Clinicians may be more likely to see mental illness in white children than in black or Hispanic ones, according to an experimental study in the February Journal of Consulting and Clinical Psychology (Vol. 75, No. 1, pages 1-8). Regardless of the clinicians' own race, psychologists, psychiatrists and social workers all tended to label white children with conduct disorder-like symptoms as mentally ill more often than they labeled children of color with the same symptoms, notes study author Kathleen Pottick, MSW, PhD, a professor in the Rutgers School of Social Work.
"It may be that these negative behaviors are seen as more normative for minority children than for white children," Pottick notes.
Pottick and her colleagues asked 1,401 clinicians to read a vignette about a child named either Carlos or Carl. In some of the vignettes, Carl was white and in some he was black. The remaining participants read about Carlos who was Hispanic. Carl or Carlos was causing a lot of trouble in school, bullying his classmates, skipping class and, in one incident, attacking a classmate with a baseball bat. In some of the stories, his actions could be explained because he recently was forced to join a gang. In other versions of the vignette, Carl or Carlos went to a safe school, and his behavior was completely out of the ordinary.
Though Carl or Carlos met the diagnostic criteria for conduct disorder in all the versions of the vignette, the clinicians were less likely to view him as mentally ill if his behavior seemed adaptive, given his violent school. But regardless of the contextual information, clinicians were more likely to label the white Carl as mentally ill than the black Carl or Hispanic Carlos.
The findings suggest that either white children are being overdiagnosed or ethnic-minority children are not getting the diagnosis--and treatment--they need, Pottick says.
"This might...explain how, in part, minority children disproportionately end up in the juvenile justice system while white children end up in the mental health system," Pottick says.
The study also found that:
Older clinicians were less likely to report mental disorder than were younger ones.
Social workers were the least likely professionals to see mental illness. Psychologists were three times as likely to see mental illness as social workers, and psychiatrists were five times as likely to.
Psychodynamic and psychoanalytic clinicians more often saw the antisocial behavior as indicative of mental illness than did clinicians from other orientations.