NCJ Number
52240
Journal
Archives of General Psychiatry Volume: 18 Issue: 1 Dated: (JANUARY 1968) Pages: 42-46
Date Published
1968
Length
5 pages
Annotation
DATA COLLECTED IN A CLINICAL STUDY OF PATIENT ACCESS TO MARYLAND STATE MENTAL HOSPITALS FROM BALTIMORE CITY JAIL WERE EVALUATED TO TEST HYPOTHESIZED DIFFERENCES BETWEEN THE WHITE AND BLACK MALE POPULATIONS.
Abstract
THE PURPOSE OF THIS RESEARCH PAPER WAS TO COMPARE THE CLINICAL EVALUATION OF 50 WHITE AND 50 BLACK MALE PATIENTS AS THEY APPEARED AT THE CITY JAIL IMMEDIATELY PRIOR TO STATE HOSPITAL ADMISSION AND AGAIN 72 HOURS AFTER HOSPITALIZATION. THE DATA WERE COLLECTED DURING JUNE, JULY, AND AUGUST 1964. THE HYPOTHESES WERE STATED AS FOLLOWS: (1) BLACK JAIL-ADMITTED MALE PATIENTS EXHIBIT MORE SEVERE DEGREES OF CLINICAL DISTURBANCE THAN WHITE JAIL-ADMITTED PATIENTS AND (2) AFTER HOSPITALIZATION, BLACK MALES EXHIBIT A MORE RAPID RATE OF CLINICAL IMPROVEMENT THAN WHITE MALES. THE TERM 'JAIL' AS USED HERE REFERS TO THE SOUTHWESTERN POLICE STATION IN BALTIMORE WHERE MALES WHO REQUIRE EVALUATION, CERTIFICATION, AND TRANSPORTATION TO MENTAL HOSPITALS ARE POOLED. THE POLICE MEDIATE PATIENT ACCESS TO MARYLAND STATE MENTAL HOSPITALS TO AN UNUSUAL DEGREE. ONLY ONE-THIRD OF THE PATIENTS COMMITTED BY POLICE SURGEONS FROM THE JAIL ARE EVALUATED BY AVAILABLE NONPOLICE EMERGENCY PSYCHIATRIC SERVICES. CLINICAL IMPRESSIONS AND DATA INDICATE THAT THE STATISTICAL LIKELIHOOD OF BLACK PATIENTS BEING TRANSPORTED DIRECTLY TO THE HOSPITAL BY THE POLICE IS HIGHER THAN FOR WHITE PATIENTS. EVALUATIONS OF THE DEGREE OF MENTAL DISTURBANCE AND THE EXTENT OF CLINICAL CHANGE OVER TIME WERE MADE BY MEANS OF 14 RATINGS ON A SPECIALLY DEVISED ADJUSTMENT INDEX. RELATIVELY OBJECTIVE ITEMS INCLUDED ACTIVITY LEVEL, APPEARANCE, LEVEL OF HOSTILITY, QUANTITY OF SPEECH, SOMATIZATION, AND ORIENTATION TO TIME, PLACE, AND PERSON. A SUBJECTIVE ITEM WAS THE RATER'S IMPRESSION OF THE DEGREE OF CONTROL REQUIRED. THIRTY-FIVE MATCHED PAIRS OF WHITE-BLACK INDIVIDUALS SUFFERING FROM THE SAME DEGREE OF DISTURBANCE WERE STUDIED TO EVALUATE CLINICAL CHANGE. THE RESULTS OF THE RESEARCH VALIDATED THE FIRST HYPOTHESIS BUT NOT THE SECOND. WHEN EXAMINED AT THE JAIL, THE BLACK MALES DISPLAYED MORE AREAS OF SEVERE CLINICAL DISTURBANCE THAN THE WHITES. HOWEVER, THE COMPARISON OF THE IDENTICALLY MATCHED GROUPS INDICATES THAT WHITES AND BLACKS RECOVER FROM MENTAL ILLNESS AT AN EQUIVALENT RATE. THE ABSENCE OF MORE MILD FORMS OF CLINICAL DISTURBANCE AMONG THE BLACKS IN THE SAMPLE INDICATES THAT BLACKS PROBABLY REMAIN IN THE COMMUNITY WITHOUT BEING LABELLED AS MENTALLY ILL MORE OFTEN THAN WHITES AND THAT POLICE EXERCISE A SELECTIVITY SUCH THAT A BLACK'S BEHAVIOR MUST BE MORE ABNORMAL THAN THAT OF A WHITE IN ORDER FOR IT TO BE RECOGNIZED. REFERENCES ARE INCLUDED. (MPK)