Harold W. Neighbors, PhD, School of Public Health, University of Michigan, 1420 Washington Heights, Ann Arbor, MI 48109, (734) 647-6665, woodyn@umich.edu and Sophia Hussen, MPH, School of Medicine, University of Pennsylvania, 295 John Morgan Building, 3620 Hamilton Walk, Philadelphia, PA 19104.

Improving mental health care for African Americans rests upon the ability to make accurate diagnoses. Studies have alluded to the importance of studying clinician race, but few have done so. This presentation is based on a content analysis of four Black and four White clinician focus groups. Significant clinician race differences in substantive themes were revealed. White clinicians exclusively mentioned that they saw no difference between patients of different races. Black clinicians never endorsed this view. Black and White clinicians also cited different reasons for diagnostic challenges. Black clinicians more often raised issues of bias, which included comments about stereotypes, faulty assumptions, and over-generalizations based on client race. Religious differences and differences in idioms of distress were cited as two specific sources of cultural misunderstandings contributing to diagnostic difficulties between Black patients and White clinicians. Both Black and White clinicians saw socioeconomic disadvantage as contributing to behavior that might appear disordered in Black patients. Black clinicians were more likely to comment on the shortcomings of diagnosis, some even questioning the utility of diagnosis in general. Black clinicians described different tactics used to work effectively with Black patients. Several observed that it was more important to take extra time to establish rapport with Black patients before assigning a diagnosis.

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