(Mis)Diagnosed: How Bias Distorts Our Perception of Mental Health (Pre-order)



By Jonathan Foiles

Hysteria. Neurasthenia. Shell shock. When the Diagnostic and Statistical Manual of Mental Disorders was first published in 1952, it was meant to do away with such hypothesized, dubious disorders--now we had science on our side! But the mental health diagnoses of ages past should not be forgotten. In (Mis)Diagnosed, social worker Jonathan Foiles, author of the acclaimed This City Is Kiling Me, returns with this look at how they shed light on how we used to view mental suffering, and how our biases defined and continue to define mental health. 

Consider drapetomania, for example, a nineteenth-century diagnosis concocted by a Southern doctor who theorized that something must be wrong with slaves who sought to escape to freedom, and came up with this term to name the irresistible compulsion to flee. This diagnosis was laughable to most even then, yet some psychiatric diagnoses (e.g., schizoaffective disorder) maintain an alarming racial bias and raise the question whether or not scientific racism is really that far removed from our present-day reality. Homosexuality, remember, was not removed from the DSM until 1980. The series of failed diagnoses Foiles chronicles here are, he argues, all a way of ignoring our societal responsibility for the conditions we helped create. Our gradually increasing understanding of the brain may help make diagnosis more biological than observational, but still fails to take into account the social context that both creates suffering and labels certain existences and beliefs as pathological. (Mis)Diagnosed ultimately is a call to make diagnosis more interactive with one’s environment in a way that is fair to those who are suffering and can help give them hope.

Jonathan Foiles is a lecturer at the University of Chicago School of Social Service Administration. He is the author of This City Is Killing Me: Community Trauma and Toxic Stress in Urban America (Belt, 2019).