Attending to Trauma in Diagnosis: a case study of the REACT Clinic at the University of Chicago Medical Center

Racial segregation deeply diminishes the wellbeing of communities of color in myriad ways, including affecting mental health, yet mental health services to those communities are inadequate and often delivered without context. Beginning with diagnosis, mental health professionals have historically provided children of color with biased and stigmatized diagnoses, which are then followed by treatments that may be inappropriate to the child and the situation. This study aimed to explore how attending to trauma that often results from racial segregation impacts diagnoses and needs assessments. Using a chart review of patients at the REACT Clinic at the University of Chicago Medicine, this study looked at what mental health professionals attend to in the diagnostic process and how that impacts patient diagnoses. The results showed that, when patients received other mental health services before going to the REACT Clinic, their previous mental health encounters did not attend to their full trauma histories. Additionally, this study illustrated that an incomplete understanding of patients' trauma histories decreased the likelihood that patients received trauma-related diagnosis. It also increased the likelihood patients received more stigmatized diagnoses such as conduct disorder or a psychosis-related disorder. These results suggest that a detailed trauma history should be taken in psychiatric diagnostic settings to ensure that children of color can receive appropriate diagnoses and treatment.