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Addressing Racial & Ethnic Groups in Bipolar Care: Stigma and Misdiagnosis Exposed

December 1, 2025 · 32 min

Show notes

The mental health system didn’t start out fair — and in many ways, it still isn’t. In this powerful episode, Dr. Nicole Washington sits down with fellow psychiatrist Dr. Leesha Ellis-Cox to unpack the long, painful history that continues to shape the experiences of Black Americans seeking mental health care. From the horrifying “diagnosis” of drapetomania in the 1800s to the Tuskegee Syphilis Study, they trace how mistrust, stigma, and systemic bias became woven into the Black community’s relationship with psychiatry.
But they don’t stop there. Dr. Nicole and Dr. Leesha explore the research showing that Black and Hispanic people are 3 to 4 times more likely to be misdiagnosed with schizophrenia instead of bipolar disorder — a mistake that can derail treatment, worsen symptoms, and put lives at risk.
Listener takeaways

  • the historical roots of racial disparities in psychiatric diagnosis
  • why Black Americans are more likely to be misdiagnosed with schizophrenia
  • how stigma and generational trauma shape attitudes toward treatment
  • practical steps to find culturally humble, affirming providers

Most importantly, they offer real, actionable advice: how to find culturally affirming care, how to navigate bias in the system, and how Black and other communities of color can break generational silence around mental health. This conversation is validating, eye-opening, and deeply empowering. Listen now!

Our guest, Dr. Leesha Ellis-Cox, affectionately known as Dr. Leesha, is a double board certified child, adolescent, and adult psychiatrist. She earned both her Bachelor of Science and Doctor of Medicine degrees from the University of North Carolina at Chapel Hill and completed her general psychiatry residency training, child and adolescent psychiatry fellowship, and community mental health/public psychiatry fellowship at Emory University School of Medicine in Atlanta. Since 2009, she has lived and worked in Alabama and is the medical director at Central Alabama Wellness, a community mental health center located in metro Birmingham.


Our host, Dr. Nicole Washington, is a native of Baton Rouge, Louisiana, where she attended Southern University and A&M College. After receiving her BS degree, she moved to Tulsa, Oklahoma to enroll in the Oklahoma State University College of Osteopathic Medicine. She completed a residency in psychiatry at the University of Oklahoma in Tulsa.
Since completing her residency training, Dr. Nicole has spent most of her career caring for and being an advocate for those who are not typically consumers of mental health services, namely underserved communities, those with severe mental health conditions, and high performing professionals. Through her private practice, podcast, speaking, and writing, she seeks to provide education to decrease the stigma associated with psychiatric conditions. Find out more at DrNicolePsych.com.

Our host, ⁠Gabe Howard⁠, is an award-winning podcast host, author, and sought-after suicide prevention and mental health speaker, but he wouldn’t be any of those things today if he hadn’t been committed to a psychiatric hospital in 2003.Gabe also hosts Healthline's ⁠Inside Mental Health⁠ podcast has appeared in numerous publications, including Bipolar magazine, WebMD, Newsweek, and the Stanford Online Medical Journal. He has appeared on all four major TV networks, ABC, NBC, CBS, and FOX. Among his many awards, he is the recipient of Mental Health America’s Norman Guitry Award, received two Webby Honoree acknowledgements, and received an official resolution from the Governor of Ohio naming him an “Everyday Hero.”

Gabe wrote the popular book, "⁠Mental Illness is an Asshole and other Observations⁠," available from Amazon; signed copies are available ⁠directly from the author⁠ with free swag included! To learn more about Gabe, or to book him for your next event, please visit his website, ⁠gabehoward.com⁠.




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