Evaluating racial bias in inpatient risk assessments
Item
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Title
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Evaluating racial bias in inpatient risk assessments
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Identifier
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d_2009_2013:ebab9e35b4d0:11968
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identifier
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12627
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Creator
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Smith, Stephen M.,
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Contributor
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Philip Yanos
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Date
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2013
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Language
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English
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Publisher
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City University of New York.
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Subject
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Clinical psychology | Ethnic studies | inpatient | mental illness | race | violence risk assessment
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Abstract
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Research has consistently identified disparities in the mental health treatment of black individuals with mental illness. Specifically, black individuals with mental illness are shown to be more likely diagnosed with a psychotic disorder, subjected to coercive treatment services (involuntarily hospitalized, receive emergency medication, be physically restrained on inpatient unit), prescribed first-generation antipsychotics, referred for outpatient group psychotherapy, and expected to be violent in the future. A web-based experimental study was conducted with advanced clinical psychology doctoral students and licensed clinicians to examine the role that race plays in clinical judgments of future violence. Clinicians read the same clinical vignette, but were randomly assigned to one of four conditions: black race/no salience instructions, black race/salience instructions, white race/no salience instructions, white race/salience instructions. It was hypothesized that predictions of violence would vary by race, with clinicians giving higher estimates of violence when given a hypothetical vignette describing a black psychiatric patient. It was also hypothesized that making clinicians aware of this tendency ahead of time (bias salience) would significantly reduce ratings of future violence. Overall, ninety clinicians participated in the study. Though no significant differences in violence predictions were evidenced according to race and/or bias salience, a non-significant pattern was observed for predictions of serious violence, with higher estimates of serious violence being given for vignettes describing a black psychiatric patient without the preemptive mention of the potential to bias. In addition, it was found that clinicians were significantly more likely to recommend seclusion in the "black" conditions. These findings suggest that race may play a role in predictions of future serious violence and affect subsequent treatment decisions. Future studies are needed to further explore this possibility. Implications for race and racial bias in violence predictions are discussed.
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Type
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dissertation
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Source
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2009_2013.csv
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degree
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Ph.D.
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Program
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Psychology
