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Unveiling Implicit Bias in Healthcare: A Crucial Step Towards Equitable Treatment

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the definitive source for diagnosing and categorizing mental health disorders. This recognized guideline not only directs the practices of psychiatrists and healthcare professionals, but it also has far-reaching ramifications for insurance corporations and other industries. The DSM has the ability to influence our common view of what constitutes "normal." However, the DSM's history is not without controversy, highlighting the need to tackle unconscious bias in healthcare.


The DSM's position on homosexuality is a clear illustration of the DSM's effect on altering cultural ideas of normalcy. Surprisingly, homosexuality was still categorized as a sociopathic personality disorder in the DSM in 1952. This classification reinforced damaging stereotypes and prejudice against LGBTQ+ people. It wasn't until 1974 that the DSM officially dropped homosexuality as a condition, replacing it with the phrase "sexual orientation disturbance." This label remained in use until 1980, when it was renamed "ego-dystonic homosexuality." Despite changing nomenclature, the basic assumption that homosexuality constituted an illness persisted until 1987.


For more than three decades, the prevalence of such a stigmatizing and discriminatory classification inside the DSM demonstrates how deeply rooted prejudices may infiltrate the healthcare system. These biases were not just maintained within the field of psychiatry but were also absorbed by society as a whole, perpetuating discrimination and generating an atmosphere of intolerance.


Another concerning example of implicit bias in the DSM was the designation of hysteria, an illness solely associated with women, which remained in the handbook until 1980. Historically, the term "hysteria" has been used to dismiss and denigrate women's experiences, adding to the notion that emotional suffering was a symptom of mental instability. This categorization perpetuates discrimination based on gender in healthcare, prolonging disparities in the treatment of female patients.


These instances demonstrate the inherent biases that have entered healthcare procedures over time. Implicit bias, which comprises unconscious views and prejudices, can have an impact on how healthcare providers perceive and treat patients. Recognizing and correcting these prejudices is critical to providing equitable healthcare to all people, regardless of race, gender, sexual orientation, or identity.


Implicit bias training is a helpful resource for tackling implicit bias in healthcare. This training program equips healthcare workers with the skills and information they need to recognize and manage implicit bias in their practice.


Implicit bias is not confined to prior DSM categories; it continues to have an impact on healthcare outcomes today. Because of these prejudices, patients from disadvantaged areas frequently encounter gaps in access to care, misdiagnosis, and unfair treatment. To break away from these discriminatory practices, healthcare practitioners and professionals must attend implicit bias training and engage in self-reflection.


Furthermore, healthcare should be provided without bias or judgment, and it is the duty of both healthcare providers and society at large to establish a more inclusive and fair healthcare system. Recognizing and eliminating unconscious prejudice is a critical step in this approach.


The history of the DSM's classifications of homosexuality and hysteria is a striking reminder of how deeply ingrained prejudices may pervade healthcare procedures and impact society's notions of normalcy. Implicit prejudice in healthcare can have far-reaching repercussions, ranging from stigmatization to perpetuation of discrimination. To promote improved healthcare delivery, healthcare staff must be trained to detect and overcome unconscious prejudice. The Michigan Health Council's implicit bias training is a good place to start, and anyone may take the first step toward a more equitable and inclusive healthcare system by visiting mhc.org/education.

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