This assignment will highlight and discuss the case study of Victor a 22-year-old black African male from the Nottingham area. I will discuss and provide detailed evidence on Victor's case through investigations and theories. This will help explain how Victor's race, gender and class could have had a big impact on his life and potentially discriminated against him when he has been a part of the criminal justice system and seeking mental health support.
Sewell in 'Mad or Bad? A Critical Approach to Counselling and Forensic Psychology' discusses the topic and intersectionality of race. It introduces Victor, a black male of African origin whose parents were originally from Nigeria but moved to. Victor has had multiple issues with criminality, the justice system (after being convicted of grievous bodily harm and robbery) and experienced mental health issues.
Data from reliable analysis tools such as the census that regularly records population changes, plus the gathering of feedback reports from service users in the mental health system help to support Sewell's argument that a person's ethnicity negatively impacts the mental health care services they receive. On pages 70-73, Sewell highlights and partitions the inequalities that occur in mental health into five sections. In the first of these sections, Sewell describes how individuals from black and minority ethnic groups (BAME) will experience a high level of social inequalities, such as racism abuse trauma, poor housing and unemployment. In addition, he adds that migration and the impact of moving to another country can also negatively impact a person's mental health. In the second section, Sewell describes how members of the BAME group, in particular black African individuals, are more likely to be what he calls 'overrepresented' in mental health care. He adds that BAME members will have statistically higher than average detention rates in hospitals, have more referrals by other agencies such as the courts, and will more likely receive a diagnosis of psychosis and receive more formal community treatment orders from the mental health team. In his third section, Sewell argues that research conducted by Glover and Evison (2009) identified that men and women from BAME backgrounds (Bangladeshi, Chinese, Indian and Pakistani origins) were less likely to utilise psychological therapy services and therapies such as cognitive behaviour therapy (CBT). The fourth section describes how data gathered suggests that BAME members who accessed mental health care services were more likely to ultimately receive poorer outcomes such as repeated admittance and longer on the hospital ward than their white counterparts and were more likely to drop out when accessing talking therapies such as CBT. In the fifth and final section, Sewell describes how several researchers have identified significant issues between BAME communities and their satisfaction with their therapists and mental health care services. One study was the 'Breaking the Circles of Fear' research in 2002. It found that African Caribbean communities reported very unsatisfactory levels of mental health services. Another study conducted by the Mental Health Commission in 2006 also reported that black and mixed-race groups reported high rates of dissatisfaction in mental health inpatient stays.
Several research studies have been undertaken to identify if there are any issues with race in the criminal justice system as in the case study Victor had experienced. Section 95 of the Criminal Justice Act 1991 compels the Justice Secretary to publish data on ethnicity in the criminal justice system for Wales. The findings for 2013-2014 highlighted that BAME members were more likely to be a victim of crime than white people. Due to disproportionate stop searches made by the police on BAME community members, black people were more likely to be arrested, convicted, and given custodial sentences than their white counterparts. On page 75 of 'Mad or Bad? A Critical Approach to Counselling and Forensic Psychology', Sewell explains that mental health and the criminal justice system have similar trends when it comes to black people being overrepresented. This could be heavy due to racism in the system and the individuals involved within it. Another reason Sewell offers for this overrepresentation is social inequality. Due to higher proportions of BAME members experiencing social inequality, which is a direct link to crime, it is reasonable to conclude that BAME members will more likely be a part of the criminal justice system.
Callaghan and Alexander in 'Mad or Bad? A Critical Approach to Counselling and Forensic Psychology' discusses the topic and intersectionality of gender on mental health and crime. In the case study, Victor is male. On page 83, Callaghan and Alexander explain that men are reported to commit more crimes than women. Men account for 85% of arrests, 75% of criminal sentences, and 95% of the prison population from Ministry of Justice data in 2014. Callaghan and Alexander further explain that it is reasonable to establish a link between gender and crime due to the statistics gathered. They believe that one reason for this link was the biological makeup of men compared to women. As men have higher testosterone levels and high testosterone levels, according to Batrinos (2012), it can make men more aggressive and lead to men committing more violent crimes. Men are also seen in society as more threatening than women due to their size and stature. Callaghan and Alexander conclude that within the general media, women who commit violent crimes are presented as evil or mentally unwell, whereas men are labelled as aggressive.
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Also, Callaghan and Alexander discuss the link that gender has to mental health. According to Gale (2007) and Hinshaw (2006), mental health is highly stigmatized throughout society, with certain conditions such as personality disorders being more stigmatised than others. Just like the research on crime, there are links between gender and mental health. For example, according to the Mental Health Foundation 2015, women are more likely to receive a diagnosis of depression than men. Research studies such as one conducted by Altemus, Sarvaiya and Neill Epperson (2014) have concluded that women have a biological vulnerability to depression due to having different hormones to men. However, there are other factors that can impact women's mental health, such as childcare, domestic work and paid employment.
Another example of gender-based mental health is the condition of personality disorder. There are various types of personality disorders, such as narcissistic and borderline. While both conditions are similar in nature. The diagnosis of narcissistic personality disorder will be mainly given to men. In contrast, women are more likely to receive a diagnosis of borderline personality disorder, according to the American Psychiatric Association (2013). The diagnosis of psychosis is given more to men than women, according to Aleman, Kahn and Selton (2003). These differences in gender-based mental health condition diagnoses are due mainly to men's and women's behaviour. Men are seen as angry and confrontational, whereas women will internalise their issues and not act out. This behaviour difference, in my view, has an influence rightly or wrongly on a medical practitioner's decision on a diagnosis for patients.
Holman in 'Mad or Bad? A Critical Approach to Counselling and Forensic Psychology' discusses the link that social class has on mental health and criminality. The case study (Victor) grew up in a Nottingham housing estate with his family and then moved to a twelve-floor tower block with his friend. There have been a lot of studies conducted to establish the link that class has with mental health. One study by Faris and Dunham in 1939 examined hospital admissions data in Chicago (USA). It found that the poorest and most deprived areas had the highest rates of conditions such as schizophrenia and substance abuse. Another study conducted in the United States by Hollingshead and Redlich (1958) analysed data from courts and hospitals and identified that individuals who come from a lower-class position were overrepresented in therapies and treatments and were more likely to enter those treatments through the court system rather than voluntarily. Furthermore, their treatments were found to be more like shock therapy rather than talking-focused counselling therapies. In addition, evidence published in 2007 from the Adult Psychiatric Morbidity showed that those living in high-income households were less likely to have mental health issues than those individuals who lived in lower-income households.
Holman also explains that there are three reasons for social class linked to mental health. The first explanation is that lower social class circumstances lead to poor mental health. The Faris and Dunham study in Chicago in 1939 also concluded that the city's poorest areas had experienced high levels of mental health issues due to isolation and loneliness. Other factors linked to poor mental health are work, family life, childhood experiences, poor-quality housing and poverty. The second explanation is that mental health problems create to poor social class. A study undertaken by Researcher Eaton (1980) concluded that individuals who develop mental health issues fall down the social class tier system. The third explanation is the labelling theory. This is where individuals' behaviour who are from social class environments are labelled as having mental health issues.
To conclude, Victor's case study explains that he developed mental health issues and has been part of the criminal justice system throughout his life. Intersectionality between a person's race, gender, age, and social class can cause prejudice and discrimination when individuals seek treatment for mental health disorders or become a part of the criminal justice system.
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