Tracing the history of how the mental health of African Americans was characterized during slavery sheds light on why disparities in psychiatric care still exist.
Historically, concepts of race and mental illness have been intimately linked in American psychiatry, policies, and public opinion. Starting in the 1700s, two diametrically opposed medical views were alternatively used to predict vulnerability of black populations. From 1700 to 1840, enslaved blacks were described as immune to mental illness. John Galt, M.D., medical director at Eastern Lunatic Asylum in Williamsburg, Va., hypothesized that enslaved Africans were immune from the risk of mental illness because they did not own property, engage in commerce, or participate in such civic affairs as voting or holding public office. The immunity hypothesis assumed that the risk of “lunacy” would be highest in those populations who were emotionally exposed to the stresses of profit making—principally wealthy white men.
Blacks could receive care until the “immunity hypothesis” was displaced. Regrettably, the exaggerated risk hypothesis predicted excess mental illness, dependency, and dangerousness of black people if slavery were abolished. From 1860 into the 20th century, free blacks were seen at the greatest risk of mental illness. The causes included poverty, urban living, adverse family structures, and migration. The exaggerated risk hypothesis supported increased hospitalization of blacks as a means of control and safety.
In 2020, the Commonwealth of Virginia will acknowledge the 150th anniversary of the first mental institution for blacks in America and the theoretical and political roots that marked its segregationist origins.
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