Butts H F
J Natl Med Assoc. 1979 Apr;71(4):375-9.
This paper correlates economic stress with minority status, resource allocations for mental health programs, and vulnerability to mental disability. Several hypotheses are advanced:1. A major and recurring psychological pattern of the American national character is prowhite, antiblack paranoia.2. Mental health fiscal allocations and programmatic determinations in ghetto, lower socioeconomic, minority-populated urban areas are predicated on political and racist considerations, the underlying motivation being to keep minorities at greater risk of mental disability.3. Economic privation and stress increase vulnerability to mental illness, especially in a minority population for whom health, mental health, educational, and social services are grossly inadequate.4. Poverty and economic stress combine with health systems that are unresponsive to the needs of blacks and other minorities, resulting in the perpetuation of disabilities and other conditions in blacks that are potentially preventable.5. Health and mental health resources should be increased rather than diminished during periods of economic stress, especially in the public sector.6. In order to provide each citizen with access to quality health and mental health care regardless of race and/or economic status, there must be enacted a national health insurance program based on tax-levy monies that will cover all aspects of health and mental health care.7. Racism and social status will continue to be powerful determinants of the quality of service that white professionals render to black patients and to poor white patients, unless our training institutions mount a massive campaign to train appropriately and to include significant numbers of minority candidates and trainees in the effort. To date this effort is virtually nonexistent.
本文将经济压力与少数群体地位、心理健康项目的资源分配以及易患精神残疾的因素联系起来。提出了几个假设:1. 美国国民性格中一个主要且反复出现的心理模式是亲白人、反黑人的偏执。2. 在贫民区、社会经济地位较低、少数族裔聚居的城市地区,心理健康财政拨款和项目决策基于政治和种族主义考量,其潜在动机是让少数群体面临更大的精神残疾风险。3. 经济匮乏和压力会增加患精神疾病的易感性,尤其是在健康、心理健康、教育和社会服务严重不足的少数群体中。4. 贫困和经济压力与对黑人和其他少数群体需求无反应的卫生系统相结合,导致黑人中潜在可预防的残疾和其他状况持续存在。5. 在经济压力时期,应增加而非减少健康和心理健康资源,尤其是在公共部门。6. 为了让每个公民无论种族和/或经济状况如何都能获得优质的健康和心理健康护理,必须制定一项基于税收资金的国家健康保险计划,涵盖健康和心理健康护理的各个方面。7. 种族主义和社会地位将继续成为白人专业人员为黑人患者和贫困白人患者提供服务质量的有力决定因素,除非我们的培训机构开展大规模活动进行适当培训,并让大量少数族裔候选人及受训人员参与其中。迄今为止,这项工作几乎不存在。