The Full Cost of Silence: Black Mental Health
The past week has been Mental Health Awareness week, a cause I will always support. However, a single week is barely sufficient to even begin to speak about the myriad of issues that fall under the umbrella of “mental health”. When we speak about mental health, often the focus is on mental illness of general poor mental health. These conversations are necessary and can be life changing, if not life-saving, but they do not cover the full story. If you want to talk about mental health, you must talk about the wider social issues that lead to ill mental health and govern the treatment of those in need. In Britain, race and racism is one of the most prominent issues that needs to be discussed.
Currently Black people in the UK are less likely than the rest of the UK population to be diagnosed with common mental health issues (read: stress and depression) and yet are more likely to be diagnosed with more serious conditions, most notably schizophrenia. According to some statistics Black people in the UK are five times more likely than the rest of the population to be diagnosed with schizophrenia. Black people are also less likely to seek professional care for mental health issues and more likely to access care through the prison and criminal justice system. These sets of figures should make a compelling case for Black people in this country having more conversations about mental health. Perhaps seeking help at an earlier stage would help redress some of these numbers over time, it cannot make things any worse surely. Or can it?
Black people are reported as having more negative experiences with the healthcare system when they do engage. Black people have also reported a fear of the stigmas that come with a mental health diagnosis. In a study of BAME experiences with mental health, one respondent said: “the stigma attached to seeking for a mental health problem. I though it would affect my work/employment chances” Another, more harrowing response as to why Black people do not seek help for mental health issue read: “Stigma and hearing tragic stories about Black men in the system.” Just this week, we learnt just how poignant those words were.
One 9 May, an inquest found that Olaseni Lewis died as a result of “excessive force” used when he was restrained by 11 officers in 2010. Aged 23, Olaseni Lewis had actually voluntarily admitted himself to Bethlem Royal Hospital for mental health treatment. Ultimately, Bethlem would be the scene of his death. The circumstances of Lewis’ death echo those of the death of David Bennett, a 38-year-old Black man diagnosed with schizophrenia who, in 1993, died when he was restrained, face down by four nurses. It took him twenty-eight minutes to die.
What is the value in sharing tragic stories like these? Well, I am a firm believer in knowing the full extent of a problem if you ever wish to find a viable solution. And currently I do wonder how much the full extent of the issues impacting Black people and mental health are being discussed, particularly in more “mainstream” settings. In 2012 I started blogging about my own experiences of ill mental health. Since then I have seen a definite rise in the number of Black people talking about the issue. From documentaries and short films to art exhibitions, podcasts and articles in mainstream, well respected national publications. Conversations are happening.
I have personally benefitted, if that is the appropriate word to use, in the rise in Black mental health conversation. I have had chances to share my story in many places. And with every article request, podcast or workshop booking, I hear the same thing said to me; Black people do not talk about mental health. There is some truth in those words, but not fully. As I pointed out in piece about my own negative experiences accessing care, Black people very much do talk about mental health. We work in mental health, we access care and thus are at times forced to talk about it. I am increasingly feeling what we do not do enough is engage in a solution focused manner with the topic.
On 28 April I was lucky enough to be invited to a live talk about mental health at BBC Radio Theatre put on by BBC 1Xtra and BBC Asian Network. The panel included actor Adam Deacon and rapper NoLay among others. Both shared their own mental health stories; Adam Spoke about his sectioning and NoLay about growing up with a father living with Bi Polar Disorder. It is important that people feel capable of sharing such stories. They illuminate and help many others feel less isolated. And I have no desire to see or hear less of that.
However, after the event, a friend and I discussed some frustration in the fact that the two people who worked in mental health, including Dr Dawn Estefen, did not have more time to share their considerable experience and knowledge of mental health, and specifically Black British mental health. The truth is negative experiences and even the deaths of Black people in the mental health system are nothing new. I have learnt this listening to people like Dr Dawn. Dr Joanna Bennett, sister of David Bennett mentioned earlier, launched an independent inquiry into the death of her brother, which has led to her and other Black psychologists and psychotherapists to question the label of schizophrenia on Black people in the UK. There is work being done to provide real solutions to the crisis in Black mental health in the UK. Work done by those who have lived not just professionally but personally with the wide ranging, life changing and heart breaking circumstances of Black mental health. And we would all be the wiser for engaging more.
As Black people we need to talk about mental health more to remove stigma. I feel most of us understand that and slowly this is starting to happen. Long may it continue. But we also need to talk about the experiences in care, reasons we may fear care, systematic racism, how to access the best care for us, the kind of care that engages with our specific issues. We need to think uncover the ugliest of ugly truths, as this is the only ways to find solutions. Because the full cost of silence, in my opinion, is the state of Black mental health in the UK never getting better. And that is no future for any of us.
