Summary
The role that patients' social class plays in the diagnoses that they are given and the treatments that are recommended for them, has been of continuing interest to the mental health profession. Charges of “bias” have not been infrequent. Examination of this issue was the primary focus of this study. Thirthy psychiatrists in private practice and thirty-eight experienced clinicians from a community mental health center were presented with four psychiatric case descriptions. They were asked for their diagnoses and treatment recommendations. Each case description contained upper class or lower class cases. This paper reports on the diagnoses that were made and the treatment modalities that were recommended by private and public practitioners, using social class as the independent variable.
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References
Avnet, H. H.: Psychiatric Insurance. New York, Group Health Insurance, (1962)
Baldwin, W. K.: The Social position of the educable mentally retarded child in the regular grades in the public schools. The Exceptional Children. 25, 106–108 (1958)
Baum, O. E., Felzer, S. B.: Activity in initial interview with lower-class patients. Arch. gen. Psychiat. 10, 345–353 (1964)
Beck, J. C.: Outpatient group therapy of the poor. Cur. Psychiatric Therapies. 9, 241–244 (1969)
Conger, J. J., Miller, W. C., Walsmith, C. R.: Antecedents of delinquency, personality, social class and intelligence. In: P. H. Mussen, J. J. Conger, and J. Kagan (Eds.), Readings in Child Development and Personality. New York: Harper and Row, 1965
Derbyshire, R. L.: Adolescent identity crisis in urban Mexican Americans in east Los Angeles. In: E. B. Brody (Ed.), Minority group adolescents in the United States. Baltimore: Williams and Wilkins, 157–204 1968
Detre, T. P., Jarecki, H. G.: Modern Psychiatric Treatments, Lippincott, 1971
Freidson, E.: Patients' Views of Medical Practice. Russell Sage Foundation, 1961
Gardener, E., Gardener, M.: A community mental health center case study: innovations and issues. Seminars in Psychiat. 3, 172–198 (1971)
Glueck, S., Glueck, E. T.: Unraveling juvenile delinquency. New York: Commonwealth Fund, 1950
Group for the Advancement of Psychiatry: The crisis in psychiatric hospitalization. Intern. J. Psychiat. 9, 565–586 (1970)
Hasse, W.: Rorschach diagnosis, socioeconomic class and examiner bias. Unpublished doctoral dissertation, New York University, 1956
Hess, R. D., Shipman, V. C.: Early experience and the socialization of cognitive modes in children. Child Development 34, 869–886 (1965)
Hollingshead, A. B., Redlich, F. C.: Social class and mental illness. New York: Wiley 1958
Kurtz, N., Kurtz, R., Hoffung, R.: Attitudes toward lower and middle-class psychiatric patients as a function of authoritariansim among mental health students. J. Cons. and Clinical Psychol. 35, 338–341 (1970)
Lerner, B., Fiske, D. W.: Client attributes and the eye of the beholder. J. Cons. and Clinical Psychol 40, 272–277 (1973)
MacMahon, B., Feldman, J. J.: Infant mortality rates and socio-economic factors. National Center for Health Statistics: United States Public Health Service, 1972
Miller, M., Mishler, E. G.: Social Class, mental illness and American Psychiatry. Milhank Memorial Fund Quarterly 37, 174–199 (1959)
Mischler, E. G., Scotch, N. A.: Socio-cultural factors in the epidemiology of schizophrenia. Psychiatry 26, 315–351 (1963)
Myers, J. K., Bean, L. L.: A decade later: A follow-up of social class and mental illness. New York: John Wiley and Sons, Inc., 1968
Osofsky, H. J.: The walls are within. In: Among the People: Encounter with the Poor. Irwin Deutscher and Elizabeth J. Thompson, Eds. New York: Basic Boods, 1968
Riessman, F.: New approaches to mental health treatment for labor and lower income groups. Mimeographed report, National Institute of Labor Education, Mental Health Program, 1963
Rosengren, W. R., Lefton, M.: Hospitals and patients, 197–198. New York: Atherton Press 1969
Smith, A. C., Flick, G. C., Ferriss, G. S., Sellmann, A. H.: Prediction of developmental outcome at seven years from prenatal, perinatal and postnatal events. Child Development 43, 495–507 (1972)
Rushing, W. A.: Occupation, income and mental hospitalization. Ment. Hygiene 52, 248–252 (1971)
Siegel, N. H., Khan, R. L., Pollack, M., Fink, M.: Social class, diagnosis and treatment in three psychiatric hospitals. Social Problems 10, 191–196 (1962)
Routh, D. K., King, K. M.: Social class bias in clinical judgment. J. of Cons. and Clinical Psychol. 38, 202–207 (1972)
Star, S. A., What the public thinks about mental health and mental illness. Paper presented at the annual meeting of the National Association for Mental Health, November 19, 1952
Tischler, G. L., Henisz, J. E., Myers, J. K., Boswell, P. C.: Utilization of mental health services: II Mediators of service allocation. Arch. Gen. Psychiat. 32, 416–418 (1975)
White, A. M., Fichtenbaum, L., Dollard, J.: A measure predicting dropping out of psychotherapy. J. Cons. Psychol. 28, 326–332 (1964)
Yamamoto, J., Goin, M. K.: On the treatment of the poor. Amer. J. Psychiat. 122, 267–271 (1965)
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Crocetti, G., Spiro, H.R. & Siassi, I. Psychiatry and social class. Soc Psychiatry 11, 99–105 (1976). https://doi.org/10.1007/BF00579308
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DOI: https://doi.org/10.1007/BF00579308