Breaking it down: Mental health and the African community

By The Ligali Organisation | Mon 18 December 2006

Morenike Fasuyi discusses her personal experience within the british mental health institutions and highlights the need for the government to honestly address the serious issue of mental health and the African community in the UK.

Morenike Fasuyi

Dealing with the pressures of life in the United Kingdom as an African person is extremely difficult. The general consensus suggests that African people have to work twice as hard as their european counterparts in every aspect of our social, cultural and economical existence in order to make ends meet.

Coupled with the covert oppression exhibited by the powers that be, we also have to contend with the difficult issues that manifest in our relationships, marriage, family and work. The accumulation of the above factors, of course leads to stress. In some cases, the stress levels are so high that you end up having a nervous breakdown. I should know because I have been there.

I am not ashamed to express my views on this matter. I believe that my experience should be shared in order to inform some of you that anybody can break down at anytime and remind those who have gone or are going through similar experiences that you are not alone. I have positively been able to identify my experience as a journey. The views I hold are based on my local health authority and what I have experienced, others health authorities may be different.

One minute I am a successful individual, reasonable income and full of confidence. The next minute, at the age of 31, I was diagnosed with Bipolar Affective Disorder. This is a condition where your mood can go between extremes of high to low causing you to act in ways that are out of character. Another term for the condition is manic depressive. I still have reservations about the diagnoses as I am against the mental health profession attaching labels which ultimately define you. Thus you become part of the system.

The reason I hold this view is because my Bipolar is triggered and predominately based around African issues, such as slavery, politics, oppression, Africa and the suffering of my brothers and sisters in the Diaspora. I suffered from flashbacks as to what it would have been like for our brothers and sisters on the boats, shackled and naked. I imagined the stench, as where they lay, was where they released all bodily functions. Imagine the Women during their menstruation… I imagined their screams in their African dialect shouting ‘Oyinbo bo, Oyinbo bo, sa re sa re!’ - The white man is coming run run!! - in Yoruba Dialect. I would get flash backs of how they were taken off the ships shackled, soiled naked and cold. When we are cold, we have the luxury of wearing jackets or coats and we as African people, are still cold!!

Basically my condition takes me back to the time of enslavement. I feel the pain, sorrow and suffering and the obvious hatred towards europeans. I begin to get agitated and unable to cope with the reality of what has happened and what continues to happen in the world pertaining to African people. I feel hopeless and scared because we are still experiencing the effects of our enslavement. This is not to say, that there are no successful African people in the world, however the ratio is very unbalanced and it is time that we united as a mighty African race. I feel that there appears to be a concerted effort by Western Governments to keep African people oppressed, through neo-colonialism and indoctrination.

My feelings are anxious and grandeur, which is not a crime. My condition encourages me to push for change now as the exploitation and oppression of African people globally has gone on long enough. As a campaigner, naturally I want action now. We have been going to meetings upon meetings, talking for the past 50 years about the struggle yet we are still fearful of moving forward. This feeling also affects my wellbeing. The only individual in my opinion, who courageously fought for the rights of his people through his ideology of how we emancipate ourselves economically and culturally, was Marcus Garvey.

On May 1st 2004, I awoke from my bed and screamed “Oh my God” - I can only explain it in spiritual terms. It was as if the ancestors called upon me and removed the scales from my eyes. I was able to see the ugly world we live in and the high level of conspiracy that has been logistically planned to avoid a potential African “Revolution”. Karl Marx discusses this pattern when he talks about groups that are oppressed eventually gaining a class consciousness that ultimately leads to a revolution.

May 1st is where my journey began. I became overwhelmed with a spiritual understanding of numerology and how numbers relate to African people especially the numbers 7 and 9. I also felt alerted to the fact that 2007 may be the year that could potentially homogenize the divisions within the African community in order to effect change. There was also a strong sense of acknowledging, ‘European Envy’ towards African people which has historically continued to fuel their oppressive practices.

With all these thoughts going on in my head I could not sleep. In fact, I did not sleep for three days. I called a friend to come to my aid as I did not know what was happening to me. My views about the ancestors, African history and politics caused concern for my family and friends. I was concerned myself! And this is how I gained my pass into the british Mental Health system.

The mental health system is killing us point blank. If you are not strong, the system will break you down, so that you fit the part of looking dishevelled, impoverished and “mad”. In some cases, your family, although unconsciously, will hand you over to the system as they do not have the knowledge to understand what is really going on. This is why you see many brothers and sisters looking rough in the street, hair uncombed and with poor personal hygiene. Families tend not to ask relevant questions or challenge the practices of hospital consultants and doctors. In some cases families neglect that the member of their family who has mental health issues.

