Guyana and Trinidad and now makeup around half of the The extent of conflict populations there. In the post emancipation period, between being black many of the economies have long since declined and the population experienced great difficulties in their and being British quest for security and stability. Many descendants of ex-slaves and the Aggrey Burke writes a cautionary tale of a white master-class migrated to Central American countries, Cuba

#BLACKLIVESMATTER stigmatised minority and USA to seek work in this period. The peoples in Caribbean countries were largely unknown to each other before migrating elsewhere. The majority had been n a recent radio programme, a from country to country: in Jamaica brought up in settings in which the group of workers lamented the fact and Barbados the involvement was African mask (slave tradition skin Ithat black youngsters did not have almost total; in colour, language and religion) was role models and might be suffering a and several other islands in the despised, ridiculed and a source of number of difficulties because of this. Eastern Caribbean, the British and great shame. In a brief moment the general French alternated as rulers; and in It was against this backdrop that problem was identified but there was Guyana, South America the Dutch an unprepared and largely deprived a sense of hopelessness regarding the were dominant for much of the time migrant population arrived here in solution. The specific question is prior to emancipation (freedom) from Britain, facing difficulties far greater whether widespread problems exist British slavery in 1833. It is of than anyone might have predicted. among now distant descendants from interest to note that Jamaica These were associated with high the grim history of African slavery in (population of 2.8 million, represents levels of rejection - at work, in the Americas and the Caribbean. half the regional total), is 1100 miles housing, in schooling and childcare By presenting an historical away from the other main population and in everyday life. overview we are able to witness the group in Trinidad and Tobago and a With the passing of time it may stark realities of a migrant population further 350 miles from Guyana. be true to say that these wounds better understood by its fractured might have healed, but if so, this interpersonal relationships and Before emancipation raises a number of questions: struggle to maintain an inherent Prior to emancipation the institution dignity and semblance of its own of slavery paid little regard to human • What were the cumulative effects identity. life or custom. There was no contact of traumatic injury? As such, I will attempt to discuss between Caribbean people and their • What was the likelihood that the the issues leading to the introduction African forefathers and efforts were population choosing to migrate of the inhumane and brutal system of made to eradicate all aspects of did so at random? African slavery and the difficulties Africanisms among the slaves. • Were the expectations of this encountered by subsequent Slaves were property to be sold or population based on their beliefs generations in overcoming (or bought (chattel) and to be regulated. in belonging to the ‘mother recovering) from this tragic set of Mating behaviour was dictated by country’? circumstances. I shall contend that it those running the estates. Women is the cumulative effects of the were not accorded any greater Some time ago, I carried out traumatic injury respect than men, a follow-up study of patients prior to coming to The institution of slavery and evidence repatriated to Jamaica because of Britain that has suggests that they mental illness. Evidence suggested sought only to paid little regard to were subjected to that the great majority did not use compound an very high levels of English as their first language and already fragile human life or custom abuse and only ten per cent of those migrating migrant psyche. exploitation. to Britain in adulthood gave a history This vulnerable group, having Following emancipation, the of attending a secondary school. suffered rejection and exclusion in British recruited indentured (contract) Most came from poor backgrounds Britain, manifest in the high rates of workers from China initially, then and could be described as highly behavioural and mental disorders. small numbers from African vulnerable. Britain has been involved in the countries, the Middle East from Syria These findings indicate that the lives of Caribbean people for around and Lebanon and from Ireland and migration to Britain was heavily 360 years, but the extent of this other parts of Europe. Large numbers weighted in favour of deprived and involvement has not been consistent of South East Asians settled in vulnerable persons, rather than the

