The discomfort of institutional racism

I was intrigued by Lewis Mitchell's letter 'What does evidence look like?' in the November issue, arguing that we need scientific proof of institutional racism. Such evidence would be hard to find in a field dominated by Western-Caucasian culture. There is some 'scientific evidence' showing that a majority of clinical trials in mental health took place on 'white only' wards (Metzl, 2010) and that BME healthcare professionals are more likely to have cases of fitness to practice raised to a full investigation (West et al., 2016). Intersectionality effects of fitness to practice investigations are not reported by the HCPC.

If we do not collect the data to report these figures, then how can we find evidence for institutional racism? Does this not put BME colleagues within our profession in a difficult position? To speak of institutional racism, we must find evidence, but such evidence is not made possible. Perhaps we should be debating whether the lack of these figures is an unconscious bias – evidence itself of institutional racism.

These recent arguments for evidence follow the Black Lives Matter movement which has rocked the world. Histories of the oppression of BME individuals have started to be uncovered and taught. I am fascinated that I have reached doctoral training without much study of the use of psychology in oppressing those from diverse backgrounds. Just the other day I came across Drapetomania; a diagnosis used in the 1850s to label black slaves who ran away from their white 'owners', and Drysatheshia Aethiopis; a label applied to black slaves who showed disrespect to their 'owners' and for which the prescribed 'treatment' was extensive whipping (Metzl, 2010). These events were highlighted ten years ago, but they are still not in undergraduate psychology programmes.

These histories are shocking and difficult to talk about. They make us feel uncomfortable that psychology could be used in a harmful way. However, the fact that these historical events make us feel uncomfortable is a good thing – it shows there has been significant progress within the field that such bad practices are recognised as both shocking and an abuse of power. Although this subject is difficult to speak of, without doing so we cannot see the progress made in mental health. We should continue to have these conversations, to challenge our unconscious biases and feel comforted that this builds on good practice within the profession.

We should not hide behind a need for 'scientific rigour' before we make changes. Should we be cautious about the label of institutional racism? If we have some understanding that institutional racism exists, then its presence should not be doubted. A professional colleague should feel able to tell you how they feel and share their lived experience – who are we to question how they feel? In questioning their experiences we unconsciously squash voices of BME psychologists within the profession, so they do not speak out against malpractices. Understanding our own social GGRRAAACCEEESSSS [not a typo but an acronym] and how they influence our practice is needed more than ever to benefit not only our clients but also the people and systems we work with.

Yes, psychology is a field of science. It is also about understanding the individuals we work with and not prescribing a one-size-fits-all approach. Psychology understands people – we appreciate their differences. We should not lose sight of this by claiming we need proof.

Jasmin Kaur Gill
Trainee Clinical Psychologist, Birmingham
[email protected]

References
Metzl, J.M. (2010). The protest psychosis: How schizophrenia became a black disease. Beacon Press.
West, E., Nayar, S., Taskila, T. & Al-Haboubi, M. (2016). The progress and outcomes of Black and Minority Ethnic (BME) nurses and midwives through the nursing and midwifery council's fitness to practise process. University of Greenwich.

Illustration: Tim Sanders