Racial Bias in the Diagnosis and Treatment of Psychosis
Psychology Today
by Atlanta Behavioral Health AdvocatesFebruary 20, 2026
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Racial Bias in the Diagnosis and Treatment of Psychosis
Recent research has highlighted significant racial biases in how psychosis is diagnosed and treated, particularly affecting Black individuals. Historically, schizophrenia has been overdiagnosed in Black communities, a trend that dates back to the mid-20th century during the U.S. civil rights movement. Psychiatrist Dr. Jonathan Metzl’s work revealed that societal shifts led to schizophrenia being framed as a "Black disease," associating it with danger and violence rather than mental health struggles. This bias continues to influence modern healthcare systems, contributing to disparities in diagnosis rates and access to treatment.
The overdiagnosis of psychosis in Black individuals stems from historical stereotypes and systemic racism embedded in both medical practice and societal attitudes. For example, terms like "paranoid" are often used to describe Black patients, reinforcing harmful stereotypes that link mental illness to perceived threats or aggression. This mislabeling not only perpetuates stigma but also limits opportunities for proper care. Additionally, even when diagnosed accurately, Black individuals with psychosis face significant barriers to treatment. Studies show they are far less likely than white individuals to receive adequate mental health services, despite similar socioeconomic adjustments.
The impact of these biases extends beyond individual lives, creating a vicious cycle of under-treatment and increased social challenges. Untreated psychosis can lead to prolonged suffering, strained relationships, and further marginalization within communities. Moreover,
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Originally published on Psychology Today on 2/20/2026