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rCJM No 101 September 2015.indd 6 08/09/2015 15:52:28 more established and socially aware. In the USA, researchers have adolescence. It would also explain Reports suggest that Caribbean pointed out that in this ethnic group the finding that delinquency among migrants to the USA and Canada designation of a similar population, African Caribbean youngsters in have enjoyed a better fate than their there is employed as a proxy of Britain is associated with multiple British counterparts. deprivation and disadvantage with separation experiences from carers in Migration to Britain was knock on effects of further early life. associated with both return migration stigmatising the group by adverse Theories on the role of adversity home of vulnerable persons and research findings. in psychosis might suggest that the others as well as re-migration It is likely that Caribbean migrants group of individuals migrating in elsewhere of the more robust. to Britain were of the opinion that adolescence will be doubly loaded they were moving from one part of in terms of loss and adversity. Origins and nationalities the Empire to another and would Evidence suggests that members of #BLACKLIVESMATTER It is unclear where best to place the have been treated as equals and not the group display high levels of African Caribbean people in terms rejected. anxiety, irritability and depression of origins and nationalities. The and become victims in the classroom European historical link runs hand Theories where they may be excluded in glove with the African but the Sociological and psychological permanently for disruptive behaviour. two were on different levels. This theories do not explain the very high At a later age they are far more likely duality in background becomes a rates of behaviour (conduct) disorder to be detained because of delinquent source of conflict among these much among black youngsters the USA, in behaviour. displaced groups South America, The experience of African of individuals Caribbean migrants the Caribbean, Caribbean youngsters suffering from identified by and Britain and learning disabilities may be of orientation, to Britain were of the elsewhere in interest; they seemed more likely to language, Europe. be accommodated in locked units history, church opinion that they were Anomie theory than clients from other ethnicities. As attendance and moving from one part of may to some the same is true for the less socio-economic extent explain vulnerable sector of the population variables. The the Empire to another rates of deviant (not learning disabled) it suggests a conflict may behaviour among tendency to label the population as be acted out and would have been racial groups in ‘dangerous’. This may be the or it could treated as equals and the USA and outcome of two groups responding remain dormant these theories are to each other with the threatened or hidden or not rejected unlikely to group deemed to be aggressive and indeed may be explain findings stigmatised because of this. experienced as here in Britain. It is of considerable concern that being quite marked and the basis for The fact is that African American and rates of being ‘looked after’ by local a psychological disorder. African Caribbean people suffered authorities might be up to five times In Caribbean countries, African profound displacement in slavery greater for African Caribbean and Asian ethnic groups are and subsequently as well. children than others. Statistics of this considered to be separate, with one Attachment theory attempts to phenomenon have been consistent group adopting the religion and style provide a framework for explaining for many years, with little change in of the owner class, whilst the other the extent to which human behaviour the proportion of children without a retains its strong cultural and will be modified by faulty home and who are likely to religious links with ‘Mother India’. relationships between caregivers and experience life lonely and without The former is encouraged to deny its their offspring in early life. The support. It would be easy to argue African background and instead to history of European slavery in the that this situation is the responsibility seek to be British or American. The Caribbean provides a reservoir of of the families of these children and contradictions in this journey are all material on this issue. It is unlikely has little to do with the historical too obvious. that secure attachments (cf. insecure background. However, the fact is, Researchers have argued that attachments) were prevalent among that a secure base is acquired by way research methods should be slaves. of a family structure in a community employed in quantifying the extent Some have argued that with its customs in rules and in the of and the consequences of attachment theory may help to context of a country. If the concept this among different groups. Some explain the effects of traumas of country of belonging is eroded take the view that, despite disparate suffered by children left behind in then it is necessary to supplant this Caribbean styles and country serial migration from the Caribbean idea by creating another country. For histories, it is not unreasonable to and joining their parents later on. many of the Caribbean people include these groups as members of This might explain the high levels of migrating here to Britain it is not one ethnic group by virtue of British mental disorders among the second- unreasonable to suppose that they slavery and colonisation. generation who migrate in believed that the secure base was

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rCJM No 101 September 2015.indd 7 08/09/2015 15:52:28 Britain. Instead the migration Marked over-representations of stages of the experiences of Venture ensured that family structures would African Caribbean clients are found Smith and Jimmy Smith in their be destroyed with extended family on locked wards of mental hospitals, respective journeys from Africa and members remaining behind and on special hospitals for the from the Caribbean (see Table 1): unlikely to be allowed to reunite dangerous; in prison facilities, and with their migrant kin. among patients held by the police on Stark findings As indices of malfunction do not emergency sections of the Mental Language is an important suggest that the Health Act. These factor preventing meaningful long-term effects Migration ensured findings may well communication between threatened of stress and be the outcome of and threatening groups; mistrust conflict among that family structures how society deals exists between these groups. #BLACKLIVESMATTER British-born with behavioural One consequence of this mistrust African Caribbean would be destroyed disorders whether might be the fear of black persons residents have with extended family or not these are displayed by those in authority in been reduced, in associated with facilities for , and comparison with members remaining mental illnesses the criminal justice system. For findings among and indices of some time now, the Institute of Race second- behind and unlikely to social exclusion. Relations has been monitoring deaths generation be allowed to reunite What does seem in custody whether in prison units, migrants, it seems to be true is that hospitals or elsewhere. The findings likely that the with their migrant kin findings of are stark, black youngsters mostly rates of behavioural men are markedly overrepresented. behavioural malfunction and excesses among children and Some years ago, I visited a remote psychological disorders will continue adolescents will be followed by village in Jamaica to explore the to be significantly higher in the similar findings of excesses among possibility of the return home of a African Caribbean sector of society. adults. troubled young man incarcerated in It should be of interest in passing It would be important to consider a locked unit. Sadly he suffered an that the small Asian Caribbean the extent to which these findings unpleasant death in that setting population living here in Britain have might have been evident in the early shortly after I returned to tell him of not had a similar experience as the African Caribbean group. Yet, it is unclear whether the selective factors Venture Smith, 1729-1805 Jimmy Smith, 1944-1980 leading to migration are different and whether the populations were likely • Born in West Africa • Born in Jamaica to be exposed to different levels of • Enslaved at age six • Seeking personhood stress; finally whether one group is • Marched to the coast, the ‘point’ • Enforced economic migrant age more resilient than the other. of departure 15 • Became a chattel (personal • The belief in rescue in the Behaviours property) a slave ‘Mother country’ It is widely accepted that self- harm and suicidal behaviours • Sold to West Indian bound ship • A migrant’s experience - a repeat are symptomatic of depressive of the first journey from the syndromes, whilst physically violent village in Africa behaviours indicate the likelihood of • The triangular trade- struggle • Life of a displaced soul seeking a crime and not invariably a psychiatric against the odds-fight for survival home disorder. Clinical practice suggests • Estate owner purchased self and • Realities of a life of exclusion and that the two behaviours are related to family alienation gender and ethnicity with an excess • Lived in colonial Jamaica • Survival or restoration of self of suicidal behaviours among females and white British. The two conditions • Lived on the sugar estate as • Experience of the second may co-exist with causation factors someone’s property generation - deprivation, fear, for the resulting three groups (separate removal into children’s homes, and co-existing) in need of study. It permanent exclusion from is known that experiences of abuse, school, juvenile detention, relationships with parental figures, the delinquency, behaviour disorder, misuse of illicit drugs and the extent criminal justice, mental disorder, of psychotic disorders are important repatriation ‘home’ factors in all three conditions. It is not • Fought to survive and/or to • Premature death unusual for clients to become restless, restore self unsettled and suicidal following loss or threatened loss (rejection). Table 1: The juxtaposition of a ‘journey of self’

