‘Culture’ in the field of race and mental health
Consideration of the autonomy and ideological interests of particular hum an sciences is a m atter for historical and cultural in terpretation . In the absence of detailed accounts of everyday clinical practice, it is often difficult to assess the specific motivations for the practitioner of racist theories in psychiatry (Rackett 1992). The recent development of transcultural psychiatry in the United Kingdom may throw light on how individual practice relates to political contingencies, and how it develops a body of expert knowledge associated with ‘cu ltu re’ which becomes medical common sense.Unlike the U nited States or Australia, B ritain has never considered itself a nation of im m igrants, yet considerable num bers of Europeans have settled here during the whole of the m odern period. Cardiff, Liverpool and London have had substantial Black m inorities since the eighteenth century. In the 1950s and 1960s, im m igrants arrived from the Indian subcontinent and the British West Indies, and also from Eastern Europe, Hong Kong and West Africa. Although stim ulated initially by governm ent recruiting campaigns for unskilled labour, a series of increasingly restrictive im m igration acts from the 1960s lim ited m igration to dependent family m em bers of those already established. The Irish Republic and the U nited Kingdom continue to have unrestricted movement between them , and more recently m em bership of the European Community encourages free migration between mem ber states. The 1991 census lists the percentage population of England and Wales by self-reported ethnicity as W hite 94, Black Caribbean 1, African 0.4, Black other 0.4, South Asian 2.9, Chinese 1 (Balarajan and Raleigh 1992). Previous censuses had asked place of b irth (or place of b irth of the head of the household), which had the epidemiological advantage of particularising the countries of origin (and thus ‘cu ltu re’) in more detail, but the increasing num bers of children and grandchildren of m igrants made any calculation of ethnicity from household origins more difficult. Given the popular British equation o f ‘im m igrant’ with ‘Black’, it is necessary to recall that the majority of m igrants, in all but 1 year since the war, has been W hite, and tha t the largest single overseas-born minority community in B ritain - perhaps 2 per cent of the population - is the Irish (Littlewood and Lipsedge 1982, revised 1997).