Racism in psychiatry: paradigm lost-paradigm regained

Racism and psychiatry have been 'linked' in the public imagination, largely because psychiatry is seen as an instrument of social control, and, racism as a different form of oppression which permeates society at large. Racism in psychiatry is often believed to be the mediating factor in cases of 'ps ychiatric misdiagnosis' and 'mismanagement'. Misdiagnosis includes underdia gnosis and overdiagnosis; this can account for the non-delivery of appropri ate treatments because of an erroneous diagnostic label. In some instances this leads to a deferred intervention, or lit some ethnic groups, help-seek ing is delayed for unnecessarily long periods. Racism is nor a recent pheno menon. The blunt application of the word 'racism' perpetuates conceptual co nfusion about what is meant by the term, what processes are taking place, h ow much Of the processes are institutionalized or individual and to what de gree individuals are aware of the impact of their actions. We propose a way of understanding racism ill psychiatric practice, and suggest that within such a framework, the therapist/professional and rite patient can work toge ther towards improving patient care.