Racism therefore creates the nervous condition of being black. It can be deemed as a trigger, or a central tenant to why black people suffer from mental illness. Evidently, if one’s existence is based on fighting against the odds of being the other, it is hardly a healthy state of being.
In the first instance, we must acknowledge that in South Africa, and Africa in general mental illness carries crude stigmas. Culturally, it is viewed as a phenomenon that comes as a result of practices that go beyond the modern medical domain. Its effects and manifestations are credited to witchcraft, or some other misfortune that is of supernatural origin, a result of envy from fellow members of a community and a range of other reasons that are usually not based on empirical or argumentative logic. It is therefore important that from the outset we acknowledge that mental illness is a legitimate state of illness that can be traced to the chemical imbalances that occur in the human brain or within the human anatomy. This is important before we delve into the causes and effects of social forces in the mental state of the black subject in South Africa. That we accept mental illness as plausible medically, and its manifestations and effects as dilapidating and negative as any other form of illness.
At the centre of this paper however is how mental illness is a result of the socio-economic, cultural and historical contradictions of being black in a society that is structured and organized to alienate black people. It seeks to unpack how the process of alienation from humanity, history, and normative ideals of beauty, from the economy, knowledge production and social security results in a constant state of anxiety, and possibly a variety of other mental illnesses or disparities. It seeks to put at the centre of mental discord of black people, their reality. Perhaps more provocatively put, this paper will unpack how simply by definition of their existence and what their existence entails, all black people suffer from a state of mental discord. It will address how for the black being, mental illness is largely a product of their sociological reality.
The black subject is first and foremost a victim of arguably the greatest, most technical and enduring forms of prejudice to exist in human society: racism. Racism, a theory and an exertion of structural power. It begins by dehumanizing the human subject that exists outside of the norms of what it means to be human. It is a form of oppression that locates all that is not white in pigmentation, not of European descent as the scourge of the earth, as a quintessential evil. As no different from livestock, as expendable labour, as an anomaly in the stream of history and evolution. The black subject possesses all the physical characteristics of being a human, yet as per the analysis of the earliest race theorists the black subject is hindered from being human by their “primitivistic” norms and customs. The black subject is not human because of their difference. This difference from norms defined and established by the oppressive race, by those who colonized is a negative difference. It zooms in on a conceptualized abnormality of everything that constitutes the black life, in contrast to the ordained purity and righteousness of everything white in form. This is the foundation of the existential crisis faced by black people, and that crisis, that lack of certainty of one’s humanity, worth and role in modern society permeates through a black subject’s consciousness across the world. It is a burden on the shoulders of all black people, the constant race to humanize the self by any means necessary, or to sink into the reality of the doomed state of being black in the world.
Racism therefore creates the nervous condition of being black. It can be deemed as a trigger, or a central tenant to why black people suffer from mental illness. Evidently, if one’s existence is based on fighting against the odds of being the other, it is hardly a healthy state of being. To constantly exist on the outskirts of existence. Understanding that racism is a sociological phenomenon, how then does sociology and societal relations mould the state of mental discord? Which illnesses are common to those who carry the mark of being black? What is the social state of black people that may lead to psychological disorder? Raymond Cochrane, author of The Social Creation of Mental Illness writes on a theory called social causation in his book, and how the variants of social classes reveal differences in prevalence of mental illness. He writes that the category of social causation postulates that social class is correlated with a large number of other variables which might contribute to a higher rate of psychological disturbance in the lower social groups. This is to say that, those who live in a lower social class are more prone to mental illness than those who live in a higher social class are more prone to mental illness. Cochrane continues and writes that,
“The single factor which has received the most attention, and indeed which may incorporate many of the other factors is stress. It was noticed in the Midtown Manhattan study that poorer people experienced more stress in the form of poorer physical health, marital disharmony, periods of unemployment and so on, than do their richer counterparts. It is also quite possible that when these kinds of events do affect the better educated and those with a higher standard of living, they are better able to cope with the vicissitudes of stress, by, for example, taking a holiday or seeking professional advice. . . A major insight into the way in which social class interacts with stress to produce differential mental illness rates was provided by Phillips (1968). He looked at the distribution of positive experiences across the social classes as well as stressful experiences. The hypothesis was that positive or pleasant feelings might counteract the influence of stressful experiences. In his community survey of 600 people in New England. Phillips found that…although there was no noticeable social class differential in his study on the proportions of each social class reporting negative feelings. . ., there was a considerable social class differential in the reported experience of positive feelings. He found that more than twice as many higher social class individuals reported having a lot of positive experiences in the past month – such as being pleased, proud, interested and so on – as lower social class people.”
In the above Cochrane captures two important aspects of social causation of mental illness that are relevant in the South African experience. This is the role of one’s standard of living in elevating the prevalence of mental illness, and one’s ability to elevate one’s standard of living in alleviating the symptomatic effects of a state of mental discord. What becomes important then is to locate and understand who suffers from a low standard of living as a social class in South Africa that would allow for the prevalence of conditions such as stress and depression within such a society, and how this condition stems from a structural and systemic program of exclusion.
