New work by Tarek Younis at Middlesex University reflects on the hurdles facing anti-racism efforts in mental health systems. Contrasting liberal with illiberal racism, Younis stresses the importance of macro-level policies and politics, using the UK’s Prevent policy as a case study of formally “colorblind” liberal racism in the mental health system.
Structural racism in the mental health system has been documented in, for example, racial bias in the diagnostic process and injustices in the process and definition of recovery. Black people also make up a disproportionate percentage of the inpatient population in both the US and the UK.
In general, Younis writes, communities of color are “at higher risk of mental illness and more likely to be impacted by social detriments; less likely to access mental health services and more likely to do so through crisis care; more likely to be medicated (rather than offered talk therapy) for mental ill-health, while external risk factors such as poverty and racism are overlooked.”
Younis uses a case study that underscores how politics cannot be dissociated from public health. The article describes the UK’s Prevent policy, which requires health staff to report individuals they suspect are susceptible to radicalization based on elusive “pre-criminal” risk factors. The Prevent policy essentially targets Muslim patients for comprehensive risk assessment screenings and referrals.
“The notion of policy-based evidence, as opposed to evidence-based policy, showcases the explicit role of political agendas underlying healthcare strategies,” Younis writes. “The significance of policy-based evidence in racism cannot be understated, given how political discourse both pivots and reproduces dominant, racialized moral panics.”
In the case of Prevent, prejudice is given institutional legitimacy via the racialization of “threats to national security” within the public consciousness.
Prevent is a prime example of what Younis calls “liberal racism.” Liberal racism refers to racism that obscures the centrality of race in pre-existing social orders through the “colorblind” frames of threat, risk, and security.
“Liberal racism operates within the logic of colorblind but inevitably racist ideologies, such as nationalism, which sees some people within racialized groups as more worth – and therefore more grievable – than others.”
Liberal racism favors some groups not explicitly with reference to race but in terms of cultural integration, national loyalty, and economic value. In the mental health context, where “even the mention of racism could be cause for anxiety for white professionals,” anti-racist efforts at institutional reform tend to fail when not adopted at the level of national healthcare policy or taken seriously by those in positions of power.
Liberal racism is entangled within the logic of neoliberalism – specifically, racial neoliberalism – and its technologies of social control. While the fabric of social welfare is eroded through austerity and privatization, the neoliberal state identifies “criminals, immigrants, and security threats as its primary concerns and entrenches the web of their capture within public bodies” – including mental health service providers.
In this context, common “diversity” measures, usually consisting of educational training that focuses on individual prejudices and unconscious biases, fail to address the political and institutional nature of racism – the original liberal racist paradigms of nationalism and capitalism.
As such, critical race research in mental health must address the political structures that cause inequalities. While the American Psychological Association president, for example, has acknowledged that “we are living in a racism pandemic,” it is unclear whether organizations like the APA will go beyond statement-making to take demonstrable actions that address these structures.
Indeed, liberal racist policies like Prevent never exist in a vacuum: “issues of racism and mental health are inevitably aligned with those outside the field” and draw, for example, upon hegemonic ideals of normality and belonging. To the extent that mental health institutions adopt these racist ideals, which can inform everything from diagnosis to notions of recovery, no amount of diversity training can remedy these alignments.
As nationalist and neoliberal forms of governance intensify, efforts to deal with institutional racism in the mental health setting will increasingly face an uphill battle.
Younis, T. (2021). “The Muddle of Institutional racism in mental health.” Sociology of Health and Illness, 2021;00:1-9. 10.1111/1467-9566.13286
Can you say more about why you think nationalism was originally liberal in nature?
