Wednesday, June 08, 2016

Judicial Bias

NH wouldn't seem to have enough racial diversity to provide enough sample size for even a guesstimate measure of bias.  But note: we have lots of refugee-receiving agencies/charities and African immigrants as well. Though Sudanese, Congolese, Rwandan, and CAR non-refugee immigrants are fewer than the Caribbean and African-American blacks, they are likely a much higher percentage than in other states. As all African groups have a much higher schizophrenia rate, and trauma, adjustment disorder, and later depression are all significantly higher as well, we actually do see a fair percentage of blacks in mental-health related legal proceedings. I suppose the higher crime rate among blacks in general and the higher incarcerated-because-system-ignorant rate among Africans in specific also move the dial some. It is not "a good idea" to keep those numbers in your mind when contemplating bias, you will absolutely have no clue what is happening if you don't.  You will see a prejudice which is not there.  We have 2000 admission hearings a year a few hundred involuntary commitment and a few dozen guardianships every year.  County mental-health courts (a very worthy innovation) likely handle slightly more.

Let me tell you, in order, what will affect what happens to you in the mental health system.

1. What you did in terms of physical dangerousness.
2. How ill you are.
3. How well the sending agency did its paperwork.
4. Who the judge is.
5. What your creepiness factor is, which overlaps 1 and 2 but includes a bizarreness component.
6. Whether you have a developmental disability.
7. Whether drugs can plausibly be blamed.
8. How competent the primary witness against you is, and who it is: your mother, a police officer, an ER worker
9. Whether the judge has seen you in a mental-health or criminal context before.
10. What your sex is.  If you are helpless, females will be rescued/controlled more than males, who will be restrained/punished more if violent. For most other things, it's a wash.
Interruption: we are getting to really low percentages here.
11. Who your attorney is.
12. How well you present yourself in court.
13. Whether you are actually holding a job at the moment.
14. What race you are.

Small state, long experience.  When people speak in anecdotes at  Grand Rounds or as speakers at trainings I, and a few other superannuated clinicians, know the backstory, so they can't shade it.  Though many are stupid enough to try because their narrative would be so cool if true. They can say, when describing a supposed race or ethnicity victim that "he had an argument with a family member over a TV program" - implying that the poor boy is getting railroaded - we can bring up in the Q & A.  "I had this case.  It's Michael, in one of his 2013 admissions before he went Strafford County House of Correction for four months.  He didn't have an argument over a television program.  He beat the crap out of his mother when he tried to take the TV to sell it for drugs and she tried to stop him.  She's a wonderful sweet lady (note: rather obviously of similar ethnic group as her son) who is the only one who would take him in, even though he leaves cigarettes lying around which twice have started fires.

Race is a real factor in mental health.  Other things are bigger factors.


Christopher B said...

This also struck me when reading the 'mean maps' post - the people most likely to complain about prejudice and bigotry (mostly in other people, of course) seem the most likely to act in bigoted ways, and to be swayed by stereotypes.

Assistant Village Idiot said...

Yes, even though it is nearly always 1% true and sometimes much more, it is only certain princesses who can detect the pea.