Diagnosing and Treating Mental Illness Across Cultures: Systemic Racism in Clinical Psychology

Abstract

Diverse cultures have historically been underrepresented by psychological research (Arnett, 2008; Nielsen et al., 2017). Using western data and diagnostic criteria designed by western society leads to contemporary understandings of clinical diagnoses and psychotherapies that lack external validity beyond western society. Consequently, when immigrants from these diverse countries seek mental health services, they are disproportionately misdiagnosed and receive psychotherapies that are far less effective. The tools and training that clinicians are provided with do not effectively translate through different cultural lenses. Contemporary diagnostic instruments like the Diagnostic and Statistical Manual of Mental Disorders (DSM) need to include additional representative research to improve their sensitivity across cultures. Furthermore, psychotherapies need appropriate cultural adaptations that connect with cultural minority clients to become properly effective. Diagnostic manuals and empirically supported psychotherapies are culturally biased descriptions of clinical psychology which need cultural competence to accommodate the growing cultural diversity present within Canada and America. This literature overview details the extent of the underrepresentation in western psychological research. Subsequently, it presents a brief account of diverse cultural research demonstrating how mental health expression varies extensively by culture. Finally, expounding on these points demonstrates how the resulting DSM is not adequate for the countries that use it, and the resulting psychotherapies lack efficacy in their populations, perpetuating systemic racism in clinical psychology.