I think it is extremely telling that the APA states that we are living in a “racism pandemic.” To me, if one looks at neoliberalism and its reliance on control, especially using technology, but that is not the only way they attempt control. Although nationalism has traditionally been associated with more conservative or right wing ideologies, I can see “nationalism” also endemic to liberalism and neoliberalism. I think it is probably just differently expressed. Unfortunately, any ideology, whether towards the left or right has the capability to lead towards “fascism” in various forms. But, in the end, the main thing we must remember is that the “mental health/illness industry” in any form or structure basically doesn’t discriminate. They force their evil diagnosis, treatments, and drugs on all they “serve.” Perhaps, if the community really is “under-served” by psychiatry, etc., it might be a “blessing in disguise.” There are so many other ways to be lifted up out of distressing moments and times. Sometimes, we are just limited by a lack of imagination or creativity. Thank you.
How do you see nationalism as endemic to liberalism?
Psychiatry and neoliberalism go hand in glove. What we are now and will be seeing in the immediate future are all sorts of agendas being pushed by major corporations, and the parties and media that support them, being dressed up as “anti-racist.” When they well know that the only way to eliminate racism is to eliminate capitalism itself, which requires racism as part of its divide and conquer strategy. They also know they can divert the ignorant from this realization by fueling the visceral satisfaction privileged liberals get from calling their peers “white supremacists.” And letting the masses define their angst and confusion in terms of “disorders.”
At the same time many communist regimes have been institutionally racist in practice (if you take communism as the opposite of capitalism): China towards the Uighurs, Soviets towards ethnic Germans (who were many of the “kulaks”), Chechens, Kalmyks, and others, Vietnamese towards ethnic Chinese (so-called boat people) and so on.
There never have been any “communist regimes;” the term is an oxymoron, as communism is the absence of a state, and this has never happened, yet. What you’re talking about are in many cases socialist states, which precede communism theoretically, and are always imperfect. Also I wouldn’t define all the oppressive situations you mention as “racism” per se.
Well they called themselves communists and/or based their policies on the teaching of Marxism-Leninism, that’s good enough for me (saying they were “only” socialist and/or “imperfect” is like saying the U.S. isn’t “really” capitalistic because it has policies like Medicaid, Social Security, and so on.
And all of those “oppressive situations” (some of which directly caused the deaths of tens of thousands of people) targeted specific ethnic groups in part, regardless of whether they fit a textbook definition of racism or not.
some vocabulary that might be helpful to bridge this dispute:
“centralized economy” vs. “market economy”. ergo: Centralized communism (USSR), centralized capitalism (CCP), market capitalism (most countries today, but oligarchic influences feel very much like centralized capitalism that took the scenic route), market socialism (hopefully someday, hopefully less of a disaster). Still a rough outline, there’s more if you keep drilling down into the nuances: syndicalism, neomercantilism, corporatism, tribal-/clan- based economic systems, Shari’a…
The term persecution is a fairly useful umbrella that covers political disenfranchisement, ethnic bias, racism, cultural erasure, ideological suppression, economic exclusion, physical subjugation, oppression through soft power, etc.
To no one (in particular) — yes, true socialism would feature a centralized economy; the difference between socialism and centralized capitalism (fascism) is the element of democratic control; the inability to sustain such in most socialist states to date has been one of the key factors in their demise.
By “socialism” I don’t mean the “democratic socialism” of Bernie Sanders, AOC, etc., who are basically diversions at this point.
Liberal racism is when a therapist tells me that an asian american political scientist once said identity politics is divisive.
Translation: The non-racialized person should hold the unique privilege of politicizing minority identities, but that same privilege should not extend to racialized personhoods in how we view and speak of ourselves or acknowledging how we are viewed and spoken of by others.
Of course neither party should mention the concept of whiteness, that would be WILDLY inappropriate.
Hmm…I would think their liberalism (and racism) is likely showing in their need to quote an Asian person to promote their own views (it’s relatively easy to find anyone of any race to support a given position). But I don’t want to overgeneralize either.
And if by “identity politics” they actually mean Asians being concerned with and discussing self-determination they are using the term in a racist way. “Identity politics” has other iterations as well, which CAN be divisive. So it’s hard to say more without some working definitions.