Main Issues in Mental Health and Race

Dele Olajide, David Ndegwa

• Publisher: Taylor & Francis
• Year: 2019
• eBook ISBN: 9781351771931
• Edition: 1
• Topic: Social Sciences
• Subtopic: Sociology
• Index: Social Sciences

This title was first published in 2003. This work arose out of the editors' concerns at the British preoccupation with an alleged epidemic of schizophrenia in people of African descent. Black people in contact with psychiatric services are commonly classed as schizophrenic or normal and do not seem to attract any of the diagnoses or interventions which their white counterparts do. The editors asked contributors to carry out a critical broad-based review of a particular area using the technology that has been developed for conducting systematic literature reviews. The areas explored were selected by the editors from their own understanding of disciplines which might have something to contribute. They were largely disciplines which have an interest in beliefs, feelings, emotions, thought, politics, language and decision-making. In some areas there was little material available from literature searches so the reviewers used their own understanding of the subject matter rather than existing literature to write critical essays.

Chapter 1

From Enlightenment to Eugenics: Empire, Race, and Medicine 1780–c1950

Trevor Turner and Susan Collinson

The race question dominates all other problems of history, that it holds the key to them, and that the inequality of races from whose fusion a people is formed is enough to explain the whole course of its destiny (Essay on the Inequality of the Human Races, Comte de Gobineau, 1853).

Introduction

The idea that biology can be used to classify and judge the value of the races of humankind¹ may have formally fallen from grace with the dismantling of the apartheid (separation by race) regime in South Africa in the 1990s. Informally however, it is a theory that still holds currency with many extremist groups throughout our early twenty-first century world. In essence, there is the belief that humankind consists of genetically superior and inferior types. It has a long history; and it is a history with which the profession of medicine has had an intimate and influential relationship, to the extent that by the end of the nineteenth century, race, which is neither a science nor a disease, had become both. The nineteenth century was the great period of British imperial expansionism, a business involving not just the trade in goods and people, but also the exportation of British institutions and culture. Experienced from within the British Isles, the British acquisition and colonisation of other lands and their peoples were the actions, and responsibility, of a morally enlightened and progressive society, fulfilling its duty towards other, less fortunate ‘native’ peoples. The morality of Britain’s actions could be measured by observing how science, technology, the civil service, religion and the law were being used to improve the dependants. In 1899, a leader in The Lancet, discussing overseas medical missions, observed the important role that medicine had played within the great imperial adventure:

‘The White Man’s Burden’ [is] a complex as well as a weighty one and its medical constituent is as important as any other … no other nationality has combined, as has the British, colonial development with civilisation – civilisation of which the inferior races sooner or later feel the benefit and from which they take a new departure in their evolution.²

The encounter between European medicine (including ‘psychological’ medicine) and the societies of the lands colonised by the European powers during the period 1780–c1950 contributed to the development of a complex account of race, framed within a language of scientific neutrality. During the first part of this period, at a time when the practice of medicine was still more of an art than a science, the literature on race reflects the late eighteenth century and especially the Victorian delight, in the classification of all phenomena. One has the feeling that the Victorian anthropologists, palaeontologists, biologists, geologists and all the other men of ‘-isms’ could not quite believe their good fortune at the cornucopia of new lands, flora, fauna and peoples being set before them for their indulgence and edification.

While Britain flourished commercially during the first half of the nineteenth century, she was also busily consolidating and confirming her supreme position through the activities and industry of the growing, and increasingly prosperous, professional middle classes. This was a time, for Victorian Britain, of buoyant optimism, and a time when the Victorians confidently regarded themselves as a superior and progressive race, emblematic of the onward march of civilisation, in contrast to many of the ‘primitive peoples’ whom they had colonised, and whom they believed to be representative of degenerative races, sliding towards extinction. However, by the last quarter of the century, the very fruits of imperialism seemed to be turning rotten. The idea that other races could and would degenerate, which had been used as a powerful justification for British imperial acquisitiveness, appeared suddenly to be true, too, of the British national stock. The once unshakeable belief in the inevitability of progress was degenerating into fin de siècle pessimism. Anxieties predicated upon the very taxonomy which had once reassured the white Victorian male of his racially and morally superior position began to manifest themselves in a fatalism which suggested that all of mankind was on the edge of descent as the new century dawned.