According to Stats SA, between June 2016 and June 2017 the unemployment rate of black people in South Africa fluctuated steadily between 40.1% and 40.9%. This is contrasted starkly by the unemployment rate of white people which fluctuated between 7.9% and 9.3% over the same period. From this we can see who is unemployed the most in the country, while understanding as well that black people constitute most of the population in the country. The unemployment of black people is not the only socio-economic variable that determines mental illness. Black people are in the same vain alienated from infrastructure in terms of housing, access to water, education and ownership of the means of production in. Over 5 million South Africans are estimated to not have access to safe drinking water, with a majority being in rural and township areas. Over 21.8% of school leavers between the age of 7-15 cited lack of money as their reason for dropping out, while with regards to housing, 19.1% of black people lived in either informal or traditional dwellings. 87% of the land and mineral wealth of the country is in the hands of the private sector, one which is dominated by white ownership.
These statistics represent a common trend. That of black people being alienated from key sectors of society that determine one’s social status and mobility. In a country where it is then evident that the black identity is synonymous with a lack of access, lack of dignity. Where if one looks at who occupies informal settlements, with rife levels of crime and a lack of proper infrastructure. In a society where apartheid spatial planning locates most black people outside of industrial areas and CBD’s, how does one expect those at the brunt of these conditions to have any pride in their identity or a stable state of mental health?
These are social agents that actively erode mental health at the level of identity in relation to ones lived reality. A context of hopelessness exists in South African society for black people, with little signs of reprieve due to the lack of employment opportunities. This hopeless state of being and who exists within its confines and behavioural patterns is normalized and accepted, and thus continues with little to no disturbance. It constitutes itself as the normal order of things. It establishes itself as a structural system. When one seeks job opportunities they are confronted by their lack of education, and they lack education because they do not have the money to access it. It is as if there is an endless cycle of exclusion. How else do we expect crime, substance abuse and all other social ills that plague our people to decrease when there simply does not seem to be a way out of poverty. Substance abuse becomes the alternative, the numbing agent to escape black reality and all its consequences, which leads to further moral decay. Moral decay is attributed to a social classes behaviour and that social behaviour continues due to the exclusion of said social class which gives rise to its deviant behaviour. Cochrane has an interesting analysis and deems this the labelling theory. Although he utilizes this as a theory that analyses mental illness as a derivative of the labelling process of being deemed mentally ill, an interesting argument I would make is how the label of black, the structural consequences of being black and the racist connotations that come with being black give rise to the deviant behaviour and mental illness within the black social class as well.
Cochrane writes that,
“The most coherent, radically different approach to the medical mode of psychological disorder has been developed by sociologists using the social psychological concepts of symbolic interactionism. A core assumption of symbolic interactionism is that our self-identity arises out of our own interpretations of our social intercourse with members of society. In large part we come to know who we ourselves are by seeing what other people make of us and by making sense of the way in which they act towards us. . .Although these basic ideas were formulated many years ago, it is only relatively recently that they have been applied systemically to the study of deviant identity as well as to the study of normal identity formation. Credit for the development of the labelling theory of deviant behaviour is usually given to Howard Becker. In a book published in 1963 called Outsiders he brought together many important insights into the way in which society can contribute to the production of deviance within the individual. Becker was not merely restating the traditional sociological view that the causes of deviance are located in social forces but that, ‘social groups create deviance by making the rules whose infraction constitutes deviance, and by applying those rules to particular people and labelling them outsiders.’. . .It is equally important to notice that the labelling perspective suggests that who is labelled depends not on how they behave but on their social characteristics. . .By extension from the symbolic interactionist perspective the suggestion is that being labelled, in other words being regarded as different by important other people, has serious consequences for the self identity of the person being labelled.”
There are three interesting points to note from the above in relation to the identity of being black, the common social ills that plague black communities and mental illness. In relation to identity, the black collective in South Africa has been labelled negative in all terms by colonialism and the apartheid system. Labelled famously by Henrik Verwoerd as little more than hewers of wood and by Cecil Rhodes as beings that must not be allowed to own any land in the continent, the black being has historically since colonialism and slavery been placed as the subordinate. The interesting question then becomes what happens when the concept, the symbolic and ideological interaction becomes a structural reality? What happens when the proverbial hewer of wood becomes generations and generations of domestic workers and garden boys? What happens when the pronouncement of Rhodes becomes the 1913 Land Act? What happens when ideas, and notions about a nation of people as uneducated, a continent without knowledge and undeserving of economic sovereignty translates itself into the Bantu Education Act and Structural Adjustment Programs? These are examples of how labels become reality. How the ideas of white supremacists translated themselves into policy and created a race of people born into servitude, dependency and sub-alternativity.
The colonials and apartheid government had the power to make us black and equally provide rationale as to what constitutes blackness. Blackness as earlier alluded constitutes the anomaly, the undeveloped, the criminal and the primitive. Yet this is not a situation of the black subject’s own doing, but one manufactured by those with the power to define an identity. They did this by firstly tarnishing the identity of that which they subsequently conquered and dispossessed, then subjecting it to servitude.
