Dismantling the Racist Roots of Psychology and Psychiatry: Toward Culturally Competent and Equitable Mental Health Care

By Dr. Deilen Michelle Villegas, Ph.D.

Holistic Mental Health Advocate | Trauma Specialist | Author of Reclaiming the Unspoken

Uncovering the Racial Foundations of Psychology and Psychiatry

The fields of psychology and psychiatry, often regarded as pillars of mental health, are deeply rooted in racial bias, systemic oppression, and pseudoscientific beliefs. From the misuse of intelligence testing to the weaponization of diagnoses, these institutions have historically upheld white supremacy and harmed marginalized communities—especially Black individuals.

Understanding this history is essential to dismantling racial disparities in mental health diagnosis, care, and access, and forging a path toward culturally competent and trauma-informed care for all.

Psychology, Eugenics, and Scientific Racism

Early psychology aligned closely with eugenic ideologies. Figures like Francis Galton and Lewis Terman used psychological tools to validate racial hierarchies:

• IQ testing, developed with eugenics in mind, falsely framed intelligence as hereditary and racially determined.

• These tests were culturally biased, privileging white, Western experiences and devaluing non-Western intelligence.

• IQ scores were used to justify segregation, restricted immigration, and involuntary sterilization—disproportionately impacting Black, Indigenous, immigrant, and disabled populations.

  
  

The American Psychological Association (APA) failed to challenge these ideologies for decades, effectively normalizing discriminatory practices in research and clinical care.

Pathologizing Blackness: Diagnoses as Tools of Oppression

From slavery through the Jim Crow era and into modern clinical settings, mental health diagnoses have often served as tools to dehumanize and control Black individuals.

• Drapetomania: A fabricated diagnosis created by Samuel Cartwright to explain why enslaved people ran away—framing freedom-seeking as mental illness.

• Dysaesthesia Aethiopica: A racist term used to describe resistance or refusal to work among enslaved Africans.

  
  

These pathologies were used to reinforce submission, deny personhood, and justify abuse.

In modern contexts, Black individuals are overdiagnosed with disorders like schizophrenia and psychosis, while mood disorders and trauma are underdiagnosed or dismissed.

Long-Acting Antipsychotics and Racialized Treatment

Today, Black patients are disproportionately prescribed long-acting injectable antipsychotics (LAIs). These medications, while helpful for some, often:

• Reflect implicit biases about "noncompliance."

• Are used without adequate patient education or consent.

• Replace holistic care with paternalistic control.

  
  

The overreliance on LAIs and psychotropics underscores the pharmaceutical industry’s influence in psychiatry, which prioritizes profit over person-centered, culturally appropriate care.

Cultural Beliefs and Historical Erasure

African spiritual traditions, resistance, and community care models were historically:

• Labeled as delusional or pathological

• Criminalized or eradicated

• Misinterpreted through Eurocentric frameworks

  
  

Expressions of spirituality, grief, and resilience in Black communities have been routinely pathologized rather than understood in cultural context.

Persistent Racial Disparities in Mental Health Care

• Black individuals are more likely to be diagnosed with severe psychiatric disorders than white counterparts with similar symptoms.

• BIPOC patients often experience dismissiveness, misdiagnosis, and limited access to non-pharmacological care.

• Stigmatization and mistrust rooted in historical abuse (e.g., Tuskegee, forced sterilizations) lead to lower engagement with mental health systems.

Toward an Equitable Future: Healing and Accountability

✔ Cultural Competency Training

Mental health practitioners must receive comprehensive education in:

• Implicit bias

• Cultural humility

• Historical trauma

  
  

✔ Diversifying the Workforce

• Support BIPOC students in psychology, psychiatry, and counseling

• Recruit diverse leadership in mental health institutions

  
  

✔ Community-Based Interventions

• Culturally relevant care models like peer support groups, ancestral healing, and spiritual integration

• Reinvestment in community clinics and mobile mental health services

  
  

✔ Accountability in Research and Practice

• Audit diagnostic and prescribing patterns for racial disparities

• Fund research centering BIPOC experiences and cultural healing frameworks

Reclaiming Mental Health for Marginalized Communities

We must move beyond symptom suppression to root-cause healing:

• Recognize the intergenerational trauma that fuels mental distress

• Honor ancestral wisdom and cultural practices as valid healing modalities

• Offer care that is collaborative, not coercive

What Equity in Mental Health Looks Like:

• Anti-racist curriculum in all mental health degree programs

• Clear patient rights education

• Spiritual and emotional support integrated into clinical care

• Policy reform to eliminate systemic disparities

Final Thoughts

The racist roots of psychology and psychiatry can no longer be denied. Healing begins with honesty, historical reckoning, and systemic accountability.

The path forward must be guided by those most impacted. Black and marginalized communities deserve access to mental health care that sees their full humanity, respects their history, and empowers their healing.

#MentalHealthEquity #AntiRacismInPsychology #CulturallyCompetentCare #BlackMentalHealthMatters #TraumaInformedHealing #RacialJustice #DecolonizeTherapy #BIPOCHealing #DrDeilenMichelle