Advertisement

Clinician Bias in Diagnosis and Treatment

  • Danielle R. Hairston
  • Tresha A. Gibbs
  • Shane Shucheng Wong
  • Ayana Jordan
Chapter
Part of the Current Clinical Psychiatry book series (CCPSY)

Abstract

Clinicians’ attitudes and biases, both implicit and explicit, contribute to disparities in psychiatric care. Biases impact medication dosing and choices, use of restraints, the level of care, and involuntary commitment, especially in the treatment of black patients. Stigma, lower socioeconomic status, and limited access to care contribute to differences in management of patients’ mental health needs. However, the impact of stereotypical beliefs about black and other racial minorities on diagnosis and treatment cannot be ignored. The ideal clinical encounter is one in which both the provider and the patient are keenly aware of the impact of racism and bias on mental health, and they are both able to freely discuss the experience and consequences of racism. This chapter identifies evidence of bias in mental health care and discusses strategies for avoiding common pitfalls that negatively impact the care of racial minorities.

Keywords

Implicit bias Explicit bias Clinician bias Disparities 

References

  1. 1.
    van Ryn M, Fu SS. Paved with good intentions: do public health and human service providers contribute to racial/ethnic disparities in health? Am J Public Health. 2003;93(2):248–55.PubMedPubMedCentralCrossRefGoogle Scholar
  2. 2.
    Institute of Medicine. Unequal treatment: confronting racial and ethnic disparities in health care. Washington, DC: National Academies Press; 2003.Google Scholar
  3. 3.
    Snowden LR. Bias in mental health assessment and intervention: theory and evidence. Am J Public Health. 2003;93(2):239–43.PubMedPubMedCentralCrossRefGoogle Scholar
  4. 4.
    Hunt J, Sullivan G, Chavira DA, Stein MB, Craske MG, Golinelli D, et al. Race and beliefs about mental health treatment among anxious primary care patients. J Nerv Ment Dis. 2013;201(3):188–95.PubMedPubMedCentralCrossRefGoogle Scholar
  5. 5.
    Liberman Z, Woodward AL, Kinzler KD. The origins of social categorization. Trends Cogn Sci. 2017;21(7):556–68.PubMedPubMedCentralCrossRefGoogle Scholar
  6. 6.
    Hall WJ, Chapman MV, Lee KM, Merino YM, Thomas TW, Payne BK, et al. Implicit racial/ethnic bias among health care professionals and its influence on health care outcomes: a systematic review. Am J Public Health. 2015;105(12):e60–76.PubMedPubMedCentralCrossRefGoogle Scholar
  7. 7.
    FitzGerald C, Hurst S. Implicit bias in healthcare professionals: a systematic review. BMC Med Ethics. 2017;18(1):19.PubMedPubMedCentralCrossRefGoogle Scholar
  8. 8.
    Kubota JT, Banaji MR, Phelps EA. The neuroscience of race. Nat Neurosci. 2012;15(7):940–8.PubMedCrossRefGoogle Scholar
  9. 9.
    Staats C, Capatosto K, Wright RA, Contractor D. State of the science: implicit bias review. Columbus: Ohio State University: Kirwan Institute for the Study of Race and Ethnicity; 2016.Google Scholar
  10. 10.
    Welch K. Black criminal stereotypes and racial profiling. J Contemp Crim Justice. 2007;23(3):276–88.CrossRefGoogle Scholar
  11. 11.
    Williams DR, Yan Y, Jackson JS, Anderson NB. Racial differences in physical and mental health: socio-economic status, stress and discrimination. J Health Psychol. 1997;2(3):335–51.CrossRefPubMedGoogle Scholar
  12. 12.
    Perinelli E, Gremigni P. Use of social desirability scales in clinical psychology: a systematic review. J Clin Psychol. 2016;72(6):534–51.PubMedCrossRefPubMedCentralGoogle Scholar
  13. 13.
    Todorov A, Engell AD. The role of the amygdala in implicit evaluation of emotionally neutral faces. Soc Cogn Affect Neurosci. 2008;3(4):303–12.PubMedPubMedCentralCrossRefGoogle Scholar
  14. 14.
    Santos S, Almeida I, Oliveiros B, Castelo-Branco M. The role of the amygdala in facial trustworthiness processing: a systematic review and meta-analyses of fMRI studies. PLoS One. 2016;11(11):e0167276.PubMedPubMedCentralCrossRefGoogle Scholar
  15. 15.
    Knutson KM, Mah L, Manly CF, Grafman J. Neural correlates of automatic beliefs about gender and race. Hum Brain Mapp. 2007;28(10):915–30.PubMedCrossRefPubMedCentralGoogle Scholar
  16. 16.
    Terbeck S, Kahane G, McTavish S, McCutcheon R, Hewstone M, Savulescu J, et al. Beta-adrenoceptor blockade modulates fusiform gyrus activity to black versus white faces. Psychopharmacology. 2015;232(16):2951–8.PubMedPubMedCentralCrossRefGoogle Scholar
  17. 17.
    Greenwald AG, McGhee DE, Schwartz JL. Measuring individual differences in implicit cognition: the implicit association test. J Pers Soc Psychol. 1998;74(6):1464–80.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Sabin J, Nosek BA, Greenwald A, Rivara FP. Physicians' implicit and explicit attitudes about race by MD race, ethnicity, and gender. J Health Care Poor Underserved. 2009;20(3):896–913.PubMedPubMedCentralCrossRefGoogle Scholar
  19. 19.
