Implications from Psychiatric Diagnoses in Milledgeville State Hospital Open Access

Jeong, Leanne (Spring 2022)

Permanent URL: https://etd.library.emory.edu/concern/etds/z029p623d?locale=en
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Abstract

Recent studies on the psychiatric diagnoses of Black patients have shown evidence of racialized diagnoses of certain mental disorders. In Jonathan Metzl’s The Protest Psychosis: How Schizophrenia Became a Black Disease, he states that one of the reasons for the racialization of schizophrenia may be due to the transitioning of the first Diagnostic and Statistical Manual of Mental Disorder (DSM-I) to the second edition (DSM II). However, there may be evidence of racialized diagnoses before the transitioning of the DSMs in 1968. To better understand how diagnoses may have become racialized before changes were made to the DSM-I, this thesis investigated Milledgeville State Hospital during the 1950s and 1960s. Previously known as the Georgia State Asylum for Lunatics, Epileptics, and Idiots, this psychiatric facility was at one time the largest mental hospital in the nation. While Milledgeville State Hospital was known for its inadequate care and horrific conditions, the occurrence of misdiagnosis at the facility is highly suspected considering the passage of the Jim Crow laws and other racial disparities during the 1950s and 1960s. Therefore, this study looked at psychiatric diagnoses at Milledgeville State Hospital from 1956 to 1967 to see whether one race-sex group was more likely to be diagnosed with a certain mental disorder compared to another. The diagnoses analyzed were “schizophrenic reactions”, “chronic brain syndrome: cerebral arteriosclerosis”, “chronic brain syndrome: senile brain disease,” and “psychotic disorders: manic depressive reactions.” After performing pairwise comparisons and a test for trend in proportions, the data showed that “Nonwhite” patients were more likely diagnosed with “schizophrenic reactions” and “manic depressive reactions” compared to the “White” patients from 1956 to 1967. In addition to this study highlighting the history of racialized diagnoses at Milledgeville State Hospital, it also exhibits how important it is for current psychiatric practices to continue taking steps in dismantling racial disparities and institutionalized discrimination when providing mental healthcare.

Table of Contents

Chapter 1: The Problem of Diagnostic Disparities……………………………………….…1

Chapter 2: Issues in the History of Georgia: Milledgeville State Hospital……………….…7

Chapter 3: The “Bible” of Psychiatry: The Diagnostic and Statistical Manual of Mental Disorders (DSM)……………………………………………………………………………16

Chapter 4: Analyzing Historical Diagnoses……………………………………...…………20

Chapter 5: Discussing the Results…………………………………………………………..30

Chapter 6: Today’s Psychiatric Diagnoses – Grady Memorial Hospital with Dr. Jennifer Grant………………………………………………………………………………………...34

Chapter 7: Conclusion………………………………………………………………………36

Bibliography………………………………………………………………………………...38

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