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The Umbrella Organisation

The Umbrella Organisation

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White psychiatric interpretations of Black psychosis: colonial Africa and modern-day Britain
Raks New Profile Pic Square
rakspatel wrote in mycroft_brolly
I ran an article about David Bennett earlier this week to provide a bit of background to this original feature that I am running today. The article stated that institutional racism was rife throughout the mental health service of the NHS, according to an independent inquiry into the "unnecessary and tragic" death of a black man (David Bennett), restrained at a secure clinic in Norwich. The David Bennett feature is here:

Photo: David Bennett
Photo credit: http://www.telegraph.co.uk/news/uknews/1454134/Patients-death-reveals-festering-NHS-racism.html

White psychiatric interpretations of Black psychosis: A comparative study of colonial Africa and modern-day Britian

I did an MSc in Race and Ethnic Relations at Birkbeck College, University of London, which I completed in 2004. This feature article is a summary of the dissertation that I did as part of my MSc. I looked at how white (and in particular British) psychiatrists and psychologists in colonial Africa and modern-day Britain have interpreted black psychosis.

This is my original writing and cannot be used or reproduced without my prior permission and consent.

Psychiatry and psychology, being studies of the mind, are subjective and rest on the practitioner’s subjective evaluation of the patient’s psychosis. White psychiatric interpretations of black psychosis are flawed because the white practitioner is vulnerable to the influence of prevailing societal prejudices and stereotypes about black people.

Ethnopsychiatry was produced by psychiatrists and psychologists working in different parts of colonial Africa and collectively their clinical studies and writings articulated a powerful ideology of the inferiority of the African psyche. But ethnopsychiatry was heavily influenced by the colonial environment within which it was produced, and shaped by the fact that ethnopsychiatrists were members of the ruling white settler class. It reflected prevailing white settler prejudices and stereotypes about Africans being a primitive race; with an inferior brain; vulnerable to manic, violent and dangerous psychoses; immune to depressive illnesses; hypersexual; and possessing an underdeveloped and dependent psyche. African nationalism was in the ascendant, threatening to overthrow white settler rule, and ethnopsychiatry was used to legitimise continued colonial rule by arguing that psychiatric and psychological research proved that Africans were not ready for political independence and power.

In modern-day Britain, black patients have a very negative experience of the mental healthcare process and clinical studies have documented the many and varied ways in which they are significantly disadvantaged. Black patients are more likely to be forced by the police to enter the mental health system against their will; to be detained in hospital compulsorily; to be diagnosed as suffering from schizophrenia or other forms of psychotic illness; to receive coercive physical treatments like ECT and drugs; to be denied access to psychological therapies like psychotherapy; to be given higher doses of medication; and to be kept in locked and secure facilities.

I argued that the primary driver behind the negative experience of black patients within the mental health system is the strong association forged in the public (and psychiatric) imagination between black psychosis and criminality, aggression, violence and danger. White psychiatrists perceive their black patients as innately more dangerous and this impacts extremely negatively on their treatment, resulting in more coercive forms of treatment like forced entry into the system, compulsory detention, electroconvulsive therapy (ECT), higher doses of medication, and the overuse of locked wards and seclusion.

Racial prejudices and stereotypes have played a powerful role in influencing diagnosis and distorting the diagnostic process as demonstrated by the creation of new psychiatric diagnostic categories like “frenzied anxiety” syndrome and cannabis psychosis.

Black psychosis as innately more physical, violent and dangerous is a dominant theme, common to colonial Africa and modern-day Britain. In colonial Africa the hypothesis that African psychotics were inherently more violent, dangerous and criminal gained the status of a proven psychiatric fact. In modern-day Britain, strong associations have been forged in the public imagination between black psychosis and criminality, aggression, violence and danger. These influence white psychiatric interpretations of black psychosis and are the primary driver for the very negative experience of black patients within Britain’s mental health system.

Colonial ideas and theories about the African psyche resonate powerfully within psychiatric practice in modern-day Britain. Ethnopsychiatrists believed that the underdeveloped and dependent African psyche lacked the prerequisites for depressive illness. White psychiatrists in modern-day Britain rarely refer their black patients on for psychotherapy because they believe they lack the necessary capacity for self-knowledge, insight and personal growth. Black psychosis has consistently been disassociated from depressive illnesses.

The colonial theory that the underdeveloped African psyche was imploding under the pressures of change, education and civilisation, has powerful resonances with transculturalist arguments in modern-day Britain, which attribute the high rates of black psychosis to black people being unable to cope with the stresses of migration and acclimatization. Similarly Fanon’s theory that colonialism caused much black psychosis is echoed in the modern-day hypothesis that the disadvantage and racism encountered by black people within British society has caused them to suffer higher rates of psychosis.

Having compared and analysed white psychiatric interpretations of black psychosis in colonial Africa and modern-day Britain, I have a number of key findings and conclusions.

Firstly, racial prejudices and stereotypes have critically influenced psychiatric diagnoses and distorted the psychiatric diagnostic process.

Secondly, white psychiatrists have perceived and believed black psychosis to be innately more physical, violent and dangerous. In parallel, they have disassociated black psychosis from depressive illnesses.

Thirdly, colonial ideas and theories about the underdeveloped and dependent African psyche continue to resonate powerfully within psychiatric theory and practice in modern-day Britain.

copyright © Rakshita Patel 2011 (originally June 2004)