    Hausmann LR, Myaskovsky L, Niyonkuru C, Oyster ML, Switzer GE, Burkitt KH, et al. Examining implicit bias of physicians who care for individuals with spinal cord injury: a pilot study and future directions. J Spinal Cord Med. 2015;38(1):102–10.PubMedPubMedCentralCrossRefGoogle Scholar
  20. 20.
    Oliver MN, Wells KM, Joy-Gaba JA, Hawkins CB, Nosek BA. Do physicians' implicit views of African Americans affect clinical decision making? J Am Board Fam Med. 2014;27(2):177–88.PubMedCrossRefPubMedCentralGoogle Scholar
  21. 21.
    Carlsson R, Agerstrom J. A closer look at the discrimination outcomes in the IAT literature. Scand J Psychol. 2016;57(4):278–87.PubMedCrossRefPubMedCentralGoogle Scholar
  22. 22.
    Oswald FL, Mitchell G, Blanton H, Jaccard J, Tetlock PE. Using the IAT to predict ethnic and racial discrimination: small effect sizes of unknown societal significance. J Pers Soc Psychol. 2015;108(4):562–71.PubMedCrossRefPubMedCentralGoogle Scholar
  23. 23.
    Haider AH, Sexton J, Sriram N, Cooper LA, Efron DT, Swoboda S, et al. Association of unconscious race and social class bias with vignette-based clinical assessments by medical students. JAMA. 2011;306(9):942–51.PubMedPubMedCentralCrossRefGoogle Scholar
  24. 24.
    Sabin JA, Rivara FP, Greenwald AG. Physician implicit attitudes and stereotypes about race and quality of medical care. Med Care. 2008;46(7):678–85.PubMedCrossRefPubMedCentralGoogle Scholar
  25. 25.
    Gehring WJ, Karpinski A, Hilton JL. Thinking about interracial interactions. Nat Neurosci. 2003;6(12):1241–3.PubMedCrossRefPubMedCentralGoogle Scholar
  26. 26.
    Greenwald AG, Poehlman TA, Uhlmann EL, Banaji MR. Understanding and using the implicit association test: III. Meta-analysis of predictive validity. J Pers Soc Psychol. 2009;97(1):17–41.PubMedCrossRefPubMedCentralGoogle Scholar
  27. 27.
    Cooper LA, Roter DL, Carson KA, Beach MC, Sabin JA, Greenwald AG, et al. The associations of clinicians' implicit attitudes about race with medical visit communication and patient ratings of interpersonal care. Am J Public Health. 2012;102(5):979–87.PubMedPubMedCentralCrossRefGoogle Scholar
  28. 28.
    Johnson TJ, Hickey RW, Switzer GE, Miller E, Winger DG, Nguyen M, et al. The impact of cognitive stressors in the emergency department on physician implicit racial bias. Acad Emerg Med. 2016;23(3):297–305.PubMedPubMedCentralCrossRefGoogle Scholar
  29. 29.
    Burgess DJ. Are providers more likely to contribute to healthcare disparities under high levels of cognitive load? How features of the healthcare setting may lead to biases in medical decision making. Med Decis Mak. 2010;30(2):246–57.CrossRefGoogle Scholar
  30. 30.
    van Ryn M, Saha S. Exploring unconscious bias in disparities research and medical education. JAMA. 2011;306(9):995–6.PubMedPubMedCentralGoogle Scholar
  31. 31.
    Hirsh AT, Hollingshead NA, Ashburn-Nardo L, Kroenke K. The interaction of patient race, provider bias, and clinical ambiguity on pain management decisions. J Pain. 2015;16(6):558–68.PubMedPubMedCentralCrossRefGoogle Scholar
  32. 32.
    Blair IV, Steiner JF, Hanratty R, Price DW, Fairclough DL, Daugherty SL, et al. An investigation of associations between clinicians' ethnic or racial bias and hypertension treatment, medication adherence and blood pressure control. J Gen Intern Med. 2014;29(7):987–95.PubMedPubMedCentralCrossRefGoogle Scholar
  33. 33.
    Maddox KB. Perspectives on racial phenotypicality bias. Personal Soc Psychol Rev. 2004;8(4):383–401.CrossRefGoogle Scholar
  34. 34.
    Monk EP. Skin tone stratification among black Americans 2001–2003. Soc Forces. 2014;92(4):1313–37.CrossRefGoogle Scholar
  35. 35.
    Monk EP. The cost of color: skin color, discrimination, and health among African Americans. Am J Sociol. 2015;121(2):396–444.PubMedCrossRefPubMedCentralGoogle Scholar
  36. 36.
    Alegria M, Nakash O, Lapatin S, Oddo V, Gao S, Lin J, et al. How missing information in diagnosis can lead to disparities in the clinical encounter. J Public Health Manag Pract. 2008;14(Suppl):S26–35.PubMedPubMedCentralCrossRefGoogle Scholar
  37. 37.
    Primm A. Cultural issues in assessment and treatment: African American patients. In: Lim R, editor. Clinical manual of cultural psychiatry. Washington, DC: American Psychiatric Publishing; 2006. p. 35–65.Google Scholar
  38. 38.
    Perron BE, Fries LE, Kilbourne AM, Vaughn MG, Bauer MS. Racial/ethnic group differences in bipolar symptomatology in a community sample of persons with bipolar I disorder. J Nerv Ment Dis. 2010;198(1):16–21.PubMedCrossRefPubMedCentralGoogle Scholar
  39. 39.
