Racial Bias in Arrests for Mental Health Symptoms

Black Americans with mental health symptoms are more likely to face arrest than White Americans, suggesting systemic racism in criminal justice responses.

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When mental distress or symptoms associated with mental health conditions manifest, the response from society and law enforcement can vary drastically depending on one’s race. This alarming truth is the focus of recent research spearheaded by Briana N. Brownlow and colleagues, which highlights a significant racial disparity: Black Americans, compared to White Americans, are more likely to be arrested for the same level of ‘psychopathology severity,’ including emotion dysregulation and impulsivity.

The study’s findings underscore a systemic bias where signs of mental distress in Black Americans are disproportionately met with arrest and incarceration rather than support and treatment. For Black Americans, specifically Black men, exhibiting emotional dysregulation in the form of aggression, the risk of arrest is 3.11 more likely than White men exhibiting the same levels of aggression.

This research not only sheds light on the intersection of mental health and the criminal justice system but also points to the deep-rooted structural racism that contributes to the overrepresentation of Black Americans in the criminal justice system. The research team found that in every intersection between psychopathology, anger and aggression, impulsivity, and juvenile arrests, both Black men and women had significantly higher rates of arrest than White men and women. 

“These findings held even when controlling for relevant individual and contextual factors known to increase one’s risk for involvement in the criminal justice system,” the authors write. 
“Consequently, the results of this study highlight that the overrepresentation of Black Americans in the criminal justice system is a function of systematic racism and inequitable and racially biased laws and practices, rather than a result of psychological risk factor differences in Black Americans.” 

This research indicates that symptoms of psychopathology in Black Americans are often met with criminalization. The study provides historical context, explaining how systemic racism within the criminal justice system originated from slavery. Policing in America evolved from “slave patrols” in the 1700s, which, after the Civil War, became police departments tasked with enforcing Jim Crow laws. This legacy has led to increased surveillance in Black communities and, combined with the “War on Drugs” and mass incarceration, has resulted in widespread systemic oppression. The data show that Black Americans are more likely to be arrested, convicted, and incarcerated compared to White Americans, irrespective of mental health status. This disparity extends to young people, with Black youths being five times more likely to face incarceration than their White counterparts.

The study sample consisted of 1,562 adults from Chicago, with an average age of 34.81. The gender distribution was 54.4% women and 45.6% men. Moreover, 62.5% of the participants identified as White Americans, 37.5% as Black Americans, and 42.1% had attained at least a college degree. The median annual income for the participants was between $35,000 and $70,000. The study did not include juvenile participants, although the adults reported juvenile arrests. It’s worth noting that these demographics are similar to those of the Chicago metropolitan area.

Individuals with an active substance use disorder were not considered for participation. However, those with a history of substance use disorder in the past were eligible. In addition, the research team excluded individuals with a current or lifetime history of a psychotic disorder, an organic brain disorder, or intellectual disability.

Researchers tested six variables, including Borderline Personality Disorder, Antisocial Personality Disorder, Impulsive Behavior, and two measures of Aggression. Trained individuals conducted interviews, but not all participants completed every measure, so the sample size varied. Regression testing measured the interaction between variables and found that the interaction between psychological factors and race was significant in every variable domain.

The Brownlow study’s findings highlight a stark racial disparity in arrest rates, regardless of similar symptoms of psychopathology in Black and White Americans.

When Black and White Americans showed the same level of psychological issues, Black Americans were more likely to be arrested. This was particularly evident among Black men. For example, a unit increase in BPD features led to a 2.11 times increase in arrest rates for Black men, compared to a 0.68 increase for White men.

Increases in self-reported anger and aggression were linked to higher arrest rates in adulthood, with Black men and women facing significantly higher rates than their White counterparts. Where a 1-unit increase in self-reported anger led to a 0.50 times increase in arrest rates for White men, it led to a 2.54 times increase for Black men. A similar trend was seen for aggression, where Black men faced over three times the increase in arrests compared to White men for the same increase in aggression.

Increases in impulsivity led to higher arrest rates for Black individuals compared to White individuals. For every 1-unit increase in impulsivity, the arrest rate was 2.11 times higher for Black men and 0.55 times higher for Black women, compared to 0.68 times for White men and 0.18 times for White women.

Previous juvenile arrests predicted higher adult arrest rates. Notably, Black men were 3.16 times more likely to be arrested as adults for each additional juvenile arrest, a rate significantly higher than that for White men.

Overall, the study highlights stark racial disparities in how psychological factors relate to arrest rates, with Black Americans, especially men, facing a significantly higher likelihood of arrest compared to their White peers, regardless of similar psychological profiles.