Maintaining you within the system keeps consultants in their jobs and increases the profit of the pharmaceutical industry, which has a turnover of billions. I met a patient who had been in the hospital for five years! To me this was negligence on the part of the system since it is a statutory requirement for patients to have a structured care plan, social worker and other support that would involve care in the community - What were they doing for this patient who actually lived in the hospital?

Another tactic used to undermine you is intellectual intimidation. Consultants and doctors discuss very complicated clinical issues with patients who are incapable of understanding what is actually being said. This method of complicated jargon is also used when they talk to relatives, leaving everybody somewhat confused and resigned to the fact that the system knows best.

To further reinforce this point, in The North Kensington hospital where I was, they organize weekly meetings with patients. This is called ward round. You basically have to sit before a panel of consultants, doctors, student doctors, pharmacists, social workers and therapists. You are asked questions about how you feel and they discuss medication whilst you are being assessed. This particular forum is very intimidating, especially if you do not have the ability to articulate yourself in the same manner in which the panel addresses you. And if you are drugged up, you stand no chance of making sense which ultimately means you will not be able to justify being released from detention. I found these meetings pointless as they never wanted to hear about my condition being connected to cultural, spiritual and political issues. I was just seen as being a Bipolar sufferer… end of story.

When I tried to introduce the diagnoses of Post Traumatic Slave Syndrome by Doctor Joyce Leary, which has been recognized as a medical condition in the United States, I was basically digging myself into a grave, as this assertion of mine, meant that I was unwell! I showed them the book, I read out symptoms, such as:

• Difficulty falling or staying asleep

• Irritability or outbursts of anger

• Intense Psychological distress at exposure to internal or external cues that symbolize or resemble a traumatic event, (Slave Trade)

• Feeling a detachment or estranged from others

All of which I identified with!

The mental health system in the UK is so rigid and based on discriminative European ideology that they will never accept Post Traumatic Slave Syndrome as a clinical condition. You are either schizophrenic, psychotic, bipolar and many other mental labels they have theorized, but you can not have a condition that manifests from a cultural or spiritual dimension.

The National Institute for Mental health in England conducted a study March 2003 entitled ‘Inside Outside: Improving Services for Black and Minority Ethnic Communities’. An overwhelming 66% of African people complained of discrimination within the mental health services. The Delivering Race Equality in Mental Health Care Booklet, stipulates, “There should be ministerial acknowledgement of the presence of institutional racism in the mental health services and a commitment to eliminate it”…yea right!

They pump you up with drugs many of which have side effects such as hallucinations, impotency, muscle spasms, memory loss, obesity… the list is endless.

The administering of the medication makes their jobs a lot easier because the medication sedates you. This is why we see some of our brothers and sisters walking around like zombies with very slow physical motions and speech delivery.
Medication is also administered as soon as you wake up in the morning, drowsy from your sleep; you are already sedated before 9am! I had to be strong. I had to adopt warrior like principles to address the medication as mind over matter. One positive thing that I instigated is that I told all the patients to get information about their medication as they had a right to do so. I always tried to empower them because these were my brothers and sisters caught up in the system with bleak prospects and no hope.

I found, that once you are in the system possibly under a section 1, 2 or 3, mainly section 3, which, can keep you in hospital for 6 months for assessment and “treatment” you have no power whatsoever, patients become very institutionalized and reliant upon the system.

Another aspect of their practices which concerned me was that if you refuse your medication, you are forced to have an injection. If you were agitated or questioned their motives in a passionate way, you are seen as aggressive and given an injection.

Some of our brothers and sisters at some stage of their treatment are introduced to regular injections, this method is called being on ‘Depo’. This is to ensure that you are medicated and drugged up to the eyeballs - in many cases, for life. It’s funny how the system is hell bent on administering medication but yet people are still being admitted and readmitted to hospital suffering from the same symptoms… this begs the question, what does the medication actually do?

Overrepresentation of African people in Britain’s mental health system
More than 80% of patients in psychiatric wards are African. This is a fact that the government has recognized and has always known. I have only come across a few european people in the mental health system and when I have, their mental condition always seemed to be more severe than those of African patients. Some of them tie ligatures around their necks to kill themselves, others mutilate their bodies with sharp objects or burn themselves with cigarettes. I was scared by this as I had never seen it before in my life. When I would ask them why they do it, their reply was always that the Devil tells them to do it. Some of them admitted to worshiping the devil which triggers off their mental illness.

However, African people are more likely than europeans to be given a clinical diagnosis that warrants medication, intervention and detention under the Mental Health Act 1983. The death of David Bennett in 1998, who died in a secure unit as a result of being restrained by practices that were beyond procedure, instigated an independent inquiry into his death and the discriminative nature of the mental health system in general. The government issued recommendations that all Mental Health Authorities should follow in order to deliver equality in mental health care.

