1. Rubina Jasani and Sarah Pemberton University of Warwick
“I could have died in there”: Narratives of Mental illness and the discourse of Structural Violence
Rubina Jasani and Sarah Pemberton
University of Warwick

2. Case Study One
21 year old male, African, asylum seeker with psychosis.
Rejected from university because of his undeclared status.
Differing understanding of cause of illness
Gaps in care

3. Data Collection Research is based in the Heart of Birmingham (HoB)
Research seeks to investigate the reasons behind ethnic variations in the experiences of, and admission to, acute psychiatric treatment.
Area chosen because of its high BME population

6. Main Ethnic Groups in HoB
Total population of 250,755 of HoB
–        10% Black British/Black Caribbean
–        25% White British
–        3% White Irish
–        29% British Asian/Pakistani
–        13% British Asian/Indian
–         7% British Asian/Bangladeshi

7. Criteria for Interview
Diagnosed as having had a psychotic episode by clinical team
From all ethnic groups
Aged between 18 and 65
Not considered as a real/present risk to researcher or themselves.
Ability to consent

8. Ethnicity of Sample 21% Black British/Black Caribbean
38% White British
1% Mixed Other
32% British Asian/Pakistani
3% British Asian/Indian
3% British Asian/Bangladeshi

9. Structural Violence Based on work of Paul Farmer (1997, 2003)
Farmer examines ways in which women are structurally disadvantaged with reference to the treatment of Aids.
This can be applied to mental health and the multiple ways in which people are marginalised and the impact that this has on access to care.

10. Case Study Two 30 year old male, British Pakistani with psychosis.
Negative experiences of inpatient unit
Differing understanding of cause of illness
Neglect by the system

11. Case Study Three 29 year old female, White British with psychosis.
Raped, children removed by social services, homeless, heroin user
Differing diagnoses
Gaps in care

12. Conclusion
Case studies attempt to show how structural inequalities of culture, class and gender play a role in disadvantaging service users and excluding them from main stream health and political systems
Our research is not necessarily making a claim for culture specific services, but instead shows how culture is a dynamic concept that needs to be explored in the context of time and space, while remaining sensitive to differences of class and gender.

13. Contact Us Rubina Jasani R.Jasani@warwick.ac.uk Laura Griffith
Sarah Pemberton