Rivers of Blood and Babylon: An ethnography of social sufferingand resilience among Caribbean service users in London Pubblico
Phillips, Kwame Matsimela (2014)
Abstract
Suman Fernando (2003) argues, "racial injustices and cultural oppression are felt most acutely" by Black and ethnic minority service users in the field of psychiatry. Research on the mental health services in the UK consistently find that Black and ethnic minorities are more often diagnosed as schizophrenic, more often compulsorily detained under the Mental Health Act, more often given high doses of medication, and more often dissatisfied with statutory services. The dissertation asks how the current treatment provided under the mental health system in London, England re-traumatizes Caribbean service users. To investigate this question, I gathered ethnographic data - through official interviews, conversations, participant observation and visual material - from more than 40 adult service users and 26 health professionals. The qualitiative, ethnographic research uses both visual and textual presentations of data in its approach and resulted in the production of four ethnographic films exploring themes of identity, community, resilience, voice and civil disorder.
The dissertation puts forward that for the Caribbean population in the mental health system, there is a pervasive problem of social suffering, both as a result of mental illness and of coming into contact with the mental health system, such that coming into contact with the institution of the National Health Service itself can be considered a risk factor for furthered suffering. I further propose that the psychiatric philosophy of containment held by the mental health services, linked with a societal culture of fear and stigma, and a history of political failure to implement, follow through on and maintain progressive components within healthcare policy, must be addressed and improved if any meaningful change for the better is to be effected. The research highlights continued tension in the relationship between service users and the medical establishment, with a general sense of resentment to the amount and administering of medication, the power afforded to medical staff, and the dominance of Eurocentric academic and medical classification at the expense of their own models and theories of illness.
Table of Contents
Chapter One: Introduction 1
Prologue: The Lucky Ones 2
Introduction 3
Research Question 5
Aims and Objectives 5
Summary of argument 6
Methodology 10
Research Design 10
Context 13
Analysis 20
Constraints of methodology 21
Contribution to anthropology 24
Chapter Two: Literature and Background 28
Introduction 29
Literature 30
Transnationalism and Identity 30
Media and Representation 37
Media and Blackness 38
Media and Mental Health 45
Policy and Practice 48
The Delivering Race Equality in Mental Healthcare programme 54
The Mental Health Act 2007 55
The 2010 White Paper and 2012 Health and Social Care Act 56
Social Suffering 57
Resilience 66
Chapter Three: Family Health Isis 78
Prologue 79
Introduction 79
Family Health Isis 80
Organizational Structure 81
Activities and Services 83
Additional Services 84
Referrals 86
The role of Isis in the lives of service users 86
The Isis space 90
The Move 96
Chapter Four: The Service Users 99
Prologue 100
A note on quotations 100
Introduction 101
Noel 103
Noel's Interview 105
David 110
David's Interview 111
Mary 117
Mary's interview 118
The Family Health Isis Men's Group 123
The Men's Group Interview 125
The Social Action for Health focus group 133
The SAfH interviews 134
Chapter Five: The Professionals 147
Prologue 148
Introduction 148
Academics 149
Professor Frederick W. Hickling 149
Professor Tom Craig 151
Professor Roland Littlewood 154
Dr. Dawn Edge 154
Dr. Frank Keating 157
Community workers 159
Juliana Frederick, Janice Williamson and Frederica Joseph 159
Ray Johnson 165
Dr. Yemi Oloyede 166
Caroline Morris 167
Directors 168
Estella Weston 168
David Pinder 172
Malcolm Phillips 174
Jan Oliver 177
Matilda MacAttram 179
NHS Professionals 180
Yvonne Coghill 180
Mary Clarke 185
Sean Cross 186
Chapter Six: The Photographs 189
Chapter Seven: On Social Suffering, Identity and Resilience 250
Prologue 251
Introduction 251
On Social Suffering 252
Social Suffering Defined 252
Social suffering as structurally violent 253
Social suffering as interpersonally experienced 260
Social suffering as caused or intensified by bureaucracy 263
On Identity 279
The Identity Narrative 279
Media and Identity 281
(Re)defining Black Identity 287
On Resilience 294
On Double Consciousness 294
On Voice and Agency 296
The Resilient Space 304
The Resilient Community 307
Chapter Eight: Conclusion 313
Prologue 314
Introduction 314
Recommendations 316
Change philosophy of containment 317
Utilize local knowledge and innovation 319
Facilitate service user agency 324
Use innovative methodologies and engagement 327
Bibliography 330
About this Dissertation
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Primary PDF
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Rivers of Blood and Babylon: An ethnography of social sufferingand resilience among Caribbean service users in London () | 2018-10-31 10:32:43 -0400 |
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Supplemental Files
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Dominoes_Phillips_supplement1 (Phillips_supplement1) | 2018-10-31 23:05:13 -0400 |
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ISIS1 (The Circle, Part1)_Phllips supplement2 () | 2018-10-31 23:06:33 -0400 |
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ISIS2 (The Circle, Part 2) _Phillips_Supplement_3 (ISIS2 (The Circle, Part 2) _Phillips_Supplement_3) | 2018-11-01 14:29:19 -0400 |
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