    Simon RJ, Fleiss JL, Gurland BJ, Stiller PR, Sharpe L. Depression and schizophrenia in hospitalized black and white mental patients. Arch Gen Psychiatry. 1973;28(4):509–12.PubMedCrossRefGoogle Scholar
  40. 40.
    Raskin A, Crook TH, Herman KD. Psychiatric history and symptom differences in black and white depressed patients. J Consult Clin Psychol. 1975;43(1):73.PubMedCrossRefGoogle Scholar
  41. 41.
    Gibbs TA, Okuda M, Oquendo MA, Lawson WB, Wang S, Thomas YF, et al. Mental health of African Americans and Caribbean blacks in the United States: results from the national epidemiological survey on alcohol and related conditions. Am J Public Health. 2013;103(2):330–8.PubMedPubMedCentralCrossRefGoogle Scholar
  42. 42.
    Snowden LR, Cheung FK. Use of inpatient mental health services by members of ethnic minority groups. Am Psychol. 1990;45(3):347.CrossRefPubMedGoogle Scholar
  43. 43.
    Minsky S, Vega W, Miskimen T, Gara M, Escobar J. Diagnostic patterns in Latino, African American, and European American psychiatric patients. Arch Gen Psychiatry. 2003;60(6):637–44.PubMedCrossRefGoogle Scholar
  44. 44.
    Hu TW, Snowden LR, Jerrell JM, Nguyen TD. Ethnic populations in public mental health: services choice and level of use. Am J Public Health. 1991;81(11):1429–34.PubMedPubMedCentralCrossRefGoogle Scholar
  45. 45.
    Lawson WB, Hepler N, Holladay J, Cuffel B. Race as a factor in inpatient and outpatient admissions and diagnosis. Psychiatr Serv. 1994;45(1):72–4.CrossRefGoogle Scholar
  46. 46.
    Loring M, Powell B. Gender, race, and DSM-III: a study of the objectivity of psychiatric diagnostic behavior. J Health Soc Behav. 1988;29:1–22.PubMedCrossRefGoogle Scholar
  47. 47.
    Strakowski SM, Keck PE Jr, Arnold LM, Collins J, Wilson RM, Fleck DE, et al. Ethnicity and diagnosis in patients with affective disorders. J Clin Psychiatry. 2003;64(7):747–54.PubMedCrossRefGoogle Scholar
  48. 48.
    Strakowski SM, Hawkins JM, Keck PE Jr, McElroy SL, West SA, Bourne ML, et al. The effects of race and information variance on disagreement between psychiatric emergency service and research diagnoses in first-episode psychosis. J Clin Psychiatry. 1997;58(10):457–63. quiz 64–5PubMedCrossRefGoogle Scholar
  49. 49.
    Neighbors HW, Trierweiler SJ, Munday C, Thompson EE, Jackson JS, Binion VJ, et al. Psychiatric diagnosis of African Americans: diagnostic divergence in clinician-structured and semistructured interviewing conditions. J Natl Med Assoc. 1999;91(11):601.PubMedPubMedCentralGoogle Scholar
  50. 50.
    Adebimpe VR. Overview: white norms and psychiatric diagnosis of black patients. Am J Psychiatr. 1981;138(3):279–85.PubMedCrossRefPubMedCentralGoogle Scholar
  51. 51.
    Neighbors HW, Trierweiler SJ, Ford BC, Muroff JR. Racial differences in DSM diagnosis using a semi-structured instrument: the importance of clinical judgment in the diagnosis of African Americans. J Health Soc Behav. 2003;44:237–56.PubMedCrossRefPubMedCentralGoogle Scholar
  52. 52.
    Gara MA, Vega WA, Arndt S, Escamilla M, Fleck DE, Lawson WB, et al. Influence of patient race and ethnicity on clinical assessment in patients with affective disorders. Arch Gen Psychiatry. 2012;69(6):593–600.PubMedCrossRefGoogle Scholar
  53. 53.
    Strakowski SM, Flaum M, Amador X, Bracha HS, Pandurangi AK, Robinson D, et al. Racial differences in the diagnosis of psychosis. Schizophr Res. 1996;21(2):117–24.PubMedCrossRefPubMedCentralGoogle Scholar
  54. 54.
    Arnold LM, Keck PE, Collins J, Wilson R, Fleck DE, Corey KB, et al. Ethnicity and first-rank symptoms in patients with psychosis. Schizophr Res. 2004;67(2):207–12.PubMedCrossRefGoogle Scholar
  55. 55.
    Trierweiler SJ, Neighbors HW, Munday C, Thompson EE, Binion VJ, Gomez JP. Clinician attributions associated with the diagnosis of schizophrenia in African American and non–African American patients. J Consult Clin Psychol. 2000;68(1):171.PubMedCrossRefGoogle Scholar
  56. 56.
    Trierweiler SJ, Neighbors HW, Munday C, Thompson EE, Jackson JS, Binion VJ. Differences in patterns of symptom attribution in diagnosing schizophrenia between African American and non–African American clinicians. Am J Orthopsychiatry. 2006;76(2):154.PubMedCrossRefGoogle Scholar
  57. 57.
    Whaley AL. Cultural mistrust and mental health services for African Americans: a review and meta-analysis. Couns Psychol. 2001;29(4):513–31.CrossRefGoogle Scholar
  58. 58.
