Tuesday, 2 December 2014

Race & Mental Illness / Angela

Mental illness was probably the first taboo, so why is there still stigma around
it? Will it ever go away? People are discriminated against for lots of reasons,
including their race and sex, so what is it like to be a black, female, mental
health service user, like me?

In many urban areas, Black and Minority Ethnic communities are significantly
over-represented in the poorest wards, notably people of African, Caribbean,
Bangladeshi and Arab origin. Research suggests that both the experience of
racial harassment and perceptions of racial discrimination contribute to health
outcomes (Chakrborty & McKenzie 2002). There are proportionally more black people in the mental health system than white people. This maybe for reasons like racism, poverty, unemployment, unstable family units, prison, drug abuse, alcohol abuse and bereavement.

Mental breakdown, also know as nervous breakdown, is a colloquial term for
an acute, time-limited psychiatric disorder that manifests itself primarily as
severe stress-induced depression, anxiety or disassociation in a previously
functioning individual.

The Disability Discrimination Act (1995) makes it unlawful to discriminate against employees with a disability. Those with a mental illness that has a substantial, adverse and long-term (over 12 months) effect on their ability to carry out normal day-to-day activities are considered to have a disability under the Act. It is intended to offer protection but attitudinal changes towards disability and mental health lag behind legislation. Despite this, a report of Mental Health and Social Exclusion, published by the Social Exclusion Unit in 2004, showed that amongst those with long-term mental health problems, only 24% were employed.

When people using mental health services are asked about the major issues that concern them in their daily lives, personal finances are consistently identified as a major source of difficulty and distress. 1 in 3 people with a serious mental health condition is thought to be in debt. Concerns and anxieties regarding finance constitute a significant stressor (In the red: debt and mental health, Mind, 2010). 

A study by the South London and Maudsley Trust found that people diagnosed with serious mental illness had significantly reduced life expectancy (8.0 to 14.6 life years for men and 9.8 to 17.5 life years for women). Highest reductions were found for men with schizophrenia (14.6 years lost) and women with schizoaffective disorders (17.5 years lost). Living with schizophrenia and bipolar disorder increases the risk of certain physical diseases (cardiovascular and chronic respiratory disease, diabetes, hepatitis C, HIV).

According to the Mental Health Foundation, only 1 in 10 prisoners does not have a mental health problem, counting substance abusers (and those with dual diagnosis), those with a primary mental illness and others who become unwell under the psychological stresses of imprisonment. There are a disproportionate number of people from ethnic minorities in prisons in this country; in 2010, the ethnic minority prison population (of which the highest proportion is black) had doubled in a decade (‘More black people jailed in England and Wales, The Guardian, 10 Oct 2010). 

I am a black Caribbean women born in the UK. The family unit is often very unstable in the Caribbean community. Unfortunately there are too many one parent families. The National Child Development Study (which has tracked around 17,000 people born in Britain during one week in 1958 over the course of their lives) has recently shown that greater social acceptance of divorce has not reduced its impact on children. When outcomes for this group were compared with children born in 1970, children from both cohorts whose parents split up are ‘equally likely to end up without qualifications, claiming benefits and suffering  depression’ (Elliot J  Vaitilingham, Now we are 50: Key findings from Child Development Study, Centre for Longitudinal Studies, Institute of London, 2008)

My story
During my time as a service-user, I have noticed that there are a lot of social
workers and nurses who are from the Caribbean and Africa. I found this useful
as a black Caribbean woman. The black staff would always make sure that I
looked after my appearance; they would tell me, for example, when I needed
to go to the hair salon, tell me to wear smart clothes and shoes, and would
check my hair and skin to make sure I was looking after it properly and it
wasn’t too dry. However, I have not seen a lot of black doctors in the mental
health services (only 2 doctors from Africa).

What I found strange the first time I was admitted to hospital was that they
said they had to medicate me because I was smiling all the time and over
happy. This sounds like they would prefer me to be some kind of zombie
(smile and the world smiles with you?!). One of the social workers set up a
support group for black women in the mental health system. We used to meet
up every week at St Anne’s Hospital and talk about our experiences. I will
never forget the session when we discussed being manic, because it was so
funny. One Saturday, they took us to Margate seaside resort. We had lovely
Caribbean food and really fantastic weather. I am glad that I went because I
didn’t have anyone else to go to the seaside with.

Lambo Day Centre
I was pleased to see Lynton Bedford’s recent letter in the Islington Tribune, as
she is just saying what everyone in the black community is thinking: race is at
the heart of the decision about Lambo Day Centre. The Afro-Caribbean Day
Centre at Despard Road in Archway was created to compensate for the
disproportionate number of black people locked up in psychiatric wards.
Moving all the users from two other centres into what is currently an all black
centre will mean that Despard Road will no longer be a black service.

I used to attend Lambo Day Centre. All the staff are black. We get African and
Caribbean food, such as rice and peas and chicken, and curries. We have
had a speaker in talking about sickle cell, which is a blood disorder that
affects the black community. The first group I attended there was a music
group. We made our own songs, which was really good. This group had even
produced its own CD. Other activities include sewing, going to the gym,
cinema trips, dinner and dancing, going to the West End for Christmas,
holidays in Centre Parks, Belgium and France, fire safety talks by the local fire
brigade, a restaurant manager talking about healthy eating – the list is

We celebrated Windrush in 1998, and have also attended black theatre
productions and black concerts. We went to a cooking show which featured
Ainsley Harriet, a black celebrity chef. He came to talk to us and took pictures.
We have visited African restaurants and took part in an exercise class led by
a trained black service user. We also went to African Village and have had
lots of parties (any excuse for a party!). The anthem for the Day Centre was
‘Lean on Me’ by Bill Withers.

The Minister for Mental Health, Norman Lamb, says he is supporting mental health is Black Britain and the Mental Health Foundation is a charity involved in research, who hopefully can help us understand some of the issues better. If we can’t get rid of the taboo about mental illness, let’s get rid of mental illness (prevention is better than cure)! 
A lot of doctors in mental health services are white and middle class, and do not understand our culture which can lead to misdiagnosis. We all need to know how to handle stress and be happy.

For further information, please see:
Goldberg RW, Seth P; Hepatitis C services and individuals with serious mental illness. Community Ment Health J. 2008 Oct;44(5):381-4. Epub 2008 May 9.
Sajatovic M, Dawson NV, Perzynski AT, et al; Best practices: optimizing care for people with serious mental illness and Psychiatr Serv. 2011 Sep;62(9):1001-3.

If you’re in distress or need immediate help, there are many services and organisations that you can talk to, including The Samaritans, who offer emotional support 24 hours a day. Get in touch with them on 08457 90 90 90 (UK)/1850 60 90 90 (Republic of Ireland) or email jo@samaritans.org.

The Black and Minority Ethnic Mental Health Network campaign is gaining
momentum. For further information, call 0208 215 2424, or visit

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