Origins of Black Aversions to Mental/Behavioral Health

Psychology, and medicine in general, has never been rooted in treating the Black community as fairly they should be treated. To understand why the Black community has so many aversions to accepting mental/behavioral health services, you have to understand the origins/source of the fears and anxieties. My hope is that with this understanding, we (the Black community) can begin to embrace treatments today, which focus on objective and effective treatments for everyone. Also, that we (society as a whole) can begin to understand the learning history of the Black community, and help implement interventions that will provide effective and lasting change.

John Minson Galt, MD

Galt was the Superintendent and Physician of the Eastern Lunatic Asylum of Virginia, at Williamsburg from 1841 to 1862. The Eastern Asylum was the first public psychiatric hospital in the U.S. Galt was a major influence on the Superintendents’ Association, writing essays, reports, and papers that had major implications on the Black community.

Inside the Mind of John M. Galt is a website devoted to collecting and presenting the works of Galt, including materials from his personal library and historical records. This includes a 1848 Annual Report of the Eastern Asylum for the Superintendents’ Association, which reported that Galt’s Eastern Asylum did not separate Black and White patients; however, the White patients treated the Black patients the same as the hospital servants, whom were all slaves. This resulted in White patients having little to no direct communication with Black patients, requiring no special arrangements to deal with Black male patients. He reported that Black Slaves became deranged far less than both Free Blacks and Whites, and were “somewhat exempt” from the causes of becoming deranged. One of the reasons is that they do not have to deal with the anxieties of daily life that the free population does – including, but not limited to, religion, politics, mental stress from a republican form of government, and ownership of property. This lack of stress allows for life with the depressions that the White population faces. “Moreover, not only are they less exposed to causative influences of a moral character, but the mode of life which they lead tends to strengthen the constitution, and enable it to resist physical agents, calculated to induce insanity.” Meaning, they live a healthier life, resulting in a low likelihood of developing insanity.

Road to Mental Health Inequality

King Davis, Ph.D. of the University of Texas at Austin, and former Commissioner of Behavioral Health and Developmental Services for the Commonwealth of Virginia, dove into Galt’s reporting of Blacks being naturally immune to insanity. He stated how many of Galt’s views on slaves boiled down to insanity being the affliction of wealthy White males, due to the stresses of profit making. Making this view more impactful, in 1848, Galt was appointed as 1 of the 2 Virginia Medical Superintendents, along with Francis Stribling, MD. Despite believing the Black Slaves should be excluded from treatment of mental illness, Virginia’s state legislation allowed for their admission into asylums if their care was paid for by their owners. Opposite of Galt, Stribling believed that Blacks should generally be separated from Whites, and proposed segregated asylums. This was the beginning of inequality (lack of quality) regarding Black mental health care, as segregation became national policy.

Following the Immunity Hypothesis came the Exaggerated Risk Hypothesis. This new theory predicted that if Black Slaves became free they would acquire excessive levels of “mental illness, dependency, and dangerousness”. Free Blacks were now the greatest risk group for mental illness, due to poverty, migration to urban areas, and negative family structures. There was now support for increasing hospitalizations of the Black community to control their expected maladaptive behaviors and ensure the safety of the White community. Following the conclusion of the Civil War, the Central Lunatic Asylum for Colored Insane was opened, assuming an increased need for mental health care for the newly freed slaves. As a result, admissions increased significantly, along with the frequency of severe diagnoses.

Talking Points

This is not an indictment on John M. Galt, who generally advocated for ethical treatment of asylum patients, and didn’t believe in the need for segregation. However, his views of the Black Slaves’ immunity to insanity led to the arguments against allowing freed slaves to integrate into free communities. With a focus on hospitalizing Free Blacks in general, and the false implementation of separate-but-equal that segregation brought to the Black community, the beginnings of unethical mental/behavioral health treatment sprouted its roots. As a side note, the article written by King Davis, Ph.D is via the American Psychiatric Association Publishing. The same APA dating back to 1844 and John M. Galt.