    Havens JF, Gudino OG, Biggs EA, Diamond UN, Weis JR, Cloitre M. Identification of trauma exposure and PTSD in adolescent psychiatric inpatients: an exploratory study. J Trauma Stress. 2012;25(2):171–8.PubMedPubMedCentralCrossRefGoogle Scholar
  59. 59.
    Rand MR. National crime victimization survey. Criminal victimization 2008. Washington, DC: Bureau of Justice Statistics, US Department of Justice, 2009.Google Scholar
  60. 60.
    Roberts AL, Gilman SE, Breslau J, Breslau N, Koenen KC. Race/ethnic differences in exposure to traumatic events, development of post-traumatic stress disorder, and treatment-seeking for post-traumatic stress disorder in the United States. Psychol Med. 2011;41(1):71–83.PubMedCrossRefPubMedCentralGoogle Scholar
  61. 61.
    David Finkelhor. Children’s exposure to violence: a comprehensive national survey. US Department of Justice. Washington, DC: Juvenile Justice Clearinghouse; 2009.Google Scholar
  62. 62.
    Fitzpatrick KM, Boldizar JP. The prevalence and consequences of exposure to violence among African-American youth. J Am Acad Child Adolesc Psychiat. 1993;32(2):424–30.CrossRefGoogle Scholar
  63. 63.
    Seal D, Nguyen A, Beyer K. Youth exposure to violence in an urban setting. Urban Stud Res. 2014;2014:1.CrossRefGoogle Scholar
  64. 64.
    Goff PA, Jackson MC, Di Leone BA, Culotta CM, DiTomasso NA. The essence of innocence: consequences of dehumanizing black children. J Pers Soc Psychol. 2014;106(4):526–45.PubMedCrossRefGoogle Scholar
  65. 65.
    Primm AB, Lawson WB. Disparities among ethnic groups: African Americans. In: Disparities in psychiatric care: clinical and cross-cultural perspectives; 2010. p. 19–29.Google Scholar
  66. 66.
    Kolbert JB, Williams RL, Morgan LM, Crothers LM, Hughes TL. Introduction to professional school counseling: advocacy, leadership, and intervention. Abingdon: Routledge; 2016.CrossRefGoogle Scholar
  67. 67.
    Heard-Garris NJ, Cale M, Camaj L, Hamati MC, Dominguez TP. Transmitting trauma: a systematic review of vicarious racism and child health. Soc Sci Med. 2017;199:230–40.PubMedCrossRefGoogle Scholar
  68. 68.
    Priest N, Perry R, Ferdinand A, Kelaher M, Paradies Y. Effects over time of self-reported direct and vicarious racial discrimination on depressive symptoms and loneliness among Australian school students. BMC Psychiatry. 2017;17(1):50.PubMedPubMedCentralCrossRefGoogle Scholar
  69. 69.
    Berkowitz SJ. Children exposed to community violence: the rationale for early intervention. Clin Child Fam Psychol Rev. 2003;6(4):293–302.PubMedCrossRefGoogle Scholar
  70. 70.
    LaVeist TA, Wallace JM. Health risk and inequitable distribution of liquor stores in African American neighborhood. Soc Sci Med. 2000;51(4):613–7.PubMedCrossRefGoogle Scholar
  71. 71.
    Bell CC. High rates of neurobehavioral disorder associated with prenatal exposure to alcohol among African Americans driven by the plethora of liquor stores in the community. J Fam Med Dis Prev. 2016;2(2):033.CrossRefGoogle Scholar
  72. 72.
    Chasnoff IJ, Wells AM, King L. Misdiagnosis and missed diagnoses in foster and adopted children with prenatal alcohol exposure. Pediatrics. 2015;135(2):264–70.PubMedCrossRefGoogle Scholar
  73. 73.
    Schmidt L, Greenfield T, Mulia N. Unequal treatment: racial and ethnic disparities in alcoholism treatment services. Alcohol Res Health. 2006;29(1):49.PubMedGoogle Scholar
  74. 74.
    Wells K, Klap R, Koike A, Sherbourne C. Ethnic disparities in unmet need for alcoholism, drug abuse, and mental health care. Am J Psychiatry. 2001;158(12):2027–32.PubMedCrossRefGoogle Scholar
  75. 75.
    Knudsen HK, Ducharme LJ, Roman PM. Racial and ethnic disparities in SSRI availability in substance abuse treatment. Psychiatr Serv. 2007;58(1):55–62.PubMedCrossRefGoogle Scholar
  76. 76.
    Alegria M, Carson NJ, Goncalves M, Keefe K. Disparities in treatment for substance use disorders and co-occurring disorders for ethnic/racial minority youth. J Am Acad Child Adolesc Psychiatry. 2011;50(1):22–31.PubMedCrossRefGoogle Scholar
  77. 77.
    Quintero GA, Lilliott E, Willging C. Substance abuse treatment provider views of "culture": implications for behavioral health care in rural settings. Qual Health Res. 2007;17(9):1256–67.PubMedCrossRefGoogle Scholar
  78. 78.
    Polcin DL, Weisner C. Factors associated with coercion in entering treatment for alcohol problems. Drug Alcohol Depend. 1999;54(1):63–8.PubMedCrossRefGoogle Scholar
  79. 79.
    Chasnoff IJ, Landress HJ, Barrett ME. The prevalence of illicit-drug or alcohol use during pregnancy and discrepancies in mandatory reporting in Pinellas County, Florida. N Engl J Med. 1990;322(17):1202–6.PubMedCrossRefGoogle Scholar
  80. 80.