‘A Tangled Bank, Clothed with Many Plants of Many Kinds’³

The theoretical concept of a taxonomy of races, which became known during the nineteenth century as ‘scientific racism’, is a direct product of a golden age of biology, when the great scientists of the eighteenth century devoted themselves to the classification of all the flora and fauna in the known world. This eighteenth-century equivalent of today’s Human Genome Project was begun in an age when mankind was regarded as being set apart from the ‘great chain of being’ as devised by Linnaeus and Buffon. Mankind was not included within this essentially static and hierarchical arrangement of all living organisms, but was placed at the pinnacle. His role was to observe the beauty and wonder of God’s creation.

The orderly, intellectual framework of the eighteenth century, with its tradition of taxonomic organisation based upon the observation of the external features of living organisms was gradually dismantled during the first half of the nineteenth century. The essential stasis of the Great Chain of Being was reorganised according to a concept of organic progression by Lamarck, and then broken down by Cuvier into an immense network in which the species depended upon each other. During the early decades of the nineteenth century, as man was gradually drawn into the arena of biological study, scientists found it useful to retain the classificatory system that had characterised the work of their predecessors. Inevitably, with the publication of the Origin of Species (1859), Darwinian arguments in favour of heredity and variation dispatched forever the idea of the fixity of species, but this in turn was replaced by a chronological taxonomy, which included the concept of the plurality of the species of the mankind, and which was constructed according to a formula whereby those races which had evolved furthest would be ranged above those whose development was still judged as being at an early stage of human evolution.

Race: Changes in Meaning and the Development of ‘Race Science’

During the period with which we are dealing, it is important to bear in mind that the word ‘race’ has been the subject of shifting definitions and perceptions. Many of these are with us still today, in the form of race as territory, race as environment and time, race as revolution, and race as class.⁴ However, other meanings, and those which are at this moment most interesting, were generated by the major themes of theology, biology and economy which preoccupied European intellectuals from the middle of the eighteenth century. However, three of the essential problems for theologians, scientists and political economists during this period concerned the biblical account of the development of mankind; the position of mankind within the continuous ‘chain of being’; and the uneven civilisations of different ‘tribes’. Until the end of the eighteenth century, for example, it was commonly held that climate was the ultimate determinant for the state of civilisation of a people. This proposition was further developed by Adam Smith and other Enlightenment philosophers as the ‘four stages theory’, providing a framework whereby climate, geography and natural circumstances were the influences for the progress, or decay, of civilisations. Climate also seemed to provide an answer to questions of human physical diversity: those living in harsh, hot weather had developed dark skins in response to their environment (thus the term ‘Aethiop’ from the Greek, meaning ‘burnt face’). The European colonisation of Asia, the Far East and Africa went some way to discrediting this theory. It became apparent that despite moving to a colder climate, the darker skin of Indians and African retained their hue.

Authors on ‘race’ at this time, including the highly influential Johann Friedrich Blumenbach, a professor of anatomy, developed their accounts of racial variation according to a benevolent, monogenist⁵ theory, whereby the difference between civilised and savage tribes was judged as analogous to the difference between domesticated and wild animals. Late-eighteenth-century racialism allowed that because cross fertilisation engendering fertile offspring was possible, all humankind belonged to a single species. Although Europeans at this time commonly expressed distaste for blacks, this was based upon a cultural and aesthetic antipathy: many whites simply did not like the features of black men. However, the Enlightenment conviction that change and improvement in the less civilised peoples was both possible and desirable, is strikingly different to the theories of racial separatism and purity which were to dominate racial theory during the later nineteenth century, and led eventually to the social policies for racial improvement implemented in countries such as Sweden, Germany, Canada and the United States of America during the 1920s and 1930s.

Among those who held sympathetic attitudes towards the ‘other’ races, the Quakers were notable. The Quaker physician, Dr Thomas Hodgkin, founded the Aborigines Protection Society. Hodgkin and his fellow Quakers were firmly monogenist in their approach. In 1843, a group of professional men drawn from the membership of the Aborigines Protection Society founded the Ethnological Society (motto ab uno sanguine), ‘for the purpose of inquiring into the distinguishing characteristics, physical and moral, of the varieties of Mankind which inhabit, or have inhabited the Earth; and to ascertain the causes of such characteristics’. The Ethnological Society’s dominant tone was monogenetic and humanitarian, in accordance with the anti-slavery movement that reached its peak in England during the 1830s, led by reformers such as William Wilberforce. However, these first instances of a more humanitarian approach to the trade in slaves were soon to become eclipsed by a considerable hardening of attitudes towards the ‘other’ races. By mid-century the growth of the ‘scientific’ in fields such as medicine was to give birth to ‘race science’.

