Interview with Samara Linton for Black History Month

"... neither Freud nor Adler nor even the cosmic Jung took the black man into consideration in the course of his research." – Frantz Fanon

Samara Linton is a junior doctor, award-winning writer and content creator. She is the co-author of Diane Abbott: The Authorised Biography and co-editor of The Colour of Madness: Exploring BAME Mental Health in the UK. Linton is a University of Cambridge and University College London graduate who currently makes digital content for BBC3 and BBC radio. She can be found tweeting at @Samara_Linton.

What acts of self-care do have you used during these times?

I have always really struggled with self-care because often, my own mental health gets in the way. You can pick up bad habits and want to stay in bed all day, but because I have been working in media this year I have been working from home for most of lockdown, so this has given me the chance to focus on my mental health. The main things I do are; try and go for walks, eat more healthily and I have been re-learning to cook a lot of food that I grew up eating, so the food that my Mum or Grandma would make. We are Jamaican, and having that connection to the food I am eating has been a fun way of discovering recipes.

Throughout this lockdown, I have done online life drawing classes, I have started a one-thousand-piece jigsaw puzzle, which I have nearly finished. Little things like that, which serve no purpose beyond it being a nice thing to do. Lockdown has allowed me to enjoy doing these things, without feeling guilty that I should be doing other things instead.

I also video call my Godchildren, they are three and five, and they are just the joys of my world. Speaking to them always lifts my mood even if I cannot see them in person.

What role do you think psychiatry has to play in black mental health?

Historically, psychiatry has not had a positive role in black mental health. Psychiatry has been authoritarian and paternalistic, and I think it has disadvantaged those who are already marginalised, vulnerable and disempowered in society. Unfortunately, looking back at black history, there has not been a particularly positive relationship between psychiatry and black people.

Where we see examples of good, positive relationships is often in community groups or community lead initiatives, in which black people have the autonomy, individuality and respect that they usually do not receive from being in institutions. This is not the fault of any particular psychiatrist, or because people are malicious or vindictive, it boils down to the fact that psychiatry was not designed with us in mind. Frantz Fanon, in his book "Black Skin, White Masks" said "... neither Freud nor Adler nor even the cosmic Jung took the black man into consideration in the course of his research." All these figures who have shaped modern psychiatry; their ideas of wellness, illness, normality and abnormality come from white European people. I do believe that if psychiatry is to become a force for black people, it is not enough for it to shift with the times, it needs to be turned on its head completely.

How we understand what is "normal" and what is "the Other", sadly continue to be very colonial and imperialistic. These terms are rooted in a misunderstanding of people who are different.

What advice do you have for both, black people trying to access mental health care and black people working within the mental health sector?

That is a hard one because I have not been in the sector long, so the advice I am giving is based on my relatively short experience. And also, when I've worked in the sector, it has been in a very diverse part of London, so I cannot comment on what it would be like if you worked somewhere where diversity was not as present.

It has been beneficial to find – not role models - but people who are further along in their journey and their career that I can relate to in some way; learning from their experience and their insight is so important. There is no point in reinventing the wheel. If you are fortunate enough to have someone who you can reach out to, even if it is just an informal mentorship with that person, you can learn from the wealth of their experience.

Because being a black person in the mental health sector is a different experience than being, for example, a white person in the mental health sector, because I often felt I related more to the stories of the patients coming in through the door than to my colleagues.

I often felt there was a burden on me, almost, to transform the entire system for them because you see so many things that need to transform and you go in there with high hopes. It is very easy to burnout if you take on the burden of changing things for your entire ethnic group. It is important not to do these things alone, and to see where others have gone before and learn from them and use that to add to our own way of doing things.

The deaths of George Floyd and Breonna Taylor are just two names from a long list of tragedies that have woken up many to how ingrained racism is in society. However, despite things like blackout Tuesday, some recognition by brands, as well as countless statements released by organisations, what do you feel needs to be done for black people to be seen?

I would argue that black people are seen; the issue is how we are seen. Often, we suffer from hypervisibility in certain spaces, especially in the world of mental health. We are seen as aggressive or intimidating; the issue is we are not seen as vulnerable or in need of help. We might be seen as threatening rather than threatened; we are seen as being defiant, uncooperative, resistant, rather than being seen as assertive, scared and traumatised.

I think the deaths that you have mentioned and the things that have been brought to light again this year; it is showing how these people are seen is probably for me the real issue.

Are they seen, for the extreme situations where people end up dying, like people who you are there to protect, who you have a responsibility for? Are they seen as your equal, your peer, your inferior or your superior? It is how we are seen that is the issue.

It is a societal thing, psychiatry alone won't change these issues, but psychiatry does have a significant role to play. Because often we are the ones defining what society sees as normal and abnormal; If psychiatry perpetuates the prejudices and stereotypes that are ingrained in wider society, then it is not only not challenging the way we are seen, it is actually almost justifying it, because then often people see statistics such as black people are nine times more likely to be diagnosed with schizophrenia or psychosis – and they think "Yes! We knew they were unhinged the whole time!".

If the message is not that these groups are experiencing severe trauma and disadvantage, then if anything, psychiatry is perpetuating these ideas, stereotypes and this discrimination.

There is a dual role for psychiatry in terms of its broader sense, clinicians, policymakers and researchers to challenge and reshape the way black people are seen, and that will help the way we can move through this life as black people.

In America, the hashtag 'walking while black' was popular because often, your mere presence puts you at risk. There are certain shops I know I will go and be followed around no matter what I am wearing. There is not an issue of being visible; it is what being visible means.

Black people have done a lot to try and challenge that and to campaign for that and to be their own advocates, but it is not just up to us, the responsibility is not just on us to change it.

Do you think there is an issue that white people try to represent something on social media, that is not put into practice – for instance, brands releasing statements but not making core changes?

It was hard not to be sceptical when you saw all this happening. I am a pessimistic, sceptical person by nature, but I try not to be, I try to think "finally they get it" - even though there are individuals that will never see things the way we have been trying to say.

But lo and behold it feels we have gone back to where we were this time last year. It is not about people being disingenuous at that moment, but it is what happens when activism becomes trendy when it becomes profitable. There came a point where it felt like if you were not speaking out as a brand, it would harm your brand because people might think brands were racist for not speaking out.

When that happens, it is good for awareness and publicity, but it is dangerous because if activism is profitable, what happens when it stops being profitable?

For me, I never really expected very much from these brands but it is frustrating as a black person, that even when the hashtag has died down and even when people's Instagram feeds go back to normal, the reality has not changed, and people are still suffering from the trauma of everything that is going on.

Through change and understanding, the stigma on Black Mental Health has somewhat been reduced. However, what more would you like to see changed, and what role do you think organisations such as the RCPsych play?

COVID is still happening the disparities have not gone anywhere. We are still suffering with that trauma, but the compassion we received earlier in the year, where people were saying, "maybe you want to take some time out, we understand this must be hard for you." That compassion has gone, things have moved on, and that is what happens when the people in charge don't have that lived experience when it is not their life.

I do not necessarily expect people to get something that is not their lived experience. I do think it is shameful that you can have whole leadership boards where there is no-one on that board that understands what it is to be a minority. No-one in that position of power and influence who will wake up each morning and have those issues on their mind because of who they are.

But if they are only there to echo company lines, and have no real influence, there is no point them being there. Representation is only necessary if it means the way the organisation thinks and breathes and moves changes based on its make-up.

We cannot treat equality like a trend, as something fashionable rather than something that is a matter of life and death, or real change will not happen.