(MIS)DIAGNOSED

A report on how mental illness diagnoses can be negatively influenced by personal history, race, and class.

As Foiles notes, the internal ramifications of a mental health diagnosis are vexing enough without the additional stigma of gender and racial biases compounding it. In clear, concise language, he highlights cases in which clinical presumptions compounded societal stigmatization in psychotherapeutic patient care settings. On the clinical side, he describes a therapist’s tightrope walk of matching a psychiatric diagnosis with a medical treatment that will blunt a patient’s symptoms and restore the self but without erasing the patient’s identity. Throughout, he shares the fascinating history of an industry once preoccupied with the condemnation of witchcraft, supposed female hysteria, and homosexuality. While confirming that a diagnosis for depression or mental illness is “purely based on observation and patient self-report,” Foiles notes that labeling a patient with a specific diagnosis can also become the person’s “lifeline,” linking a sense of humanity, reality, and closure to what might have been years of terrifying uncertainty. The author examines how patient care proceeds once a diagnosis is determined while also acknowledging the root causes of trauma, including racism, poverty, and interpersonal violence. He spotlights specific racial disparities, noting that Black men, in particular, are more likely to be diagnosed with schizophrenia and will typically receive a subpar level of care. As he did in This City Is Killing Me (2019), his debut on the correlation between inner-city community trauma and mental health, Foiles uses his experiences to illuminate issues of care-based laxity. He cites cases where patients suffered from inaccurate diagnoses and were demonized by labels such as “crazy,” “psycho,” or “borderline,” which further impeded their treatment. The author delivers a brisk, condensed text on disorders ranging from schizophrenia to workforce-induced ADHD, and he implores mental health professionals to consistently assess “the social surround of individuals asking for help.”

A passionate and well-informed study on the importance of improving inclusiveness in mental health evaluations.