“Taken together, the results suggest that race, or racism as it were, matters in characterizing the relationship between psychological factors and arrests because these associations should be consistent irrespective of race. However, across every psychological risk factor for arrests in adulthood, we found that Black Americans had a heightened rate of adult arrests compared with their White counterparts,” the researchers write.
“Our findings imply that Black individuals are more likely to be penalized and criminalized even when at the same levels of emotion dysregulation or impulsivity as their White counterparts.”

The research team has identified a few limitations in this study. It was found that levels of anger, aggression, and impulsivity are likely to be higher compared to the general population. This is because the study oversampled these traits for research purposes. However, individuals with severe substance use disorders were excluded from the study, even though this disorder is often comorbid with other identified study variables. Nonetheless, individuals with past substance use disorders were included in the study. The self-reported rates of arrest for two participants were extremely high, so they were excluded from the analysis to examine the effect. All tests remained statistically significant.

The study acknowledges that socioeconomic status (SES) as a variable is influenced by systemic racism, as highlighted by the Pew Research Center in 2020. This bias means that White families generally have higher wealth compared to Black families. Consequently, it’s challenging to apply SES uniformly across racial groups due to the varying impacts of racial oppression. The authors point out the difficulty in comparing Black and White Americans in terms of SES, given the pervasive effects of structural racism.

In the American criminal justice system, Black Americans face disproportionate oppression. The initial point of contact with this system is often an arrest, which can lead to involvement in the court system and eventually incarceration. Incarceration itself can have detrimental effects on mental health. The study finds that Black Americans showing signs of emotional dysregulation are more likely to be arrested, exacerbating their mental health issues.

Previous reports have shown that responses to calls made to the 988 mental health hotline often involve criminal justice interventions. This trend is particularly concerning for Black Americans, who disproportionately face economic inequality, police brutality, and disparities in education.

 

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Brownlow, B. N., Harmon, K. S., Pek, J., Cheavens, J. S., Moore, J. L., & Coccaro, E. F. (2024). Criminalizing Psychopathology in Black Americans: Racial and Gender Differences in the Relationship Between Psychopathology and Arrests. Clinical Psychological Science, 0(0). https://doi.org/10.1177/21677026231217312 (Link)

2 COMMENTS

  1. Thank you for writing this. I’ve been working on several pieces myself regarding this topic. The history goes very deep. The symptoms of systemic racism in mental health services are what are reported here: higher incarceration rates of black individuals with a potential mental health crisis. With that, there is also a higher rate of schizophrenia/psychosis diagnosis, as well as antisocial personality, and a higher rate of larger doses of antipsychotics. This diagnostic criteria took place during the beginnings of the civil rights movement, when black voices grew loud, and opposing (generally white) voices felt threatened. Schizophrenia and psychosis was largely regarded a white American issue, a problem of incorrect parenting (think “schizophregenic mother). It became a method of control later, and black families, civil rights leaders, and loud voices became the target; psychosis then became synonymous with “violent.” This was also one of the major shifts in political diagnosis, for the millionth time. Malcolm X’s mother was a victim of this. Often black individuals were incarcerated in mental hospitals with no history of mental health issues, and no history of violent crimes. The Protest Psychosis is a good book on this, and this article has been refreshing on the topic, although it is more clinical minded: https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2020.20071091

    Today, we see this echoed in over-diagnosis and overmedication. We see it in clinical assessments that may note the importance of cultural/racial experiences, but label it under the very large umbrella of “trauma” and never address it. We see it in social and psychology research that largely tells the story of European-Americans and their descendants. We see it, even, in “cultural competency” trainings, that get re-labled as cultural humility or cultural responsiveness, but basically teach the same thing: “people’s culture and ethnic experience is important. When you have someone of a different ethnicity or culture come in, remember how different their experience is to yours.” But let’s not have the big discussion of what it really means to experience the expansive, scorching rage that accompanies racial distress, the pain and anxiety and “paranoia” that comes with seeing people like you gunned down, locked up, abused, and consistently oppressed. Let’s not be that culturally competent, right? Let’s not talk about how that keeps some of us up at night. Let’s not talk about the pernicious status of American philosophy, western philosophy, that keeps the lie going. Let’s not talk about how someone’s belief that people are out to get them may not be true in our consensual reality, but may echo in their racial reality. We see our family members abused, consistently, and I personally grew up listening to stories my dad shared about real people, adult white men chasing him down the street with bats when he was a child, ten years old. And what did I grow up with? An intense anxiety of people, an intense feeling of being targeted, watched, hated. And what is that diagnosed as? Generalized Anxiety. Social anxiety. Schizophrenia, eventually. But let’s not talk about that secondary racial trauma either, let’s just take our cultural competency training and make sure we can tick off our CECs.

    This is why I left the mental health system. It wasn’t built with me in mind.

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