The ‘Delivering Race Equality’ report published in January 2005 stipulates:

• There should be a reduction in the disproportionate rate of admissions of people from BME groups – (Black Minority Ethnic)

• A deduction in the disproportionate rates of compulsory detention of BME users in inpatient units

• Increased satisfaction of services

• A more balanced range of effective therapies other than medication, support services counselling treatments as well as pharmacological interventions that are culturally appropriate and effective.

• The Government also recommended that all NHS staff involved in mental health should undertake a course called Cultural awareness and sensitivity training.

All Talk No Action
The report and its recommendations are just words. The various training strategies for NHS staff members to be aware of the cultural needs and differences of service users are not working. Whilst in hospital, I conducted a mini research by asking nurses, consultants and doctors if they had been on any cultural awareness training. Out of 15 staff members only 2 had attended the training. Most of them had not even heard of it or read the independent inquiry into the death of David Bennett.

Further recommendations stipulated that there should be a National Director for Mental Health and Ethnicity. National Directors should be appointed by the Secretary of state for health to oversee the improvement of all aspects of mental health services to the African community. A Professor Kamlesh Patel has agreed to lead the Departments programme of action and chair its ‘BME’ Mental Health Programme. My concern is what does an asian man know about the serious cultural and social issues that continue to affect the African british community, causing stress and mental health problems?

We have Lord Victor Adebowale, the chief executive of Turning Point, who will advise the national steering group on relevant issues. I question what he has done thus far and whether he has made any adequate recommendations. I would advise him to visit St Charles Hospital in North Kensington to check their race equality plan and commitment to the government’s recommendations.

We have the CRE, the Race Relations Amendment Act (2000) and a plethora of groups, committees, national bodies, recommendations and statutory requirements and yet we have failed to make any substantial progress with a smoke screen shielding the pure, unrelenting discrimination!

No Cultural Awareness and Discrimination
Not once did anybody take out the time to sit down with me to explore why I have these episodes and their cultural content. I asked to be referred to an African psychiatrist who would be able to understand some of my issues. This was a slow process as I was also told there are hardly any. I feel that if they looked hard enough, they would have found one. It all comes down to resources and limiting the funds that are awarded to the African Mental Health community.

I finally managed to get a counsellor through the Oremi organisation in North Kensington who do a fantastic job of rehabilitating African mental health service users on a small budget! I also asked for an African social worker but instead they gave me an insensitive male european social worker who adversely affected my health with his actions, racist remarks and incompetence.

The british Mental Health System has no real interest in understanding the core root of African mental health issues which are predominately caused by issues relating to socio-economics, cultural identity, employment, racism, oppression and learning the historical facts of African Evolution.

The system is not interested in how brothers and sisters became the way they were or what the triggers are. They are more concerned with medication and sedation. Whilst I was in hospital, I observed things that were completely discriminative! For example, the ward issued small thin tooth european combs for everybody with no regard as to how these combs would be used by African patients with afro hair texture. This is why you see some brothers and sisters walking around with their hair always in a mess or even matted. Patients are not encouraged or supported to address their personal care and hygiene. There was no body lotion on the ward suitable to moisturize African skin and as a result some patients had to walk around with dry, flaky skin. In addition, there was no hair grease, no deodorant and cheap shampoo that resembled washing up liquid and was not at all compatible with African hair texture. These observations were particularly painful as so many inpatients have issues around abandonment. There is no family member to say “fix up, look sharp”. Thus they end up looking the part and playing the role of the “Mad Man” or “Mad Woman”. There was no implementation of an efficient equality action plan or a commitment to addressing our “cultural needs”.

African Staff without a Clue!
The most astonishing thing about the ward that I was on was that the manager was an African woman! Another observation is the overrepresentation of African mental health nurses who are not doing the job for the love of people. They have no sensitivity to what is going on regarding their own people. It is as if they are simply and mindlessly carrying out the masters orders. Many of them will tell you that there is no such thing as racism or discrimination! Despite the negativity of some staff members, there are also African people who work in mental health who actively challenge the discriminative practices of the mental health system.

Be Real
There is so much going on that needs to be addressed once and for all. Despite government recommendations and the announcement of £510 million being injected into mental health over the next 3 years, to add to the existing £180 million, there is still a lack of acknowledgement of the cultural needs of African patients. We are still exposed to serious insensitivity, labelled as aggressive, marginalized and severely discriminated against. The system still simply does not understand African culture, spiritualist identity, mannerisms and the issues that come with being African.

The Department of Health and the british government are still failing our people in mental health and there appears to be no intention of addressing the inequalities ranging from diagnoses, detention, sectioning and medication. I feel that we need to establish a grassroots African Mental Health Body that has the capacity and ability to consult, advise and make recommendations on any issue that concerns African people and the mental health system, and then maybe we can fix this mess.

External Links
Black Mental Health UK

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