    Cohen A. How white users made heroin a public-health problem. The Atlantic. 2015.Google Scholar
  81. 81.
    Sussman LK, Robins LN, Earls F. Treatment-seeking for depression by black and white Americans. Soc Sci Med. 1987;24(3):187–96.PubMedCrossRefPubMedCentralGoogle Scholar
  82. 82.
    Wang PS, Demler O, Kessler RC. Adequacy of treatment for serious mental illness in the United States. Am J Public Health. 2002;92(1):92–8.PubMedPubMedCentralCrossRefGoogle Scholar
  83. 83.
    Kuno E, Rothbard AB. Racial disparities in antipsychotic prescription patterns for patients with schizophrenia. Am J Psychiatr. 2002;159(4):567–72.PubMedCrossRefPubMedCentralGoogle Scholar
  84. 84.
    Barrio C, Yamada AM, Hough RL, Hawthorne W, Garcia P, Jeste DV. Ethnic disparities in use of public mental health case management services among patients with schizophrenia. Psychiatr Serv. 2003;54(9):1264–70.PubMedCrossRefPubMedCentralGoogle Scholar
  85. 85.
    Swanson J, Swartz M, Van Dorn RA, Monahan J, McGuire TG, Steadman HJ, et al. Racial disparities in involuntary outpatient commitment: are they real? Health Aff. 2009;28(3):816–26.CrossRefGoogle Scholar
  86. 86.
    Strakowski SM, Lonczak HS, Sax KW, West SA, Crist A, Mehta R, et al. The effects of race on diagnosis and disposition from a psychiatric emergency service. J Clin Psychiat. 1995;56:101–7.Google Scholar
  87. 87.
    Flaherty JA, Meagher R. Measuring racial bias in inpatient treatment. Am J Psychiat. 1980;137:679–82.PubMedCrossRefPubMedCentralGoogle Scholar
  88. 88.
    Gudjonsson GH, Rabe-Hesketh S, Szmukler G. Management of psychiatric in-patient violence: patient ethnicity and use of medication, restraint and seclusion. Br J Psychiatry. 2004;184(3):258–62.PubMedCrossRefPubMedCentralGoogle Scholar
  89. 89.
    Way BB, Banks SM. Use of seclusion and restraint in public psychiatric hospitals: patient characteristics and facility effects. Psychiatr Serv. 1990;41(1):75–81.CrossRefGoogle Scholar
  90. 90.
    Milazzo-Sayre LJ, Benson PR, Rosenstein MJ, Manderscheid RW. Use of inpatient psychiatric services by the elderly age 65 and over, United States, 1980. Ment Health Stat Note. 1987;181:1–37.Google Scholar
  91. 91.
    Zito JM, Safer DJ, DosReis S, Riddle MA. Racial disparity in psychotropic medications prescribed for youths with Medicaid insurance in Maryland. J Am Acad Child Adolesc Psychiat. 1998;37(2):179–84.CrossRefGoogle Scholar
  92. 92.
    Safer DJ, Malever M. Stimulant treatment in Maryland public schools. Pediatrics. 2000;106(3):533–9.PubMedCrossRefPubMedCentralGoogle Scholar
  93. 93.
    Leslie LK, Weckerly J, Landsverk J, Hough RL, Hurlburt MS, Wood PA. Racial/ethnic differences in the use of psychotropic medication in high-risk children and adolescents. J Am Acad Child Adolesc Psychiat. 2003;42(12):1433–42.CrossRefGoogle Scholar
  94. 94.
    Liptak GS, Benzoni LB, Mruzek DW, Nolan KW, Thingvoll MA, Wade CM, et al. Disparities in diagnosis and access to health services for children with autism: data from the National Survey of Children's Health. J Dev Behav Pediatr. 2008;29(3):152–60.PubMedCrossRefPubMedCentralGoogle Scholar
  95. 95.
    Donovan A, Plant R, Peller A, Siegel L, Martin A. Two-year trends in the use of seclusion and restraint among psychiatrically hospitalized youths. Psychiatr Serv. 2003;54(7):987–93.PubMedCrossRefPubMedCentralGoogle Scholar
  96. 96.
    Opolka JL, Rascati KL, Brown CM, Gibson PJ. Ethnicity and prescription patterns for haloperidol, risperidone, and olanzapine. Psychiatr Serv. 2004;55(2):151–6.PubMedCrossRefPubMedCentralGoogle Scholar
  97. 97.
    Copeland LA, Zeber JE, Valenstein M, Blow FC. Racial disparity in the use of atypical antipsychotic medications among veterans. Am J Psychiatr. 2003;160(10):1817–22.PubMedCrossRefPubMedCentralGoogle Scholar
  98. 98.
    Chung H, Mahler JC, Kakuma T. Racial differences in treatment of psychiatric inpatients. Psychiatr Serv. 1995;46:586–91.PubMedCrossRefPubMedCentralGoogle Scholar
  99. 99.
    Kreyenbuhl J, Zito JM, Buchanan RW, Soeken KL, Lehman AF. Racial disparity in the pharmacological management of schizophrenia. Schizophr Bull. 2003;29(2):183–94.PubMedCrossRefPubMedCentralGoogle Scholar
  100. 100.
    Breakey WR, Dunn GJ. Racial disparity in the use of ECT for affective disorders. Am J Psychiatr. 2004;161(9):1635–41.PubMedCrossRefPubMedCentralGoogle Scholar
  101. 101.
