people the overdiagnosis of schizophre The

Recognition anxiety
General

in

of depression care primary

in study writer

and

detention,2 nia in black people practice logically

the exclusion of black people, from the "softer end" of psychiatric are deemed because they psycho

Low

vitamin was

D not

concentrations function of

agree

practitioners with commentary to

seemed

to

found
children

the alienation of black unsuitable,3 serv from mainstream patients psychiatric lack of trust and extreme ices,4 the general about psychiatric that is scepticism practice evident in minority communities, with preoccupation or the echo and theories which of 19th the com the of

in study of Asian

Editor?Kessler

et al assessed

the ability

of

analytical method
Editor?I letters1 Thomas tions rickets would commenting and Iwrote in Asian in a white like to respond on the short on vitamin The infant to the two that of the report D concentra

diagnose depression health by the general * questionnaire (GHQ-12). Unfortunately, their results; from they have miscalculated a their data, the general had practitioners of 36% and a specificity of 91%. sensitivity These that the participat suggest figures least in their day ing general practitioners?at to in Heath's day practice?shared opinion her Most with a score patients commentary.1 on the >3 health do general questionnaire not have a condition. psychiatric diagnosable Allan House Senior lecturer inpsychiatry Division of Psychiatry and Behavioural Sciences in Relation toMedicine, School of Medicine, University of Leeds, Leeds LS2 9LT 1 Kessler D, Lloyd K, Lewis G, Gray DP. Cross sectional study of symptom attribution and recognition of depression and anxiety in primary care [with commentary by I Heath]. BMJ 1999;318:436-40. (13 February.)

general practitioners as defined and anxiety

professional ethnic vulnerability continue century similarities munities Unlike the that racial is to race and

inferiority, sentiments

children.2

diagnosis associated with that Zlotkin

all confirm science,5 between the black policing

use of a sunscreen potent is interesting. The author ing use of sunscreen vitamin no not of synthesis study found

their minds. controlling in other branches of medicine, in treatment and outcome bias in cannot psychiatry an examination by policy governing theories and assump are problematic when or be of

quotes with of suppression recent D3, but a more between on this on use of of be D. D metabolism.3 data the use should vitamin the national

reports a study link

association collect

evident fully

sunscreen We sunscreen, considered For both did

and vitamin

understood

procedures, practice, service The delivery. tions of psychiatry

although perhaps for future studies our Asian study and

254

BMJ VOLUME

319

24 JULY 1999

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