The shooting of an unarmed teenager in Ferguson, Mo., has ignited a global discussion about implicit racial bias. One group of people you might think would be immune from this hidden bias is clinical therapists, people trained to understand the human mind. But a new field study finds that the social identities of patients and their therapists affect the accuracy of the diagnosis: Therapists were twice as likely to misdiagnose mental illness when their patients were members of a disadvantaged, compared to an advantaged, group.

The researchers followed patients during the intake sessions with their therapists. Afterward, they asked the patients to complete a separate structured diagnostic interview (called the MINI) with an independent interviewer. Therapists also completed study measures immediately following their sessions. Comparing the therapists’ evaluation with the evaluation obtained from the independent interview provided the researchers a measure of diagnostic accuracy.

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