    Case BG, Bertollo DN, Laska EM, Siegel CE, Wanderling JA, Olfson M. Racial differences in the availability and use of electroconvulsive therapy for recurrent major depression. J Affect Disord. 2012;136(3):359–65.PubMedCrossRefPubMedCentralGoogle Scholar
  102. 102.
    Gee GC, Ro A, Shariff-Marco S, Chae D. Racial discrimination and health among Asian Americans: evidence, assessment, and directions for future research. Epidemiol Rev. 2009;31:130–51.PubMedPubMedCentralCrossRefGoogle Scholar
  103. 103.
    Rosenbloom SR, Way N. Experiences of discrimination among African American, Asian American, and Latino adolescents in an urban high school. Youth Soc. 2004;35(4):420–51.CrossRefGoogle Scholar
  104. 104.
    Yeh M, Yeh JW. The clinical assessment of Asian American children. In: Asian American Mental Health. Berlin: Springer; 2002. p. 233–49.CrossRefGoogle Scholar
  105. 105.
    Gee CB. Assessment of anxiety and depression in Asian American youth. J Clin Child Adolesc Psychol. 2004;33(2):269–71.PubMedCrossRefPubMedCentralGoogle Scholar
  106. 106.
    Huang LN. Asian American adolescents. Working with Asian Americans: a guide for clinicians; 1997. pp 175–195Google Scholar
  107. 107.
    Abe-Kim J, Takeuchi DT, Hong S, Zane N, Sue S, Spencer MS, et al. Use of mental health–related services among immigrant and US-born Asian Americans: results from the National Latino and Asian American study. Am J Public Health. 2007;97(1):91–8.PubMedPubMedCentralCrossRefGoogle Scholar
  108. 108.
    Sue DW. Asian-American mental health and help-seeking behavior: Comment on Solberg et al. (1994), Tata and Leong (1994), and Lin (1994). 1994.Google Scholar
  109. 109.
    Lee S, Juon H-S, Martinez G, Hsu CE, Robinson ES, Bawa J, et al. Model minority at risk: expressed needs of mental health by Asian American young adults. J Community Health. 2009;34(2):144–52.PubMedPubMedCentralCrossRefGoogle Scholar
  110. 110.
    Office of the Surgeon Group, Center for Mental Health Services, National Institute of Mental Health. Mental health: culture, race, and ethnicity: a supplement to mental health: a report of the surgeon general. Rockville: Substance Abuse and Mental Health Services Administration; 2001.Google Scholar
  111. 111.
    US Census Bureau. Quick facts United States 2015. http://www.census.gov. Accessed Jun 2017
  112. 112.
    Burnett-Zeigler I, Bohnert KM, Ilgen MA. Ethnic identity, acculturation and the prevalence of lifetime psychiatric disorders among black, Hispanic, and Asian adults in the US. J Psychiatr Res. 2013;47(1):56–63.PubMedCrossRefGoogle Scholar
  113. 113.
    Gilmer TP, Ojeda VD, Barrio C, Fuentes D, Garcia P, Lanouette NM, et al. Adherence to antipsychotics among Latinos and Asians with schizophrenia and limited English proficiency. Psychiatr Serv. 2009;60(2):175–82.PubMedPubMedCentralCrossRefGoogle Scholar
  114. 114.
    Laria AL-F. Roberto. Cultural issues in assessment and treatment: Latino patients. In: Lim R, editor. Clinical manual of cultural psychiatry. Washington, DC: American Psychiatric Publishing; 2006. p. 119–74.Google Scholar
  115. 115.
    Coleman KJ, Stewart C, Waitzfelder BE, Zeber JE, Morales LS, Ahmed AT, et al. Racial–ethnic differences in psychiatric diagnoses and treatment across 11 health care systems in the Mental Health Research Network. Psychiatr Serv. 2016;67(7):749–57.PubMedPubMedCentralCrossRefGoogle Scholar
  116. 116.
    Alegria M, Canino G, Rios R, Vera M, Calderon J, Rusch D, et al. Inequalities in use of specialty mental health services among Latinos, African Americans, and non-Latino whites. Psychiatr Serv. 2002;53(12):1547–55.PubMedCrossRefGoogle Scholar
  117. 117.
    Weinick RM, Jacobs EA, Stone LC, Ortega AN, Burstin H. Hispanic healthcare disparities: challenging the myth of a monolithic Hispanic population. Med Care. 2004;42(4):313–20.PubMedCrossRefGoogle Scholar
  118. 118.
    Lesser IM, Castro DB, Gaynes BN, Gonzalez J, Rush AJ, Alpert JE, et al. Ethnicity/race and outcome in the treatment of depression: results from STAR*D. Med Care. 2007;45(11):1043–51.PubMedCrossRefGoogle Scholar
  119. 119.
    Schwartz RC, Blankenship DM. Racial disparities in psychotic disorder diagnosis: a review of empirical literature. World J Psychiat. 2014;4(4):133–40.CrossRefGoogle Scholar
  120. 120.
    Bean MG, Focella ES, Covarrubias R, Stone J, Moskowitz GB, Badger TA. Documenting nursing and medical students' stereotypes about Hispanic and American Indian patients. J Health Dispar Res Pract. 2014;7(4):14.PubMedPubMedCentralGoogle Scholar
  121. 121.
    Moskowitz GB, Stone J, Childs A. Implicit stereotyping and medical decisions: unconscious stereotype activation in practitioners' thoughts about African Americans. Am J Public Health. 2012;102(5):996–1001.PubMedPubMedCentralCrossRefGoogle Scholar
  122. 122.