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rCJM No 101 September 2015.indd 8 08/09/2015 15:52:28 my findings. In that circumstance it is There is no good evidence of any being British in this population? likely that the coroner’s verdict ethnic difference in the distribution • What steps should be taken to would be death by misadventure or of commonly accepted forms of overcome this conflict? by accident. However, this verdict abuse in the causation of mental may not do justice to the disorders or criminal behaviour. At an earlier stage of this discussion combination of factors resulting from However debate on the role of I made note of my visit to Jamaica fear and mistrust between workers racism as a causative factor in these to follow up a group of patients and clients. An appropriate label for conditions has led to great dispute repatriated because of mental illness. this condition could be – ‘worker- and conflict among practitioners and It may be appropriate here to give client mistrust syndrome’. researchers. There can be no doubt some outline details of the outcome Here in Britain, there has been that racism affects the lives of those experienced by the several sub- considerable interest in the fate of the who perceive these occurrences as groups in that population: #BLACKLIVESMATTER African Caribbean population well as those who have learned to live diagnosed to be suffering from with this reality without raising the • The carers – returned home . issue. The critical because of their need to re- This is often question will establish family links necessary associated with What is the nature remain: whether for childcare. This group enjoyed criminal and extent of conflict racism may a good outcome. behaviour but this contribute to the • The alienated – remained finding is far more between being black excess findings of unsettled in Britain but did not likely among behavioural suffer from severe mental illness. African Caribbean and being British? disorders and They did not enjoy a good persons than any mental illnesses outcome. other group of among African • The displaced – returned home patients. It is also true that police Caribbean persons in Britain? An following incarceration for mental arrest and detention is far more likely attempt to answer this question illness associated with crime. The among black and minority ethnic should mean identifying an outcome was very poor. males than other groups. appropriate group for comparison. In these circumstances the basis Mental and behavioural disorders It would be of some concern to know for both police intervention and among the migrant elderly constitute whether findings in that early study mental health involvement may seem a special group and might suggest might be as relevant now, as then. to be well established. However the the need for close monitoring of When patients present with merits of one form of intervention physical health in this age group. symptoms of mental illness it is not rather than any other remains Workers in the USA take the view always very clear whether the aims unclear. that the higher prevalence of of therapy should be to protect the Clearly three conditions can be hypertension and resulting stroke public or individual, or to achieve distinguished by the nature of the among African Americans than meaningful change in the patient’s resulting incarceration: White Americans may be the relationship with self or/and others. outcome of stress related factors. Necessary conditions for change • Violent criminal behaviour (VCB) African Caribbean persons should be identified in order to without hospitalisation suffering from pre-senile dementia achieve any of these goals. When • Hospitalisation but no VCB - may be prone to behavioural faced with a client who feels more likely among white patients disorders, but the extent of the displaced and alienated it would be • VCB and hospitalisation problem is not known. important to include a community In concluding, we should approach. I do not believe that it A study of the factors contributing consider whether the African would be sufficient to attempt to to these three behaviours, and Caribbean population in Britain overcome difficulties simply by the resulting incarceration, may should give some thought to the idea counselling or or by not reveal any differences in the of whether it constitutes a group, and way of incarceration. There is a risk distribution of causative factors. if it does whether changes in its that the situation will remain If this is so, it would suggest that function and organisation may be unchanged because of the feeling of the institution of criminal justice necessary. There are a number of helplessness in respective sectors of and the field of mental health are relevant questions. the community. n interlocked, and that this is true when the task concerns African • What is the nature and extent of Dr Aggrey Burke is a Consultant Psychiatrist, Caribbean clients. conflict between being black and and Trustee,

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