Oppression of the poor and black is one of the tragic realities of American life. At first glance the psychiatric profession's record in dealing with these groups looks good; with rare exceptions psychiatrists have emphasized that social discrimination and prejudice — rather than innate weakness or illness — are the main cause of the unhappiness of both groups. However, the profession has also taken an implied negative stand toward these people by ignoring their mental health needs. By failing to uncover, dramatize, or treat the problems of poverty-stricken or minority groups, the psychiatrist has made it easier for society to ignore their problems. Furthermore, even with a growing awareness of the susceptibility of oppressed groups to emotional disorders, psychiatrists still tend to assume that these people cannot be helped with the most highly valued varieties of psychiatric treatment. It is deplorable enough that psychiatrists do not offer the poor the same quality of treatment that they offer the affluent; it is even worse when, in situations where ability to pay is not a crucial factor, psychiatrists tend to offer more prestigious (and perhaps more liberating) treatments, such as psychotherapy, to middle- or upper-class people and to use potentially repressive treatments, such as drug and other somatic therapy, to lower-class people. This practice is reinforced by the psychiatrist's tendency to label lower-class people as schizophrenic — a diagnosis that reflects hopelessness, that implies the patient cannot communicate rationally, and that can be used to justify treatments that do not require much doctor-patient communication.

Seymour L. Halleck, M.D., The Politics of Therapy
Copyright © 1971 by Science House, Inc. All rights reserved.

Posted 16 December 1996

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