Study: Black Nursing Home Residents May Be Over-Diagnosed with Schizophrenia

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A recent report found that nursing homes are more like to diagnose black dementia patients as  schizophrenic in order to administer anti-psychotic medication without being in violation of any rules or regulations.

A September report by the New York Times investigated allegations that nursing homes are diagnosing dementia-suffering residents with schizophrenia as a way of circumventing regulations forbidding the administration of unnecessary antipsychotic medication. A new study published in the Journal of the American Geriatrics Society determined that these “questionable” diagnoses disproportionately affect Black nursing home residents, according to the Times. 

The study’s lead author, a researcher based at the University of Minnesota, told the Times that “Black Americans with dementia have been 1.7 times as likely as their white nursing home neighbors to be diagnosed with schizophrenia” since the implementation of a 2012 policy against unnecessary antipsychotic medication use that contained an exemption for schizophrenia patients. 

The Times notes that these findings correspond with existing research finding that Black patients “among all age groups” are more likely to be diagnosed as schizophrenic and prescribed antipsychotic medication. As one researcher told the Times, “When clinicians talk to a Black or white patient who look otherwise similar symptom-wise, they overemphasize psychotic symptoms, delusions and hallucinations, relative to other symptoms in Black patients compared to how they do with white patients.”

The 2012 movement to reduce antipsychotic medication in nursing homes exempted schizophrenia patients “because antipsychotic medications are still considered the best treatment for many people with the disorder,” according to the Times. What makes many of the nursing home diagnoses suspect is that schizophrenia is “almost always diagnosed at a young age,” and inspectors found in 2018 that one-third of nursing home residents with schizophrenia “had no history of treatment for the disorder.” The disproportionate diagnoses of Black nursing home residents fits in with a broader body of research on the history of medical racism, which indicates that “Black Americans tend to receive less care, and often worse care, than white Americans.” 

More information on the study into schizophrenia diagnoses in nursing homes is available via the New York Times and the Journal of the American Geriatrics Society.

The attorneys at the Law Offices of Thomas L. Gallivan, PLLC work diligently to protect the rights of nursing home residents.  Please contact us to discuss in the event you have a potential case involving neglect or abuse.

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