Q&A with Rianna Walcott, editor of The Colour of Madness – an anthology exploring black and minority ethnic (BAME) people’s mental health

The Colour Of Madness is a seminal BAME led & curated anthology, exploring the BAME mental health experience in the UK. It is comprised of poetry, fiction, essays, memoirs, and art submitted by BAME writers, academics, mental health workers, artists and those still navigating life with mental health problems.

We sat down with Rianna to hear about her own experiences as a black woman struggling with mental health problems, and how counsellors can better support BAME women (and men) by redressing biases in mental health treatment.

How did the book first come about?

I was giving a talk at Creative Scotland about mental health in the creative industries, and my publisher was in the audience. She approached me afterwards basically saying that she was interested in hearing more about the perspective of BAME people who have mental health difficulties and sort of expanding that into an anthology. From there, I contacted my co-editor, and that’s pretty much where it started.

What are the additional challenges that BAME communities face when it comes to mental health?

We’re more disproportionately likely to be criminalised, institutionalised and medicated against our will, and the service that we receive is likely to be worse. There are far less BAME counsellors, so there’s less people who understand different cultural nuances. In the same way that there’s a problem with institutionalised racism in this country, it bleeds into mental healthcare.

For women of colour in particular, how does that intersection then of race and gender sort of play out when it comes to mental health services?

In terms of how race and gender intersect, it definitely affects the way in which people look at mental health issues. There are certain ones like if you look at the history of medicine and the history of the way women have been treated in terms of mental health – like when you think about things like the history of hysteria. That plays into race, but it’s different across different intersections.

Race plus gender looks different depending on the intersections at play. It’s not really a cut and dry answer as to how that plays out.

From your personal experience, what kind of stigma or impression have you come up against in terms of your mental health?

I’m thinking about some of the experiences I’ve had with different counsellors where I’ve definitely felt a need to perform my mental health in a specific way in order to get the help I needed.

Whilst I have seen white women counsellors, there’s not that connection on gender that you might expect. They are still complicit in the system of whiteness. I’ve been turned away from counselling before, I think because of an assumption that I’m high-functioning and I’m doing quite well, so a lot of people are not able to see that I’m struggling.

I’ve also suffered some pretty overtly racist stuff at the hands of counsellors before, where they try to pathologise me, and just ask leading questions where they think that my ethnicity will be part of the reason why I’m unwell. For example, I’ve had someone ask me about if my dad is a part of my life, assuming that there might be some childhood trauma, because my dad’s black and they assume that my dad would have skipped out.

The main problem is that with a counsellor who doesn’t understand, you have to spend a lot of time walking them through the basics. You get put into this position where you have to teach. That’s something that exists in almost every person of colour’s life anyway. Where you’re constantly in a position of having to educate white people around you, and then getting that in a counselling setting where you’re actually quite vulnerable, it’s not enjoyable. I don’t talk to white counsellors anymore!

From putting the book together, what have you learned about other BAME women’s experiences?

There’s a lot of crossover, but also just as much variation. As I said before, we’re all coming to it with our own unique intersections of identity, so my experience as a black woman is completely different to a gay Latinx man’s. My experience is different to the middle-aged South Asian mother who experienced post-natal depression.

Whilst this book is a collection of BAME experiences, the only thing that links us is that we aren’t white. There are some overlapping cultural experiences, but basically they are all informed by the experience of being a minority in a majority white country. That’s the only common thread we really have. I suppose that’s all I’ve learned – the variation of our experience means that we are all getting uniquely bad care and a uniquely bad service.

Did you notice any particular gender differences between BAME men’s experiences and BAME women’s experiences as you were putting the book together?

Well, I certainly noticed that there were less BAME male contributors, and that says a lot about which communities are still too stigmatised to talk about it. When we had Asian men contributing, for instance, they tended to be practitioners rather than patients.

Black men are some of the most highly victimised groups of BAME mental health sufferers. They’re far more likely to be criminalised, or locked up, or medicated against their will. But very few of them submitted to the book, and I think that tells you a lot about the situation as it is too.

Who do you hope reads the book, and what do you hope that they will take away from it?

Everyone. I think the book will mean different things to different people. It will mean something completely different to a person of colour mental health sufferer than it will mean to a white counsellor who’s reading it to learn about how better to treat their patients.

But those are both valuable perspectives. Counsellors need to read it, of all ethnicities, to understand that they need to change their positioning and understand their own biases, their own perspectives, and how they bring that into the counselling session. They need to understand how best to support whoever they have in front of them. For people reading it who might share some of the experiences in the book, that’s a very powerful feeling, to know that you’re not alone. It brings different things to different people. I think it should also be in the hands of policymakers, teachers, people who are teaching courses about psychotherapy and psychology. There’s not really a person who wouldn’t benefit from it.

What can healthcare professionals do then to improve their support for BAME patients?

We need to actually revisit the curriculum, and revisit decolonizing medicine in the first place. Because a lot of the way that we talk about medicine and mental health, comes through a very white lens.

For instance, if we’re looking at what the concept of good health should look like, we’re looking at it from a very Western, Eurocentric perspective. We’re looking at it as a very individualistic society. We’re looking at it with a white nuclear family model. We’re looking at it from a capitalist lens. There’s so many things about mental healthcare, and what wellness looks like, that is white. In order for it to be suitable for BAME people, we need to revisit what wellness looks like full stop.

A really good example I’ve been told  is how a counsellor, when looking at an Iranian woman’s family structure, labelled it as co-dependency. But she said, “No, we’re not co-dependent. I’m Iranian.” With that she distilled the problem: my culture has a different model of how family looks. You’re looking at it and comparing it to a model that we might equally look at and say, ‘Oh, that’s weird’.

It really depends on your perspective, and I think unseating that perspective from whiteness is important. Whiteness isn’t neutral.

You can find Rianna online, and on Twitter @rianna_walcott.

Buy The Colour of Madness on Amazon.