Schizophrenia in British Afro-Caribbeans: two debates confused?

The concept and aetiology of schizophrenia remain controversial issues. Epidemiological studies reveal considerable variations in rates of diagnosed cases between groups. British Afro-Caribbeans show high rates. At the same time, their psychiatric experience is marked by a high level of conflict with the psychiatric services. The two debates--that surrounding the concept of schizophrenia, and that concerning the psychiatric experiences of British Afro-Caribbeans--need to be separated so that each receives appropriate consideration. Studies based on the experiences of people diagnosed as schizophrenic may confuse rather than advance the first debate if due care is not paid to the reliability of the diagnosis. The second debate has consequences for the development of psychiatric services. Further unaddressed questions referring to the mental health of ethnic minorities are suggested.