The neuropsychiatric biopolitics of dementia and its ethnicity problem

• Published in: The Sociological review (Keele) Vol. 70; no. 5; pp. 1005 - 1024
• Main Authors: Fletcher, James Rupert, Zubair, Maria, Roche, Moïse
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-09-2022; Sage Publications Ltd
• Subjects: 21st century; Biopolitics; Dementia; Drugs; Ethnic groups; Ethnicity; Governance; Hostility; Medical diagnosis; Medical model; Medicalization; Medicine; Minority & ethnic groups; Minority groups; Nurses; Psychiatry; Residential care; inequality; racism; awareness; governmentality; medicalisation; race; BAME; Alzheimer’s
• ISSN: 0038-0261; 1467-954X
• DOI: 10.1177/00380261211059920

Sociological analyses of dementia have long drawn on critiques of medicalisation and the medical model. This approach fails to account for late 20th/early 21st century expansion of neuropsychiatric biopolitics, wherein a more subtle and pervasive (self-)governance of health, illness, and life itself is at stake. Since the 1970s, new neuropsychiatric imaginings of dementia have been promoted, as evident in government, third sector and research trajectories. From the 2000s, engagements with ethnicity have played an increasingly important role in these trajectories. Minority ethnic (ME) populations have emerged as a new type of dementia problem. Observations about diagnosis rates and timings, medication and nursing support (including care home admission) are normatively appraised to associate minority ethnicity with poor dementia outcomes. These outcomes are then attributed to purported cultural shortcomings of these populations. The emergence of (minority) ethnicity as a problem supports a neuropsychiatric biopolitics of dementia, wherein citizens must govern their conduct accordingly so as not to become like the imagined ‘ethnic’ antagonist. Ultimately, dementia’s newfound ethnicity problem may not serve the interests of people affected by dementia so much as researchers in the field, who should therefore reflect on their own contributions.