Comments by Jayasree Kalathil

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  • Wow! Thank you so much for this article. Much as it amused me, it also scared me to the core. I recently read an evaluation report of the use of MHFA in “supporting people working with the Prevent agenda.” The Counter-Terrorism and Security Act 2015 contains a duty on specified authorities in England, Scotland and Wales to “have due regard to the need to prevent people from being drawn into terrorism.” This is known as the Prevent duty. There is much going on in the UK about the link between “mental illness” and “radicalisation” (the link itself is not clear, does radicalisation cause mental illness or does mental illness cause radicallisation – the mind boggles). And this section (among many) from the report seemed especially problematic:
    “I would never as a Police Officer explain to a supervisor I needed guidance on how to investigate a crime, because the first question they would ask is ‘what sort of crime?’ If you know the type of crime i.e. Fraud, the supervisor can signpost you to the Fraud Team.”
    “I have been in multi-agency meeting where a delegate suggests there is a mental health problem, the mental health practitioner correctly asks what sort of mental health problem to which the delegate had to admit they did not know, other than it was a mental health problem!”
    The MHFA course is supposed to be helping the concerned person identify the correct mental health problem just as they would be able to correctly identify the type of crime. More than that, it is the juxtaposition of “crime” and “mental health problem” that spoke volumes to me.

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  • With respect, understanding psychosis within in personal, relational, social, spiritual and cultural context does not necessarily mean being non/anti-racist.

    But, more importantly, I am baffled why you, a co-author, would completely ignore the fact that the report failed entirely in engaging meaningfully with the “ample evidence of racism” you point out. Crucially, the process perpetuated institutional racism in the context of knowledge production by completely ignoring and excluding the expertise and knowledge within UK’s minority ethnic communities – professionals and user/survivors. These issues were pointed out in an open letter to the editor of the report and in articles on this website and in Mental Health Today.

    The editor and some of your colleagues have publicly acknowledged these shortcomings and issued an apology. Your own organisation is currently working out ways to remedy the racism inherent in the report with those of us who have raised the issue and been in conversation with your colleagues.

    Here is the ‘statement of apology’ issued by your colleagues, in case you have not seen it.

    Statement regarding the DCP‚Äôs report ‚ÄėUnderstanding Psychosis and Schizophrenia ‚Äô:
    The report ‚ÄėUnderstanding Psychosis and Schizophrenia‚Äô has generally been very well received since its free publication. However, a number of people have expressed concern that it inadequately covered racism (both as a causal factor and in mental health services), that some of the language used in relation to race and mental health was dated and patronising and that black people were not represented in the author group.
    The editor and some of the authors recently met some of those who had voiced these criticisms in order to discuss the concerns. The points raised, outlined above were conceded fully by the authors present. We personally apologised for these serious significant oversights and undertook to work with those present to propose amendments to the relevant sections of the report. Those expressing concerns offered a constructive way forward whereby they offered to participate in this process, an offer which we gladly accepted. We feel that these constructive suggestions will make the report stronger and likely to be more helpful to people from black and minority ethnic backgrounds. We will we will strive to ensure that the lessons learned through this process are shared with the DCP and the BPS so professional psychologists will be enabled to more fully address the challenges of racism.
    Anne Cooke Editor
    David Harper Co-author
    Peter Kinderman Co-author
    David Pilgrim Co-author
    30th January 2015

    It would be more honest to acknowledge these faults rather than continuing to pretend they aren’t there.

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  • I agree that identifying culture and spiritual issues as important is a key step. However, these issues are important for everyone, not just for minority groups. I am not sure how attending to these issues becomes “a very relevant step toward better mental health care for cultural minorities” alone. The issues Phil Thomas raises in his article point to a very real and embedded ‘wrong’ in our mental health care systems. First, there is a problem in re-articulating racialised communities as “cultural minorities”. Second, diagnosis – especially of schizophrenia and psychosis – is experienced as ‘racialised pathology’ by many black people in the UK (it is also true in other contexts such as the US). A more nuanced view is indeed needed and the report would have been able to do this if it had engaged with the vast literature that Phil points to which discusses these issues in much depth. To my mind, the marginalisation of black communities and the scholarship dealing with the issues affecting them in this report is indicative of a very real and embedded ‘wrong’ in academia and knowledge production itself.

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