In this guest blog, Sarah Zawacki talks about a peer support group for the Roma community, and trying to get them to open up about mental health issues, which are still largely taboo.
“Mental health is a bad subject.” It was perhaps not the most favourable of opening statements for the first peer support meeting held under the Roma Support Group’s new mental health advocacy project, yet it encapsulated the Roma community’s prevailing conception of mental health. Perhaps more revealing still was the fact that, despite the stigma surrounding mental health issues, the group was open to moving forward with the discussion.
Group members were Polish Roma, members of an ethnic minority group that began its migration out of India approximately 1,000 years ago and has since settled throughout Europe. Health in general is a taboo subject within the community, carrying connotations of impurity, and mental health represents one of the most stigmatised subjects of all. Admitting to mental health issues can bring shame not only to an individual, but also to that person’s entire family, and complex experiences of mental distress are often reduced simply to comments about feeling “crazy.”
While perceptions of mental health have undergone a shift in recent years – with more and more people talking openly about issues such as depression and requesting referrals to psychological services – the notion that mental health is an inappropriate topic for discussion remains strong.
While avoiding discussing mental health is by no means unique to the Roma, their frequently marginal social position can compound their unease in communicating about it. The Roma have experienced centuries of intense discrimination and continue to encounter opposition to their efforts to improve their life situations, with employment and educational opportunities often restricted. A strong sense of community solidarity has developed in response to these external social pressures, as well as a strong sense of the need to remain strong in the face of adversity. In this context, mental health issues can be seen as a failure to uphold duties to family and community, and, as such, community members may choose to suffer in silence out of fear of appearing weak.
As we tried to spark interest in our group discussions, we found that the stigmatisation of mental health issues greatly limited our range of topics. Community members were largely comfortable with describing general issues of accessing services: problems with requesting interpreters, long waiting times for appointments and confusion over referral procedures. But whenever we tried to steer the discussion towards topics such as depression or anxiety we found the groups to be quite adept at diverting the focus back to more superficial concerns about health services in general.
Over the next few months, it became clear a focus on mental health problems and related services was unlikely to stimulate open discussion – at least at this early stage. Instead, we sought to find topics with more overt resonance to our participants’ daily lives. And gradually people began to open up. They spoke about the sense of freedom and disorientation that accompanied the move from Poland to the UK, how negative Roma stereotypes in Poland prevented them from truly expressing themselves and how the diversity of UK society opens up the potential to live more according to personal choice than community expectations.
At the same time, though, this freedom can deprive community members of their sense of having a distinct cultural identity. When discussing the outcome of the EU referendum vote in one meeting, participants offered insight into heightened feelings of insecurity that come with experiencing health problems in a foreign country.
While these discussions did not explicitly address mental health, they nonetheless offered insights into the participants’ states of mind and methods for managing stressful situations. Discussions of life experiences and their emotional impacts give group participants ownership of the discussion, allowing them to take on the role of the expert and establish common ground with other community members. Where the close-knit social world of the Roma can heighten a sense of shame in acknowledging mental health issues, our peer support group has begun to harness this closeness to help build attitudes of acceptance of mental health issues.
There’s still quite a lot of work to be done to bring more community members into the discussion, yet those who have participated so far find that the peer support group meetings help them to feel supported in expressing their emotions – in many cases for the first time.
About the author
Sarah Zawacki is mental health advocacy coordinator at the Roma Support Group.