    Steinberg EM, Valenzuela-Araujo D, Zickafoose JS, Kieffer E, DeCamp LR. The "battle" of managing language barriers in health care. Clin Pediatr (Phila). 2016;55:1318.CrossRefGoogle Scholar
  123. 123.
    Villalobos BT, Bridges AJ, Anastasia EA, Ojeda CA, Rodriguez JH, Gomez D. Effects of language concordance and interpreter use on therapeutic alliance in Spanish-speaking integrated behavioral health care patients. Psychol Serv. 2016;13(1):49–59.PubMedCrossRefPubMedCentralGoogle Scholar
  124. 124.
    Alarcon RD, Ruiz P. Hispanic Americans. In: Ruiz P, Primm A, editors. Disparities in psychiatric care: clinical and cross-cultural perspectives. Philadelphia: Lippincott Williams & Wilkins; 2010. p. 30–9.Google Scholar
  125. 125.
    Cassano P, Chang T, Trinh NH, Baer L, Fava M, Mischoulon D. Differential impact of isolated psychotic symptoms on treatment outcome of major depressive disorder in the STAR*D cohort of whites, blacks and Latinos. J Affect Disord. 2013;150(2):578–84.PubMedPubMedCentralCrossRefGoogle Scholar
  126. 126.
    Interian A, Martinez IE, Guarnaccia PJ, Vega WA, Escobar JI. A qualitative analysis of the perception of stigma among Latinos receiving antidepressants. Psychiatr Serv. 2007;58(12):1591–4.PubMedPubMedCentralCrossRefGoogle Scholar
  127. 127.
    Vargas SM, Cabassa LJ, Nicasio A, De La Cruz AA, Jackson E, Rosario M, et al. Toward a cultural adaptation of pharmacotherapy: Latino views of depression and antidepressant therapy. Transcult Psychiatry. 2015;52(2):244–73.PubMedCrossRefPubMedCentralGoogle Scholar
  128. 128.
    Antoniades J, Mazza D, Brijnath B. Efficacy of depression treatments for immigrant patients: results from a systematic review. BMC Psychiatry. 2014;14:176.PubMedPubMedCentralCrossRefGoogle Scholar
  129. 129.
    Pineros-Leano M, Liechty JM, Piedra LM. Latino immigrants, depressive symptoms, and cognitive behavioral therapy: a systematic review. J Affect Disord. 2017;208:567–76.PubMedCrossRefPubMedCentralGoogle Scholar
  130. 130.
    Ruiz P, Varner RV, Small DR, Johnson BA. Ethnic differences in the neuroleptic treatment of schizophrenia. Psychiatry Q. 1999;70(2):163–72.CrossRefGoogle Scholar
  131. 131.
    Reyes C Van de Putte L, Falcon AP, Levy RA. Genes, culture and medicines: bridging gaps in treatment for Hispanic Americans. National Alliance for Hispanic Health, Washington, DC, 2004.Google Scholar
  132. 132.
    Nelson SH, McCoy GF, Stetter M, Vanderwagen WC. An overview of mental health services for American Indians and Alaska natives in the 1990s. Psychiatr Serv. 1992;43(3):257–61.CrossRefGoogle Scholar
  133. 133.
    Pevar S. The rights of Indians and tribes. Oxford: Oxford University Press; 2012.Google Scholar
  134. 134.
    Devon AM. American Indians: stereotypes and realities. Atlanta: Clarity Press; 1996. p. 534–53.Google Scholar
  135. 135.
    Kinzie JD, Leung PK, Boehnlein J, Matsunaga D, Johnson R, Manson S, et al. Psychiatric epidemiology of an Indian village: a 19-year replication study. J Nerv Ment Dis. 1992;180(1):33–9.PubMedCrossRefPubMedCentralGoogle Scholar
  136. 136.
    Kunitz SJ, Gabriel KR, Levy JE, Henderson E, Lampert K, McCloskey J, et al. Alcohol dependence and conduct disorder among Navajo Indians. J Stud Alcohol. 1999;60(2):159–67.PubMedCrossRefPubMedCentralGoogle Scholar
  137. 137.
    Wallace JM, Bachman JG, O'Malley PM, Schulenberg JE, Cooper SM, Johnston LD. Gender and ethnic differences in smoking, drinking and illicit drug use among American 8th, 10th and 12th grade students, 1976–2000. Addiction. 2003;98(2):225–34.PubMedCrossRefGoogle Scholar
  138. 138.
    Beals J, Manson SM, Shore JH, Friedman M, Ashcraft M, Fairbank JA, et al. The prevalence of posttraumatic stress disorder among American Indian Vietnam veterans: disparities and context. J Trauma Stress. 2002;15(2):89–97.PubMedCrossRefGoogle Scholar
  139. 139.
    Wong SS, Sugimoto-Matsuda JJ, Chang JY, Hishinuma ES. Ethnic differences in risk factors for suicide among American high school students, 2009: the vulnerability of multiracial and Pacific islander adolescents. Arch Suicide Res. 2012;16(2):159–73.PubMedCrossRefPubMedCentralGoogle Scholar
  140. 140.
    Manson SM. Mental health services for American Indians and Alaska natives: need, use, and barriers to effective care. Can J Psychiatr. 2000;45(7):617–26.CrossRefGoogle Scholar
  141. 141.
