‘Why,’ someone once asked me after a walkabout in Brixton, ‘do we have so many crazy people here?’ I said there was no more mental illness in Brixton than elsewhere. It was just that in Chelsea or Mayfair, families had more resources to look after their sick, whereas here they ended up on the street.
My answer was only half-true, though. Mental illness is not only more visible, but often more common, in poorer communities since it can induce downward social selection. Unable to find or keep decent work, for instance, people with mental illness frequently end up falling down the income-ladder.
Recently, while I was picking up something in a Brixton department store, a woman began following me around. Mumbling inaudibly, she tracked me closely, and I finally turned around and asked if I could help her. ‘I heard what you called me,’ she said. Accusing me of addressing her with a racial epithet, she began a long monologue about how racism was illegal now, that she was going to report me to the store manager, to the police, to the prime minister, that it was all caught on video. On it went.
At first, I tried reasoning with her, inviting her to join me for coffee while reassuring her that I never said, nor would say, any such thing. But it quickly became apparent that I was not dealing with someone who was fully ‘there.’ She wasn’t psychotic. Her narrative was coherent, as if she’d practiced it; and despite her rising volume the staff took little notice, as if they were used to her. But, realising that I couldn’t mollify her, I finally told her that if it made her feel better, I’d join her while she made her report to the store management.
So off we went. I accompanied her as she marched purposefully through the store, never relenting in her stream of criticism. Yet as we turned this way and that, it gradually dawned on me that we weren’t headed to any manager’s office – or anywhere in particular for that matter. We were merely prolonging this conversation.
I then recalled another peculiar feature of Brixton that an old friend of mine, the Jamaican novelist Kei Miller, once put me onto. It is that Jamaicans here – and Brixton is the heart of Jamaican Britain – display an unusually high degree of schizophrenia. Just why is a mystery. Some research, including that done by my former University of the West Indies colleague Fred Hickling, attributes it to their own historic marginalisation in British society. The social isolation caused by racism may induce the sort of stress that aggravates the onset of mental illness, while the experience of marginalisation may reinforce paranoid tendencies that might otherwise remain latent and subdued in a less unfriendly environment.
But Kei added an interesting observation. He speculated that mental illness surfaces when Jamaicans arrive in Britain because back in Jamaica, it can find relatively safe spaces in which to express itself. He reminded me of the ways in which people who suffer hallucinations which are diagnosed as psychotic episodes, are sometimes credited with prophetic or mystical powers in the religious landscape of Jamaica.
Early in my conversation with this woman, I’d ascertained that she was neither Jamaican, nor from the Caribbean. But she was clearly someone who felt marginal, even in this community. Moreover, it was obvious to me that whether or not she believed her accusation, she got a sense of power from stopping someone – someone who she regarded as more powerful, perhaps better-connected – and making him listen to her and take her seriously for a while. I finally told her I’d go wait for her in the café while she went off to find the manager, knowing full well as I walked away that would be the last I would ever see of her. My departure had put an end to her moment of power.
Investing mental illness with power isn’t necessarily a more enlightened approach than treating it as a disorder. One man’s prophet is another’s demon, and Kingston street people often bear the scars of attacks from people who misunderstood their psychotic outbursts. But it does reveal the social dimension of mental illness – that diagnosis is aimed not merely at helping the individual, but with regulating their public behaviour.
I once had a colleague who, after repeated psychotic outbursts, was forcibly interned and put on medication. He also happened to be a genius who, during his episodes, sometimes experienced moments of stunning insight during which he produced brilliant mathematical formulations. He refused his medication, saying they’d kill his creativity. Told he was a threat to others, he pointed to his small frame and asked them to produce a police record of an incident in which he hurt anyone. Told then he was a threat to himself because he’d invite the sort of retaliation that maims some Kingston street people, he said that was his risk to take.
And here’s what struck me. When he accused his psychiatrists of behaving like medieval exorcists, their exasperated ‘But you’re not well!’ didn’t sound to my ears all that different from the ‘But it’s Satan speaking!’ of a Jamaican preacher.
Image: Storm clouds gather over the Lahn, Hessen, Germany
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