Stigma in practice

Abstract

Finally facing the reality of racism in UK mental health—really facing it—reading the literature, the history, observing my own practice and that of my colleagues, has made me realise that stigma is at the very root of what we do as psychiatrists. Stigma, ie, negative stereotyping, is defined by the Oxford English Dictionary as “a mark of disgrace associated with a particular circumstance, quality, or person”. As a society, we are most likely to stigmatise those whom history has already stigmatised. Race itself is an invention, but the long tail of the transatlantic slave trade and colonialism has resulted in real group-level demographic differences between racial groups. As a group, White people are richer, better educated, and proportionately less likely to go to prison than their Black countrymen and women. Our school history lessons emphasise the culture and bold actions of White slave-owners and colonists (Columbus, for example) while saying little about the culture or actions of the black-skinned and brown-skinned people they enslaved and colonised. Even at our elite universities, White colonists are celebrated in a way that distorts history. We have all been acculturated by dominant media images that portray White people as “rich” and “gentle” and Black people as “poor” and “thugs”.