Structural Whiteness in Mental Health: Reexamination of the Medical Model Through a Lens of Anti-Racism and Decolonization

Abstract

With increasing attention on the deleterious effects of trauma across the lifespan and the intersection with racism, the topic of racial trauma has become an important subject in the quest for racial justice. There is ample evidence of the traumatizing impact of everyday racism leading many trauma researchers to include this as a marker of adverse childhood experiences (ACEs) due to their strong association with negative health outcomes. Despite this growing acceptance of the reality of racism as trauma, the current Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM V) definition of trauma excludes many such experiences unless the individual is, "exposed to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence" through direct exposure, witnessing the same, or learning of such trauma in a close relative or friend (National Center for PTSD, 2019). The only form of indirect exposure that is included within the DSM V definition of trauma is that of professionals exposed to "aversive details... in the course of professional duties." This article will critically examine the harmful effects of such narrow definitions of trauma in terms of mental health within communities of color. Specifically, this article will explore ways in which the current mental health paradigm and associated structures may reproduce colonialism in mental health care in the U.S., which can result in more harmful diagnoses when posttraumatic stress disorder is too narrowly defined and excludes chronic conditions such as racism and poverty as primary drivers of symptomatology. [ABSTRACT FROM AUTHOR]