Although the Abolitionists (those who wished to abolish slavery) were very successful during the first half of the nineteenth century⁶ this period also marks the beginning of a fundamental change in the approach to the study of humankind, and nowhere is this more apparent than in the language used in relation to man at this time.⁷ As man was gradually drawn into a more intimate relationship with the natural world (and with the apes in particular), the eighteenth century use of semi-divine imagery was abandoned in favour of a more scientific vocabulary which relied upon biological and anatomical descriptions. Although these were used initially to describe the physical characteristics of an individual, or race, it was not long before they were extended, not as metaphor but as a true explanation for the culture and civilisation of a race. The anthropologist John Beddoes developed an ‘Index of Nigrescence’ based on the principle that ‘darker types’ within any society or population were generally more ‘primitive’. This applied to Celts, Iberians and Africans alike.⁸ The degree of civilisation of any race was deemed subject to the laws of evolution, and a product of them, while the primary and dominant explanation was biological. While pre-Darwinian ethnologists had attempted to make a connection between the physical and the cultural sophistication of a race, based upon their work in comparative anatomy, Darwin and his colleague Alfred Russel Wallace, despite their apparent omission of the question of man in the Origin (‘Light will be thrown on the origin of man and his history’, wrote Darwin as his final statement in On the Origin of Species), had formulated a theory which supplied a biological mechanism which could be used to explain almost anything. For race, it was this more than any other factor that ushered in the ‘dawn of biological pessimism’.⁹

Undeniably, a scientific theory of racial taxonomy complemented nineteenth-century British ethnocentrism. It reassured the Victorian that his sense of himself, in relation to the rest of the world had been achieved according to a meritocratic, biological law. Although in the first part of the nineteenth century trade between Britain and Europe slowly fell away, so that by the 1860s only two-fifths of her trade was with the continent, her share of the world market during the same period was 25 per cent.¹⁰ By the middle of the nineteenth century, Britain appeared to be at the height of an industrial golden age that set her apart from, and in advance of the rest of the world, including Europe. Britain’s material and intellectual prosperity was there to be seen, in the form of roads, railways, factories and cities; in art and technology; in a nascent democracy, and new professional and middle classes in science, medicine and monotheistic religion. The engine of production for all these was the strength of the mid-century belief in progress and a superior racial stock. With these in sight and in mind, there could be no question for the Englishman of the superiority of his own ‘Anglo-Saxon’ culture and intellect when compared to that of the African Bushman or the Australian Aboriginal.

‘Race is Everything’; ‘Race is Nothing’¹¹

The close relationship between biology, social science, medicine and politics during the second half of the nineteenth century is rooted in the formulation of those theories of variation and heredity which, from Lamarck onwards, were also applied to the study of man. This relationship was of supreme importance in the forging of the nineteenth century Eurocentric concept of ‘race’ that was based upon the assumption that all other races of the world possessed lower mental abilities. A critical link for ‘race science’ within the different scientific specialities was that between biologists and anatomists. The great eighteenth century botanist, Linnaeus, believed in divergence of talent between the races: Homo Europaeus (whites) were lively, inventive and ruled by custom; Homo Asiaticus (Asians) were stem, haughty and avaricious, while Homo Afer (the African) was cunning, slow, phlegmatic, careless and ruled by caprice.¹²

Paul Broca, craniologist and brain surgeon, developed the goniometer, stereograph and occipital crochet for the measurement of the skull, while Ernst Haeckel used comparative anatomy as proof of the superiority of the Northern European whites over all other ‘races’.

Notable among the biologists and anatomists of race during the nineteenth century were Dr Robert Knox, the infamous Edinburgh anatomist, Jean-Baptiste Lamarck, Marie François Bichat and Georges Cuvier. However, it took the absolute conviction of the aristocratic Comte de Gobineau to persuade brilliant scientists such as those above that race was not ‘nothing’, but ‘everything’; and that the interpretation of history should be properly seen as conflict between races, characterised by continuing social decadenc...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• List of Contributors
• Foreword
• 1 From Enlightenment to Eugenics: Empire, Race, and Medicine 1780-cl950
• 2 Recovering the Obvious - Race and Mental Health
• 3 Identity and Psychopathology
• 4 Cultural Studies, Ethnicity and Mental Health
• 5 Religious Issues in Ethnic Minority Mental Health: Special Reference to Schizophrenia in Afro-Caribbeans in Britain: a Systematic Review
• 6 Law and Mental Health: Some Implications for Ethnic Minorities in England
• 7 Black Families
• 8 The Mental Health of British Afro-Caribbean Children and Adolescents
• 9 Mental Health Problems in Black Refugees
• 10 Substance Abuse in Black People of African Descent
• 11 Alcohol Use in Black People of African Descent
• Index