    Manderscheid RW, Henderson MJ. Mental health, United States, 1998: Darby DIANE Publishing; 1999.Google Scholar
  142. 142.
    Alegria M, Katz A, Ishikawa RZ, Diaz-Linhart Y, Valentine A, Lapatin S. The role of sociocultural information in mental health intake sessions. Isr J Psychiatry Relat Sci. 2012;49(3):194–201.PubMedPubMedCentralGoogle Scholar
  143. 143.
    Primm AB, Lawson WB. Disparities among ethnic groups: African Americans. In: Ruiz P, Primm A, editors. Disparities in psychiatric care: clinical and cross-cultural perspectives. Philadelphia: Lippincott Williams & Wilkins; 2010.Google Scholar
  144. 144.
    Lawson W, Johnston S, Karson C, Offord S, Docherty J, Eramo A, et al. Racial differences in antipsychotic use: claims database analysis of Medicaid-insured patients with schizophrenia. Ann Clin Psychiatry. 2016;27(4):242–52.Google Scholar
  145. 145.
    Murphy E, Hou L, Maher BS, Woldehawariat G, Kassem L, Akula N, et al. Race, genetic ancestry and response to antidepressant treatment for major depression. Neuropsychopharmacology. 2013;38(13):2598–606.PubMedPubMedCentralCrossRefGoogle Scholar
  146. 146.
    Kelly DL, Kreyenbuhl J, Dixon L, Love RC, Medoff D, Conley RR. Clozapine underutilization and discontinuation in African Americans due to leucopenia. Schizophr Bull. 2007;33(5):1221–4.PubMedCrossRefGoogle Scholar
  147. 147.
    Strickland TL, Lin KM, Fu P, Anderson D, Zheng Y. Comparison of lithium ratio between African-American and Caucasian bipolar patients. Biol Psychiatry. 1995;37(5):325–30.PubMedCrossRefGoogle Scholar
  148. 148.
    Shim RS, Compton MT, Rust G, Druss BG, Kaslow NJ. Race–ethnicity as a predictor of attitudes toward mental health treatment seeking. Psychiatr Serv. 2009;60(10):1336–41.PubMedPubMedCentralCrossRefGoogle Scholar
  149. 149.
    Burgess D, van Ryn M, Dovidio J, Saha S. Reducing racial bias among health care providers: lessons from social–cognitive psychology. J Gen Intern Med. 2007;22(6):882–7.PubMedPubMedCentralCrossRefGoogle Scholar
  150. 150.
    Aberson CL, Shoemaker C, Tomolillo C. Implicit bias and contact: the role of interethnic friendships. J Soc Psychol. 2004;144(3):335–47.PubMedCrossRefGoogle Scholar
  151. 151.
    Devine PG, Forscher PS, Austin AJ, Cox WT. Long-term reduction in implicit race bias: a prejudice habit–breaking intervention. J Exp Soc Psychol. 2012;48(6):1267–78.PubMedPubMedCentralCrossRefGoogle Scholar
  152. 152.
    Whaley AL. Cultural mistrust: an important psychological construct for diagnosis and treatment of African Americans. Prof Psychol Res Pract. 2001;32(6):555.CrossRefGoogle Scholar
  153. 153.
    Paul-Emile K, Smith AK, Lo B, Fernández A. Dealing with racist patients. N Engl J Med. 2016;374(8):708–11.PubMedCrossRefPubMedCentralGoogle Scholar
  154. 154.
    Cooper LA, Roter DL, Johnson RL, Ford DE, Steinwachs DM, Powe NR. Patient-centered communication, ratings of care, and concordance of patient and physician race. Ann Intern Med. 2003;139(11):907–15.PubMedCrossRefPubMedCentralGoogle Scholar
  155. 155.
    American Psychological Association. Health disparities. http://www.apa.org/about/gr/issues/workforce/disparity.aspx. Accessed 15 May 2017.
  156. 156.
    Okwerekwu J. The patient called me “colored girl.” The senior doctor training me said nothing. https://www.statnews.com/2016/04/11/racism-medical-education/. Accessed 12 Jun 2017.
  157. 157.
    Levy DR. White doctors and black patients: influence of race on the doctor–patient relationship. Pediatrics. 1985;75(4):639–43.PubMedPubMedCentralGoogle Scholar
  158. 158.
    Danzer G, Rieger SM, Schubmehl S, Cort D. White psychologists and African Americans’ historical trauma: implications for practice. J Aggress Maltreat Trauma. 2016;25(4):351–70.CrossRefGoogle Scholar
  159. 159.
    Staats C, Capatosto K, Wright RA, Contractor D. State of the science: implicit bias review 2014. Kirwan Institute for the Study of Race and Ethnicity. http://kirwaninstitute.osu.edu/wp-content/uploads/2014/03/2014-implicit-bias.pdf.

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Danielle R. Hairston
    • 1
  • Tresha A. Gibbs
    • 2
  • Shane Shucheng Wong
    • 3
  • Ayana Jordan
    • 4
  1. 1.Division of Consultation—Liaison PsychiatryUniversity of Maryland Medical CenterBaltimoreUSA
  2. 2.Department of Psychiatry, Harlem Hospital Health + Hospitals CorporationColumbia College of Physicians and SurgeonsNew YorkUSA
  3. 3.Department of PsychiatryMassachusetts General HospitalBostonUSA
  4. 4.Connecticut Mental Health Center, Department of PsychiatryYale New Haven Hospital, Yale University School of MedicineNew HavenUSA

Personalised recommendations