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Racism, early psychosis, and institutional contact: A qualitative study of Indigenous experiences

Author

Listed:
  • Jenni Manuel
  • Suzanne Pitama
  • Mauterangimarie Clark
  • Marie Crowe
  • Sue Crengle
  • Ruth Cunningham
  • Sheree Gibb
  • Frederieke S Petrović-van der Deen
  • Richard J Porter
  • Cameron Lacey

Abstract

Background: There is evidence of Indigenous and ethnic minority inequities in the incidence and outcomes of early psychosis. Racism has been implicated as having an important role. Aim: To use Indigenous experiences to develop a more detailed understanding of how racism operates to impact early psychosis outcomes. Methods: Critical Race Theory informed the methodology used. Twenty-three Indigenous participants participated in four family focus group interviews and thirteen individual interviews, comprising of 9 MÄ ori youth with early psychosis, 10 family members and 4 MÄ ori mental health professionals. An analysis of the data was undertaken using deductive structural coding to identify descriptions of racism, followed by inductive descriptive and pattern coding. Results: Participant experiences revealed how racism operates as a socio-cultural phenomenon that interacts with institutional policy and culture across systems pertaining to social responsiveness, risk discourse, and mental health service structures. This is described across three major themes: 1) selective responses based on racial stereotypes, 2) race related risk assessment bias and 3) institutional racism in the mental health workforce. The impacts of racism were reported as inaction in the face of social need, increased use of coercive practices and an under resourced Indigenous mental health workforce. Conclusion: The study illustrated the inter-related nature of interpersonal, institutional and structural racism with examples of interpersonal racism in the form of negative stereotypes interacting with organizational, socio-cultural and political priorities. These findings indicate that organizational cultures may differentially impact Indigenous and minority people and that social responsiveness, risk discourse and the distribution of workforce expenditure are important targets for anti-racism efforts.

Suggested Citation

  • Jenni Manuel & Suzanne Pitama & Mauterangimarie Clark & Marie Crowe & Sue Crengle & Ruth Cunningham & Sheree Gibb & Frederieke S Petrović-van der Deen & Richard J Porter & Cameron Lacey, 2023. "Racism, early psychosis, and institutional contact: A qualitative study of Indigenous experiences," International Journal of Social Psychiatry, , vol. 69(8), pages 2121-2127, December.
    • Handle: RePEc:sae:socpsy:v:69:y:2023:i:8:p:2121-2127
    DOI: 10.1177/00207640231195297
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    References listed on IDEAS

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    1. Jones, C.P., 2000. "Levels of racism: A theoretic framework and a gardener's tale," American Journal of Public Health, American Public Health Association, vol. 90(8), pages 1212-1215.
    2. Genevieve C. Lai & Emma V. Taylor & Margaret M. Haigh & Sandra C. Thompson, 2018. "Factors Affecting the Retention of Indigenous Australians in the Health Workforce: A Systematic Review," IJERPH, MDPI, vol. 15(5), pages 1-22, May.
    3. Yin Paradies & Jehonathan Ben & Nida Denson & Amanuel Elias & Naomi Priest & Alex Pieterse & Arpana Gupta & Margaret Kelaher & Gilbert Gee, 2015. "Racism as a Determinant of Health: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 10(9), pages 1-48, September.
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