I think my borough and my mental health trust has so much problems because the social model training that they receive which downplays the medical model offers a very simplified, de-skilled version of nurse training, I can speak about that as somebody whos you know visited these nurses colleges and, you know, seen what the students are learning and what they’re not learning and, and it’s quite astonishing. And I think this almost culture gap between the, this is not being understood that there are a lot of people there who, whose first language is not English and they have very good written English skills and absolutely no spoken English skills. And therefore their ability to pass tests might be quite good but their ability to take in lectures is non-existent. You’ve come across that? Yeah? Fortunately not.

But you could imagine what it would be like to have, have people like that to, and I’m not talking about people from, let’s say the, the West Indies, or India, or Hong Kong who speak their own indigenous version of English which I would call, they’re native English speakers, but they’re not British native English speakers, right. I’m talking about people whose everyday language is a, a non-European language but when they come to school they read and write in English.

And there is no attempt to recognise the cultural gap. So, of course, their version of the social model is a very, very alien one. And so when they counter patients who are more cultured and educated and who say, well actually you’re not understanding me and you’re not understanding other people and you’re not understanding your own job, they react in, in this very aggressive way. Because it’s like the patients are saying the emperor has no clothes. And you’re taking away from them the competence in the very area that they could excel in, which is the medical area. And that could be an avenue to critical thinking and to all these, if I were, in charge of this I would make sure that everybody had a grounding in, in, in straight medical nursing, let’s say two years of that and then did another two years of psychiatric nursing. But actually it’s a completely separate stream.

I was admitted to a locality mental health unit in the London of Walford [Laughter] and I at the time was admitted for observation. But actually yeah I was very pleased to be getting out of the place where I was living where I was subject to a kind of constant barrage of, of physical and verbal abuse and, and to me this was, you know, a welcome escape and it was, it didn’t take much to persuade me to, to give me a break. And I was quite happy stay on in the hospital as a voluntary patient and so there was no need to section me. And there was certainly no need to surreptitiously section me. But I think it would have been impossible to stigmatise me in the way that I’ve stigmatised if I hadn’t been section 3’d and kept in for six months without any appeal. And I think I would’ve been kept in much longer if there hadn’t been an automatic review at that point, which would have required a panel to decide that I was genuinely so ill that I had to spend an indefinite period. And even though all this went on behind my back, I was told, you know, within a very brief, given very brief marching orders that, okay we’ve got to let you go.

Right, Well. I mean the Scottish Mental Health Act, which was the one that the government was asked to incorporate into the new Mental Health Act and it refused to do, made it very clear that the same criteria for diagnosis should apply whatever a person’s ethnic group happens to be. But that was refused by the English legislators and I think it’s more or less accepted that mental illnesses present in different ways in different types because they, their presentation at least is socially shaped and that at least in some people’s opinion there are many different kinds of schizophrenia, for example, and that Jewish schizophrenia might be different from Afro-Caribbean schizophrenia and British schizophrenia and therefore the criteria for diagnosis and the method of treatment might be different and that there is therefore a, an unspoken professional folklore, what I call ethnomethodology which, which tells people how to make up your mind about these people. These people and why they’re different and why they special criteria have to be applied to diagnosing them and treating them and assessing them and their risk. And I suppose that’ that as long as we have this very untransparent secretive code that we can, you know, we don’t, we just don’t know what is going on behind the scenes.
And, you know, there are medical anthropologists who try and, and produce value-free judgments about people but I don’t think the work has been done unfortunately to interview lots of people from one ethnic group or another ethnic group and find out how their particular ethnicity shapes their presentation. Actually I suspect that it isn’t down to ethnicity, it’s very, very individual. And that, that everybody has a micro-ethnicity which is unique to them. And the only way you’d find out about this micro-ethnicity is by talking to people and getting accurate information from them and about them but there’s no way that will happen whilst people are so dependent on received opinions about, you know, Jews having sex with their mothers.
Personally I think that, that we would do better going back to first principles, actually, I don’t know if I’ve said that phrase before not in this interview yet and, and, and starting off with a strict medical-legal definition and then as we get to know the person as, as an individual through observation, through acquaintance we add in the, the cultural dimension, that the social model should never be the first thing we lean on. That, that we should explore that and that we, we should I guess one of the purposes of the CPA process, I don’t know if we mentioned that here, is that it should look at the patient’s broad holistic identity which includes, you know, their physical health and it includes, you know, their relationships with the wider community and that includes that, that is their cultural identity partly, and that their religious identity which is part of a, social religious identity, we’re not, I don’t think we’re, we should be interested in their, their relationship with God really. But that’s not something you, you, you look at first of all. It’s very presumptuous of you to do that. If you try and do that you’re sure to jump to the wrong conclusions.

