There are surely problems within psychological health care that fall hardest on minorities. There remains, for example, a tendency to over-diagnose schizophrenia in black patients. But efforts to remedy these discrepancies have led to the mental health profession becoming an intensely politicized environment where academic collegiality, open inquiry, and constructive discourse are threatened.
Central to the ideology that’s creeping into the field of mental health care is a growing aversion to recognizing personal responsibility and agency. One colleague of mine who works in a prominent psychiatry department told me that during a group discussion of the growing problem of stress and suicide in black youth, her colleagues were unwilling to discuss explanations that pointed to factors coming from within beleaguered communities. Thus, participants who pointed to fear of police aggression and societal discrimination were greeted with nods, but when she suggested they also consider bullying by classmates, chaos in the home, or neighborhood violence, she was ignored.
I have had my own encounter with this growing illiberal strain. Following a lecture I gave earlier this year to a group of psychiatrists and trainees, I was castigated by several attendees for drawing attention to personal agency in overcoming drug addiction. My transgression, as they saw it, was to “blame the victim” and take focus away from factors such as racism, poor education, and poverty—which, as I had noted in my presentation, also predispose people to heavy drug use. But I was not “blaming the victim,” I explained in an icy Q-and-A; rather, I was drawing attention to the patients’ capacities to improve their lives and, therefore, to hope.
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