‘Racialized, patriarchal-capitalist settings do something to the mind’

Husna Ara speaks to Dr Samara Linton about The Colour of Madness, her co-edited anthology that brings to life the varied experiences of alienation for migrants and people of colour in the UK.

Samara Linton moved to the UK from Jamaica at the age of seven, later attending medical school at Cambridge University. But her experience with medical and university institutions was not frictionless. Quickly she realized her mental health was deteriorating, but more so she found ‘a real disconnect’ between her experiences of distress, the conversations she combed through with friends and family, and what was being taught about mental health and psychiatry. Samara’s dual experiences of mental distress and role as a healthcare practitioner sparked her curiosity as to ‘how to reconcile those worlds’, as she puts it.

Samara is an award-winning writer and multidisciplinary content producer who worked as a junior doctor in East London before joining the BBC. Her work includes The Colour of Madness: Mental Health and Race in Technicolour (2022), co-edited with Rianna Walcott and Diane Abbott: The Authorised Biography (2020). Samara currently works as a community manager at POCIT (People of Colour in Tech) and is completing an MA in Health Humanities.

She spoke to New Internationalist about how we might go beyond the clinical language of symptom-diagnosis-treatment, to better envision what social connection could look like for marginalized people.

How do you navigate the tension between reliance on institutions – accessing diagnoses, medications or therapies on the UK’s National Health Service, for instance – and wanting to liberate yourself from them?

I can only speak from my personal experience. When it comes to navigating institutions – even though I am a Black, queer woman – I am also university educated. I’m a trained doctor and I have the language and the kind of connections to navigate institutions in a way that many Black people and marginalized people can’t. I know what I need to say in order to get put on the waiting list for therapy, and I know what resources are available to me. So I can advocate for myself in a way that my peers can’t.

Pretty much any kind of social disadvantage that you can experience in society has links with a risk of schizophrenia and psychosis

Ultimately, I think it’s ridiculous that people have to play a game in order to access services, that they have to accept a framework that maybe doesn’t resonate with them. They have to use language about mental health and illness that we know is steeped in a cruel and exploitive history.

The balance is between survival and what we’re working towards. I will engage with these institutions, as is needed, and then do what I can to reduce other people’s reliance’s on those situations. I take antidepressants, I have utilized mental health services. Are those things that I want to continue doing long term? Probably not. I’m trying to be practical, but you know, without losing the hope and the vision that we need in order to keep doing this kind of work.

I came across a really shocking statistic which suggests that that Black and brown people are significantly more likely to experience psychosis the whiter their community is. You’ve written about Black men with schizophrenia, what are your thoughts are on that?

In the Caribbean, the rates [of diagnosis] are quite similar to the rates among the white population in the UK. It’s only among the Black population in the UK, US, Canada or the Netherlands that we see these really high rates of psychosis. It’s not that there’s something inherent to the Black body that is psychotic, but rather, there’s something about being Black, being racialized in these white majority patriarchal capitalist settings, that does something to the mind. I say ‘the mind’ very loosely, because even this dichotomy between mind and body is quite unhelpful, because we also see high rates of what we consider to be physical illnesses and conditions.

There is something about being a marginalized entity in a society that functions for profits, for prosperity in the very reductionist monetary sense. Community gives you a sense of self, a sense of history and groundedness – the more isolated you are from that, the more you may struggle.

Was there anything in your research that showed why Black men were more vulnerable to schizophrenia? And how much legitimacy do you give to the concept of schizophrenia?

In The Protest Psychosis, Jonathan Metzl talks about how in the US the diagnosis of schizophrenia shifted from being a diagnosis for middle-aged white women, who were seen as emotionally fragile, to a diagnosis given to young Black men, who are seen as aggressive. Particularly in the context of the American civil rights movement, the language of violence came to be more closely associated with schizophrenia. During that time diagnosis was shifting towards young Black men who were considered agitators and disruptors.

I really try to steer away from using diagnostic labels, apart from as they apply to myself. I’m happy to talk about my experience of anxiety and depression because I feel like people understand what I mean when I say that, and they’re not heavily stigmatized labels. Whereas when it comes to other people, I tend to just either let them describe their experiences as they wish to, or talk about distress more widely.

And you’re asking about why it’s so high in those groups – there’s kind of an argument to be made against the legitimacy of that diagnosis and whether or not people are being misdiagnosed with schizophrenia who maybe have other illnesses or diagnoses, or whether they don’t have an illness at all and, actually, it’s just disruptive behaviour that’s being diagnosed.

We know schizophrenia is linked with higher rates of unemployment, lower socioeconomic status, poor educational background and migration status. Pretty much any kind of social disadvantage that you can experience in society has links with a risk of schizophrenia and psychosis. So I think if you have that coupled with the fact that young Black men can be extremely vilified, but may be at risk of misdiagnosis, then it comes together to make a lot of sense.

The Colour of Madness anthology ties together a variety of perspectives, stories and testimonies from racialized people and migrant communities on their alienation. There’s a phrase in the book that I loved – ‘technologies of past, present and future healing’ – which, to me, brought together some contradictions around yearning for community so well.

I know I have a tendency to romanticize community. The Colour of Madness touches on intergenerational connection – something which I feel is sorely lacking today. In the South Asian community, for instance, elders are good at holding gatherings and doing stuff that isn’t called ‘mutual aid’, but is effectively such. But many in that generation can also have profoundly damaging ideas about the mind and the body, and wellness.

How do you think about intergenerational connections without romanticizing them?

I can really empathize with that tension. I think anyone who’s tried to do community building, knows how unromantic community can be. Because ultimately, people can be pretty shit sometimes. These communities our elders built, that they maintained, that they grew – some of that was fruitful and life giving. What can I take from that into the communities that I wish to be a part of?

I feel that we’re reinventing the wheel in some ways, because there’s so much to be learned from our elders. There’s so much to be learned from what’s come before us. But because of hurt, and because of rejection, and in some cases, sadly, abuse, we reject all in order to start something new.

I grew up in an evangelical Christian community, and there are so many things from that community that I think are missing in my life right now. I would sit down with people from different ethnicities, backgrounds, ages and class statuses, and for that that short moment have access to a world that was so much bigger than my own. Are there other parts of that community that I absolutely love to leave behind? Absolutely. Part of the work is deciphering what is life giving? And how can you bring it into your spaces?

Samara Linton’s website is samaralinton.com