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April 2, 1999
By Christine Lehmann
Black Psychiatrists and American Psychiatry, a new book edited by Jeanne Spurlock, M.D., the director of APA's Office of Minority/National Affairs from 1974 to 1991, underscores the many contributions of black psychiatrists and their dedication to American psychiatry despite institutional and other forms of racism. The book was published in February by APA.
Historian John Hope Franklin, Ph.D., writes in the foreword, "The remarkable fact is that in some fields of inquiry, where scientific truth should be the hallmark for judging persons or, indeed, discoveries, some of the most rigid and inhospitable attitudes toward certain human beings working in the same field have been manifested."
Franklin is the James B. Duke Professor Emeritus in the department of history at Duke University.
Spurlock told Psychiatric News, "Although progress has been made in addressing diversity and cultural differences, institutional racism still exists although it may be more subtle now. To advance in their careers, young black psychiatrists need mentors.
"I felt it was important that the contributions and career experiences of early and contemporary black psychiatrists be written down for future generations. Most history of black Americans is passed down orally," noted Spurlock, a clinical professor of psychiatry at George Washington School of Medicine and Health Sciences and Howard University College of Medicine in Washington, D.C.
Spurlock's "biosketches" of black pioneers in psychiatry, including Solomon Carter Fuller, M.D., Charles Prudhomme, M.D., and Ernest Williams, M.D., reveal the impact of institutional racism on securing advanced training or experience in the field in the United States. Fuller, identified as the first black psychiatrist in the United States, obtained advanced training in psychiatry at the University of Munich in Germany between 1904 and 1905 when he could not find a place to train in the United States, according to Spurlock.
Spurlock also credits the leadership role of black psychiatrists for advancing the need for increased representation of minority psychiatrists and attention to minority mental health issues in professional medical and psychiatric organizations. The Black Psychiatrists of America (BPA), formed in 1969, requested that same year that APA increase its leadership opportunities for black psychiatrists.
The Board of Trustees responded affirmatively to many of the BPA's requests including the creation of the Ad Hoc Committee of Black Psychiatrists. Spurlock noted, however, that no black psychiatrist has been elected president of APA. Referring to the 1976 defeat of presidential candidate Mildred Mitchell-Bateman, Spurlock commented, "It's still a man's world. If you're black and a woman, that's two strikes against you."
Firsthand accounts by leaders in psychiatry reveal the successes and challenges of developing the first departments of psychiatry at Meharry Medical College and at Harlem Hospital Center. Black psychiatrists also recall their experiences in developing programs in community psychiatry and the public sector, and serving in the military.
The historical impact of racism on the mental health care of black Americans is addressed in the chapter "The Participant-Observer: The Experiences of a Black Transcultural Psychiatrist." Victor Adebimpe, M.D., who came to the U.S. from Africa in 1972 to train in psychiatry, describes his research published in the early 1980s on the role of racism in clinical studies involving blacks. He concludes that depression in blacks was underdiagnosed and schizophrenia in blacks was overdiagnosed. Adebimpe, medical director of adult psychiatry at Mercy Psychiatric Institute in Pittsburgh, also examines controversial research on race and intelligence and race and violence.
Survey results presented in the book reveal much about the current status of black psychiatrists in academe, child psychiatry, psychiatric research, forensic psychiatry, and psychoanalysis. The respondents identified several problems in academe including institutional racism and sexism, lack of mentors and role models, psychological stress, overparticipation in areas relevant to African Americans because black faculty are so few, a lack of focus on racial/ethnic cultural issues, large debt loads, and lack of research skills training, according to the book.
The results also revealed that the largest percentage of black faculty were at or below the assistant professor level (46 percent) in 1994, and only 19 percent were tenured. The rank of black medical school faculty is similar. Only 10 percent are professors, and about 75 percent remain at the assistant professor or instructor rank, according to 1998 figures from the Association of American Medical Colleges. Moreover, black psychiatrists made up 3 percent of the total number of departmental faculty (6,829) compared with white psychiatrists, who made up 83 percent, according to the 1998 AAMC figures.
Finally, the book notes that black Americans interested in pursuing a career in psychiatry face many barriers. The status of psychiatry in the black community is often lower than primary care or other medical specialties, notes chapter author Billy Jones, M.D., M.P.H., former commissioner of the New York City Department of Mental Health, Mental Retardation, and Alcoholism Services. The lack of mentors also contributes to the underrepresentation of black psychiatrists in academia and research, the chapter states.
He also addresses the impact of health care reform and managed care on black psychiatrists and their patients. For example, he refers to a 1994 study showing that a large percentage of black American physicians feel excluded from the formation of health care policies and that they face high levels of professional and health care system racial discrimination.
The book ends with a status report of blacks in organized psychiatry. It concludes that significant representation of black psychiatrists in leadership positions of professional organizations including APA has not been achieved. Jones calls on organized psychiatry to commit to affirmative action at a time when its principles are being eroded throughout much of the country.
The book's contributors are, in addition to Franklin, Spurlock, Adebimpe, and Jones, F.M. Baker, M.D., M.P.H., James Baker, M.D., Bruce Ballard, M.D., Irma Bland, M.D., Clotilde Brown, M.D., Hugh Butts, M.D., Joshua Calhoun, M.D., June Jackson Christmas, M.D., James Collins, M.D., Elizabeth Davis, M.D., Henry Edwards, M.D., Lloyd Elam, M.D., Ruth Fuller, M.D., Tana Grady-Weliky, M.D., Ledro Justice, M.D., Mildred Mitchell-Bateman, M.D., Donna Norris, M.D., and Harry Wright, M.D.
Black Psychiatrists and American Psychiatry can be ordered online by going to APPI's Web site at