Lecture by Jonathan M. Metzl, MD, PhD

"Protest Psychosis: Race, Stigma, and the Diagnosis of Schizophrenia"

Misperceptions that persons with schizophrenia are violent or dangerous

lie at the heart of stigmatizations of the disease.  For instance,

numerous studies have found that physicians, police officers, and the

general public overestimate the risk of aggression in patients with

schizophrenia more often than in other patient groups.  My project tells

the story of how these modern-day American conceptualizations of

schizophrenic patients as violent emerged during the civil-rights era of

the 1950s-1970s in response to a larger set of conversations about race. I

integrate institutional, professional, and cultural discourses in order to

trace shifts in U.S. popular and medical understandings of schizophrenia

from a disease of white docility to one of "Negro"  hostility, and from a

disease that was nurtured to one that was feared.

The first and longest section of the paper tracks the meidcalization of race

 and schizophrenia within a particular institution, the Ionia Hospital  for the

Criminally Insane in Ionia, Michigan.  I access an extensive archive of medical

records and administrative documents to show that, starting in the 1950s,

schizophrenia became a diagnostic term  disproportionately applied to the

hospital's growing population of African American men for reasons having

as much to do with perceived threats of violence as with criteria for

mental illness. 

I also show how evolving notions of violence shaped, and

were in turn shaped by, changing notions of institutional space.  Section

two contextualizes the Ionia case histories within shifting psychiatric

definitions of schizophrenia, as read through an extensive analysis of

published case studies and  classification systems.

Finally, the project's third section reads these shifts in psychiatric nosology within

changing American cultural concerns  about black masculinity. I use media

representations, films, music, protest memoirs, and literary texts to

explore ways in which civil-rights era debates about the role of violence

in promoting social change mapped  onto descriptions of schizophrenia as a

violent disease.