Experiencing racial or ethnic discrimination may significantly raise the risk of developing psychosis, according to a comprehensive review conducted by researchers at University College London (UCL) and King’s College London. The study, published in PLOS Mental Health, analyzed evidence from seven systematic reviews and meta-analyses, covering 23 studies and more than 40,000 participants in Europe and the United States.
What the findings reveal
The review found consistent evidence that individuals who endure racial or ethnic discrimination face a higher likelihood of developing psychotic symptoms such as hallucinations, delusions, disorganized behavior, and distorted thinking. These symptoms are common in severe mental health disorders, including schizophrenia.
Key findings include:
- People exposed to racial or ethnic discrimination are 77% more likely to experience psychotic symptoms.
- They are nearly twice as likely to have a psychotic episode compared to those who have not faced discrimination.
- Victims of racially motivated physical attacks are five times more likely to later experience psychotic symptoms.
Impact on general populations
The strongest effects were seen among people in the general population who did not have a diagnosed psychotic disorder but reported psychotic-like experiences after experiencing discrimination. This suggests that racism may act as a stressor that pushes vulnerable individuals closer to clinical levels of psychosis.
Understanding why discrimination increases risk
Although the review did not directly test mechanisms, researchers point to evidence that repeated exposure to racism creates chronic stress. This ongoing stress may alter how the brain processes threats and increase vulnerability to psychosis.
Lead author India Francis-Crossley, a PhD student at UCL’s Division of Psychiatry, explained: “By pulling together the best available evidence, we show a clear link between racial or ethnic discrimination and psychosis. Experiencing discrimination can profoundly affect mental health and highlights serious inequities across ethnic groups.”
The broader picture
Experts emphasize that while interpersonal discrimination is a significant risk factor, systemic racism also plays a role in shaping mental health outcomes. Structural inequities in housing, education, employment, and healthcare may compound individual experiences of discrimination.
Senior author Professor James Kirkbride (UCL) noted that public health and policy responses have been inadequate: “Too little is being done to address racism as a public health issue. This failure worsens mistrust in institutions and perpetuates disparities in severe mental health conditions.”
Dr. Juliana Onwumere of King’s College London added: “Racism is a global threat to society and to mental health. While it is not inevitable, if left unchallenged, the human cost is immense.”
Why this matters
This review underscores the urgent need to address racism not only as a social justice concern but also as a public health priority. By identifying discrimination as a measurable risk factor for psychosis, researchers hope to inform prevention strategies, healthcare policies, and community support systems aimed at reducing mental health disparities among minority groups.
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