The featured article is ‘The high cost of poverty: mental health perspectives from the Caribbean Diaspora’ by Frederick Hickling, Professor of Psychiatry at the University of the West Indies. The article is very brief at two pages and is in essence the development of a number of important issues relating to mental health in the Carribean Diaspora. Hickling suggests that in the Carribean Diaspora, European Colonial rule has resulted in a culture with differential effects on the native socio-economically deprived and white immigrants summarised in the following quote:-
‘It is suggested that the political/economic system in post-colonial countries of the Caribbean engenders severe mental illness in the poorest native-born socio-economic classes but protects White immigrants from the social stress of migration‘
Thus he cites evidence that there is upward social mobility in white migrants to Jamaica and states that this rarely occurs for white or black migrants to white majority countries. He further argues that
‘the political structure of White ‘First World’ countries seems to create psychosocial stress factors that predispose to the development of schizophrenia in Caribbean migrants‘
These two related hypotheses offer potentially important insights into the prevention and treatment of psychosis as well as having important social implications. They also make potential cultural contributions to psychosis quite concrete with racial factors figuring prominently. As this paper is brief much is left unsaid but it is here that the real debate begins. We have to be careful in remembering that these are hypotheses which as with any hypothesis will continue to be tested against the data. If these hold, then is it possible to make inferences about other racial relationships? Do these relationships arise because of colonialism or because of inter-racial relationships within the specified cultures? What role if any does cultural heritage play in such relationships and how is this transmitted? If such a heritage shapes the roles that people of different races play in the cultures above then how is such a role produced? These questions are amenable to systematic analysis which indeed has been taking place for some time already and will continue to do so. We should expect this analysis to inform strategies for influencing culture to reduce the stated rates of psychosis in the immigrant Carribeans to white majority countries. An important question also is to what extent do historical events contribute to the development of contemporary culturally induced psychoses and social mobility? Can history be playing such a role in events today and if so does this manifest through a retro-vicarious trauma – a trauma that arises from reflecting on the transmitted cultural heritage? If such a phenomenon exists, how does it arise?, how does it contribute to contemporary events? and how can it be addressed?
While Hickling’s article is short this is compensated for by the gravity of the material and the questions this asks of the reader.
Hickling F.W. The high cost of poverty: mental health perspectives from the Caribbean Diaspora. International Psychiatry. Vol 6. Number 2. April 2009. p29-30.
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