OK. Right. I was explaining to you that the social model seems to rely very heavily on certain popular stereotypes and that the popularity of these stereotypes is so compelling that where you have factual stories that contradict those stereotypes they get glossed over, that, that there’s a sort of appeal of, of, of the story, of the good old story that is so clamorous that it drowns out, you know. So I mentioned that there are stories about incest with my mother and as far as I know in spite of the fact that both I and my mother have been treated with drugs in order to try and prevent us having sex together and that in both cases, you know, it was done without our consent. My mother as a psycho-geriatric, me as a person with severe mental impairment, I mean under guardianship or whatever. There’s no truth in this, it’s just a, you know, a popular Freudian stereotype about Jews. But on the other hand, it is true that, that there were sexual crimes involving other members of my family and these were going on right, right up to the time that I was in psychiatric, put in psychiatric hospital. And, you know, I was still suffering the consequences of drug assisted rape at the point when I was admitted to psychiatric hospital. And the reason I was so keen to be, to go into hospital, insisted on being re-housed and not just being returned, right, was because these issues were so ongoing. But these, like present day issues, were being obscured by fanciful stories about, about incest and homosexuality which were considered to be typical of my Jewishness.

And as far as I’m concerned the people should, should be considered as at-risk as vulnerable adults for their mental health, for their physical safety if they’re in the community and they’re surrounded by people who seem them as, as vulnerable adults who they can hit on and sexually abuse. And I think they should be vulnerable in the sense that they are at, at risk of serious medical neglect and if, if such people die as, as this young woman of 34 died, there should be the same process of investigation that takes place where there’s a Serious Untoward Incident that, that causes a suicide.
I mean, what is so important about suicide? What is so important that we only investigate those forms of, of death? Are we telling people that they have to commit suicide in order to make a statement and get an investigation because I’ve heard people, patients saying that. And I mean I’ve heard patients saying that they’d be better off in prison so I’m only asking that, that they commit crime, are we saying that, that mental health service is so bad that it’s provoking an escalation in symptoms?

OK? I mean that’s something just very fresh in my memory and it, the point that I wanted to make to, point, although I knew relatively little about her, I only spoke to her a few times, she did mention to me that she was a fellow victim of institutional sexual abuse. And I think that once, once you’ve got that experience that, that there will be all these counter-measures taken to prevent you, your injuries being treated and therefore investigated and therefore reported to the police. And this will lead to your long term exclusion from health care. And that in turn means that you become potentially a typhoid Mary, that you can develop all sorts of infectious diseases that won’t be investigated. And that was perfectly OK when the old institutions like bleep, bleep house that were, where people could just be put away and, if you like, quarantined in those old asylums. But, I mean, you now have young nubile people who are, you know, potentially sexually available like anyone else but nobody knows whether they’re being treated or not. OK.

So I mean you weren’t having any hallucinations?
No.

Delusions?
Not that I’m aware of. I mean I think they could have argued that I was making accusations like I’m making accusations I guess now. And they wanted to punish me for making these accusations by saying that they’re delusions. But I think, you know, that there have been criminal investigations and forensic investigations and so on and they back me up.
Right
And the proof that they back me up is that the people that I have been avoiding naming names are no longer working as doctors and psychiatrists and social workers and so on and in two cases they’ve been struck off.

I would like, like to say that don’t ever expect an apology but be prepared to keep talking about your experience and not just to talk within the immediate circle who, who are caring for you but to talk to people beyond people in head office. People like local councillors. People who manage the people who manage the people who manage the people who manage the people. Don’t just talk to a small circle of, of people. I would think that, that you, you need to make it very clear that you’re, you’re not like rebelling and you’re, you’re trying to seek clarification. You’re trying to ask people to do things by the book. You’re trying to ask for due process to be followed. And don’t ever expect an apology but you might be pleasantly surprised to see that if you keep going after a few years some of the people who have wronged you might no longer be in positions to wrong others.

It is a very, very ethnically diverse borough and a huge range of nationalities and religions and degrees of assimilation to British culture. You know, from people who have really just, just arrived and who don’t speak the language to, to people who are ethnic in outer appearance but whove been born and bred in this country and who are, have kind of dual heritage but whose European-ness is probably more, more prominent to an impartial observer than, than their foreign-ness but nonetheless within the mental health system it’s their foreign-ness which is emphasised because it is their foreign-ness which is considered to, to shape their, their diagnosis and, and .

I think we’ve said this before that there is this curious belief that, that, you know, that there are many different kinds of schizophrenia and each ethnicity has its own schizophrenia and that you can’t necessarily assume that, that black schizophrenia or Jewish schizophrenia or Dutch schizophrenia is, is going to have the same presentation and the same prognosis and, and, you know, that for, one has to constantly be very culturally competent and make allowances, refine one’s, one’s approach and I, I’m not persuaded that you can classify people in this way. I think we all have a kind of micro-ethnicity that you acquire a knowledge of through getting to know us but, you know, the form you fill in when you go in hospital is not really giving you that picture and, and if, if you determine somebody’s mental identity and pathological mental identity, on that, that basis you’re going to fall back on stereotypes. And so in fact very, very old fashioned stereotypes that don’t belong in the 21st century.