Jonathan M. Metzl. Psychiatry and Women’s Studies; Director, Program in Culture, Health, and Medicine, University of Michigan
Protest Psychosis: Race, Stigma, and the Diagnosis of Schizophrenia
Misperceptions that persons with schizophrenia are violent or dangerous lie at the heart of stigmatizations of the disease. My project tells the story of how these modern-day American conceptualizations of schizophrenic patients as violent emerged during the civil-rights era of the 1950s-1970s in response to a larger set of conversations about race. I integrate institutional, professional, and cultural discourses in order to trace shifts in U.S. popular and medical understandings of schizophrenia from a disease of white docility to one of “Negro” hostility, and from a disease that was nurtured to one that was feared. The first and longest section of the paper tracks the medicalization of race and schizophrenia within a particular institution, the Ionia Hospital for the Criminally Insane. I access an extensive archive of medical records and administrative documents to show that, starting in the 1950s, schizophrenia became a diagnostic term disproportionately applied to the hospital’s growing population of African American men for reasons having as much to do with perceived threats of violence as with criteria for mental illness. I also show how evolving notions of violence shaped, and were in turn shaped by, changing notions of institutional space. Section two contextualizes the Ionia case histories within shifting psychiatric definitions of schizophrenia, as read through an extensive analysis of published case studies. The final section reads shifts in psychiatric nosology within changing American cultural concerns about black masculinity. I show how civil-rights era debates about the role of violence in promoting social change mapped onto descriptions of schizophrenia as a violent disease.
Diana Wendy Fitzgibbon. Criminal Justice, Hertfordshire University, England
Pre-Emptive Criminalisation and Black Mentally Ill People
This paper attempts to develop an account of the dynamics of discrimination against black people in the area of mental health policy and practice. It is argued that a framework for the analysis of discrimination can be usefully constructed in terms of the relationship between the processes of pre-emptive criminalisation, risk analysis and institutional racism.
Pre-emptive criminalisation, refers to a process in which the activation of criminal justice responses in Britain, increasingly takes an anticipatory form. Thus responses, are based upon the expectation that individuals are likely to commit criminal acts in the future rather than they have already done so. The second process, risk analysis refers to the practice, now common in probation, social work, and mental health, of responding to individuals by allocating them to groups categorized in terms of the statistical likelihood of committing certain types of acts. This combines with the final process, institutional racism, the dynamic of racial discrimination which is rooted in the mode of operation