BPA Fights to Remedy Health Care Discrimination

Pitts outlined three major goals of the organization: psychiatric and health services research that is focused on, and directed by, African Americans; advocacy for culturally competent mental health treatment of African Americans; and social justice, particularly in the area of juvenile justice.

“Research is one of the most important goals of my presidency,” Pitts said. “African Americans haven’t been involved in clinical trials, and we have medications coming out to which African Americans respond differently. Generally, we are misdiagnosed and overmedicated. We want more research that is focused on African Americans, but also research that is directed and conducted by African Americans.”

Pitts also said that psychiatrists and others who treat African Americans must be culturally competent. “I know it’s a buzzword that has become very politically correct, but we believe it is vital for the clinicians to understand the social, psychological, and emotional environment of the patients we are serving, including cultural mores and use of language.”

But it was the incarceration of young African-American males and the fact that the prison system is rapidly becoming the country’s largest public mental health system that aroused the greatest passion at the meeting. Pitts echoed other speakers at the conference in calling on African-American psychiatrists to become involved in the juvenile justice system by assessing the mental health of detainees and trying to prevent the incarceration of those who need treatment.

The burgeoning number of mentally ill persons in prison affects every ethnic minority, Pitts said. But the problem, like other American social ills, proves the adage that “when America gets a cold, African Americans get pneumonia,” she observed.

Pitts said African-American children and adolescents with mental illness are underserved and, if they manage to get into the treatment system, frequently misdiagnosed. She said affective disorders are not recognized as readily in the African-American population, and that African-American men are more likely to be diagnosed with a manifestation of psychosis and to be restrained when they enter an emergency room.

The pathologies afflicting the African-American community today, Pitts said, are the direct result of generations of suffering beginning with kidnapping from Africa; dire conditions often resulting in death during the “middle passage” from Africa to the Americas; slavery, torture, and rape; segregation and the forced imposition of an alien European culture—in short, a nightmare history that has afflicted the present-day descendants of American slaves with a posttraumatic stress disorder.

“It has never effectively been dealt with, and so it perpetuates itself through the generations,” she said. “And the United States has never officially apologized for slavery.”

The BPA has been challenging APA since its inception in 1969. It was born in response to what Pitts called “the apathy and neglect” on the part of American psychiatry and APA regarding the emotional, psychological, and social well-being of African Americans. It was in response to the BPA that the National Institute of Mental Health established the Center for Minority Group Mental Health Programs and that APA formed its present-day Committee of Black Psychiatrists, she said.

Pitts said there are many within APA who have been sensitive to the needs of the African-American community, but she said the organization can do more. She would like to see APA give a vote on the Board of Trustees to a representative from the Committee of Black Psychiatrists and fund a study on the health effects of racism.

Finally, Pitts called on APA to give more support to biomedical and health services research on the mental health needs of African Americans. “It has to be initiated and directed by African Americans, but we welcome APA’s assistance.” ▪