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Challenging ideas in mental health
Challenging ideas in mental health

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1.1.2 Boundaries of difference

One of the things that language does is define and give a name to differences between people – to delineate the boundaries that separate them. In the mental health field, the ‘mad’ are at one end of the social divide that separates the ‘normal’ from the ‘abnormal’. They are ‘the other’, a point made in the article by Perkins in the previous section: ‘To be mad is to be defined as “other”’.

This is a recurring theme in the mental health field. In the following passage Abina Parshad-Griffin, who at the time was the Chair of the Mental Health Action Group for the Disability Rights Commission (DRC), reflects on ‘otherness’ and what it means to be ‘the other’:

I could use different aspects of who I am that make the whole of me, as a kind of through-the-looking-glass. And I can give an example: being mixed race, if I had to fill in different forms in various countries, I’d have to tick different boxes. So in South Africa, I would have been ‘coloured’. In America, I would be ‘black’ because one drop of Black blood makes you ‘black’, and excluded. In South America, I could possibly be ‘mixed race’, or I could even pass for ‘white’ when you have the hierarchy of colour coding. But guess what I’m called in England or the UK? ‘Other’. And it’s that otherness that is part of my identity, and I believe that mental health discrimination is that otherness which is sometimes indefinable. But you pick it up – this overt and covert discrimination. I call it ‘psychophobia’: fear of mental illness. And there are certain conditions. Like somebody asks me, ‘What do you do?’ And I say, ‘Schizophrenia.’ You know that’s going to be a conversation-stopper and you will also know that it’s going to be associated with violence, with antisocial behaviour, which is not at all the case. That’s rare.

(Disability Rights Commission, taped conversation, n.d.)

To be ‘other’, in many instances, is to be on the wrong side of the boundary. The fact that Parshad-Griffin is mixed race gives her an officially designated category of ‘other’ in the UK. In addition, of course, her experience of mental distress reinforces her ‘otherness’. To be regarded as ‘other’ is to be treated differently, which often means prejudice and discrimination. ‘Otherness’ comes into play at all levels, but especially, it seems, when mental distress triggers ‘psychophobia’ in the people around. Although Parshad-Griffin’s situation also features ‘double discrimination’ (Baxter et al., 1990; Wainwright, McKeown and Kinney, 2019) because of her dual heritage, in many ways it is typical of the experiences of people who have periods of mental distress. Psychophobia leads to prejudice and discrimination. This may be something you have experienced yourself or have witnessed first-hand.

Being seen as someone with mental health problems may result in discrimination, often of a severe kind, as many people have found to their cost. The experience of being on the ‘other’ side of the mental health/distress boundary may be accompanied by unemployment, breakdown of relationships, low income and poor housing. For Black, Asian and Minority Ethnic (BAME) groups, the ‘other’ that is associated with racism is distressing and can directly contribute towards their experiences of mental ill-health. This is illustrated in the work below from the Black British artist Ashley Straker. In this piece, they graphically depict the emotional exhaustion experienced as a result of the COVID-19 pandemic, while also simultaneously dealing with racism and news about the injustice of Black people being killed. As indicated in the artwork, these stressors are a lot to ‘carry on your shoulders’.

This is an illustration of a black teenager holding on his shoulders items such as Black Lives Matters protests, a ‘Stand against racism’ sign, and the NHS.
Figure 2 ‘There is a lot we have to carry on our shoulders’.

Activity 2: David Harewood: Psychosis and Me

Timing: Allow about 20 minutes

In a BBC/Open University co-production, British actor David Harewood (MBE), reflects on his past experiences as a young Black man sectioned under the Mental Health Act (i.e. detained for treatment without his agreement). In the following clip he discusses his experiences with clinical psychologist, Dr Chanelle Myrie.

Watch the clip now. Then write your answers to the two questions in the text box below.

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Video 1 David Harewood: Psychosis and Me
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  1. Why is it thought that young Black men are sectioned more often?
  2. What are some of the factors, described as ‘accumulative effects’ in the clip, that contribute towards the development of psychosis for young Black men?
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  1. Myrie explains that Black men access mental health services later than their White counterparts. This is due to the fear of being hospitalised and the fear of being stigmatised. As a result, they arrive at hospital or services, already at crisis point (i.e. when they are extremely distressed).
  2. The cumulative effects include the everyday struggles frequently experienced by young Black men. For example, their experiences of marginalisation, oppression, and discrimination (including ‘double discrimination’).