Fighting Injustice in the Past and the Present: Charles Prudhomme, MD

PROFILES IN COURAGE

As he told the story later, in 1952, Black psychiatrist and psychoanalyst Charles Prudhomme, MD, was encouraged by his friends and colleagues at Howard University to approach the American Psychiatric Association (APA) to ask them to sign on to an amicus brief to support the cause of school desegregation in the Supreme Court case Brown v Board of Education. APA officials were not moved. As Prudhomme explained, "I was advised by the APA's 'establishment' to withdraw from involvement in the case and remain aloof from such a political issue. One eminent leader described my proposal as simply one additional example of my continuing 'acting out.'"¹

Prudhomme was born in Louisiana in 1908 and received both his undergraduate and medical degrees from Howard University. He completed analytic training with Freida Fromm-Reichmann, MD, at the Washington Psychoanalytic Society and by the mid-1960s was 1 of only 4 Black analysts in the United States at a time when psychoanalysis dominated the profession.^2,3 Prudhomme attempted to get psychiatric leadership interested in the lack of trained Black psychiatrists and met with APA medical director Walter Barton, MD, in 1963 to urge him to engage on this issue with the National Institute of Mental Health and with the National Medical Association (the all-Black medical organization that formed in 1895 when Black physicians were unable to get membership in the American Medical Association). Barton was sympathetic to the idea of more Black psychiatrists but thought that the existing standard of separate but equal, the legal basis on which Jim Crow segregation operated in the South, was acceptable.⁴

In 1969, the activist group Black Psychiatrists of America (BPA) confronted the leadership of the APA about their refusal to address systemic racism. Most of their demands were not met but they were successful in getting Prudhomme put on the 1970 APA ballot for vice president. A group of White psychiatrists attempted to contest the election with a White candidate—which was unheard of for the normally placid election process—but they ultimately withdrew their candidate.⁵ In the year he was elected as VP, Prudhomme published an editorial in the American Journal of Psychiatry in which he reflected on the unconscious processes involved in racist attitudes and behaviors. He identified scapegoating as a primitive defense mechanism to project fear and noted that it had manifestations in contemporary public spaces: "Aspirants for political office (scapegoat artists) too often are exploiters of group fear (insecurity) of impermanence and thus are perpetrators or vectors of racism."⁶

At a conference on "Racism and Mental Health" that took place at Syracuse University the same year that Prudhomme served as APA VP, he recalled a conversation he had with Winfred Overholser, MD, the superintendent of St. Elisabeths Hospital in Washington, DC, right after he completed his residency training. Overholser explained to him that he could not hire Prudhomme at St. Elisabeths because it was illegal to hire a Black man. Prudhomme said that Overholser had assured him that he was sympathetic by recounting the history of his family's work with the Underground Railroad, the 19th-century movement to smuggle enslaved persons from the South to freedom in the North.¹

Prudhomme fought segregation and racial discrimination in real time. He encountered sympathy but inaction when he tried to engage the help of members of the psychiatric establishment. As Overholser's story to him made clear, it was easier to support a fight against injustice in hindsight when it was more clear which side would be the right side of history.

Dr Hirshbein is the George E. Wantz Distinguished Professor of the History of Medicine at the University of Michigan.

References

1. Prudhomme C, Musto D. Historical perspectives on mental health and racism in the United States. In: Willie CV, Kramer BM, Brown BS, eds. Racism and Mental Health. University of Pittsburgh Press; 1973:25-57.

2. Douglass JH. Racial integration in the psychiatric field. J Natl Med Assoc. 1965;57(1):1-7.

3. WPS Creates Human Rights Award to Honor Charles Prudhomme, M.D. Psychiatric News. Accessed June 13, 2025. https://www.dcpsych.org/content.aspx?page_id=22&club_id=984812&module_id=654682

4. Geller JL. Structural racism in American psychiatry and APA: part 7. Psychiatric News. 2020;55(19):2-3.

5. Pierce CM. The Formation of the Black Psychiatrists of America. In: Willie CV, Kramer BM, Brown BS, eds. Racism and Mental Health. University of Pittsburgh Press; 1973:525-554.

6. Prudhomme C. Reflections on racism. Am J Psychiatry. 1970;127:815-817.