Post this definition, we find that the label adopted by the black being in modern society is that of the danger. When one considers the street vendor or con artist, it is the black or Indian face which etches itself across the mind. When news reports allude to a break in, a murder, or the seizure of stolen goods or narcotics, it is the black male image under a black balaclava that crosses one’s mind. When one thinks of the domestic worker or the prostitute, it is the black woman that crosses one’s mind. When you hear of cash-in transit heists, it is the image of grotesquely large black men that crosses one’s mind. When one considers gangs, shootings and rape, it is the black and coloured image that crosses one’s mind. This is not an accident of history, or as many as some may want to allude a simple fact. It is because these images are villainous images. Even black people themselves cannot deny that when walking down the street, it is the black person that gives rise to a feeling of fear in their chest, and they cross the street. We are a people afraid of ourselves. Our own people, our own failures which we consider more likely than our successes. How then is a stable state of mental health to be achieved by a collective of beings that have doomed themselves to constant fear and doubt of themselves?
The deviance that festers in spaceless township communities riddled by squalor is a result of a label, ideological and structurally imposed upon us as a people. We were the cause of moral and social decay before it had even began riddling our communities. We were conceptualized as an anomaly, and we thus became an anomaly. How else would an anomaly conduct itself? The deviance of crime that made us to be subservient, the crime of colonialism and apartheid however does not fall into this logic. However, the criminal eventualities of a state of spiritual and economic poverty are framed as the central contradiction of society. It is thus illogical to expect subjects of such a society to be functional, never mind healthy.
Mental Illness plagues us all as a race of people, our most prevalent social status in relation to our standard of living is evidence of that. It is not however a condition that affects only the poor amongst us. Keeping in mind that this chapter focuses on mental illness amongst black people simply because it has the direst effects on these people, generally goes untreated and is recklessly handled in the public healthcare sector when it comes to black people. The Life Esidimeni Massacre is a tragedy that had the privilege of making it into the public domain, with a variety of mental institutions across the country carrying stigmas of ill-treatment and poor infrastructure to the point where they are used as threats to fellow community members in black society. I remember vividly growing up, how for ill-behaviour we would be reprimanded with threats of being sent to eBhofolo, the Xhosa name for Fort Beaufort and used to reference a mental institution in Fort Beaufort, and what Zim Ngwaqana refers to as indawo yamageza in one of his jazz hits, or Duncan Mental Institution if not Valkenberg. Mental institutions in South Africa are used as a deterrent to deviant behaviour and are places that mentally ill people who are black in South Africa fear, which often stops them from seeking help. They are the novel horror-movie asylum for the mentally insane. It is a special horror for black people, hence black people are at the centre of the chapter. We culturally, socially and economically do not have the privilege of confronting our mental illness openly and have it treated conducively.
It is indiscriminate across a class divide. Those who are deemed the most successful of us, those who seemingly have access to opportunities are often haunted with this reality when confronted with the reality of their identity and racism in all its different manifestations. Frank B. Wilderson III, critical race theorist, writes on institutional racism and blackness, and how even economic freedom in Gramscian terms does not resolve the crisis of sub-humanity, that is central to the anxiety of being black as much as living standards. He writes in Black Gramsci: Wither The Slave In Civil Society,
“In other words, the slave makes a demand, which is in excess of the demand made by the worker. The worker demands that productivity be fair and democratic. . . the slave, on the other hand, demands that production stop; stop without recourse to its ultimate democratisation. . . In White Writing: On the Culture of Letters in South Africa, J.M. Coetzee examines the positionality of the KhoiSan in what he calls the early Discourse of the Cape: travel, ethnographic and scholarly writing of Europeans between the late sixteenth and eighteenth centuries. Those Europeans who encountered the KhoiSan during this period came face to face with an Anthropological scandal: a being without (recognisable) customs, religion, medicine, dietary patterns, culinary habits, sexual mores, means of agriculture, and most significantly, without character — without character because, according to the literature, they did not work. Even when press-ganged into service by the whip, by the bible, by the spectre of starvation, they showed no valuation of industry. The only remedy for this condition, according to one Cape writer, was terror — their annihilation”
In other words, to Wilderson, to alter the relationship the worker has with production would not suffice in the humanization of those located outside of humanity, and those who have been deemed outside of humanity are black. The colonial solution then was complete terror of the native Khoisan, in modern society it is a terror of existence.
This is a contradiction we have witnessed, one that shows us the connotations that black people have with destitution supersedes whatever material wealth they may accumulate. In sports we have seen it with the walk out of Ashwin Willemse from Supersport Studios’s, citing constant condescension by his white counter parts. In academia many of us witnessed as the qualifications of recently appointed University of Cape Town’s Vice Chancellor Mamokgethi Phakeng having her academic credentials baselessly questioned by her white counter parts due to her views on transformation within academia. In the acting industry, post the democratic dispensation of 1994 we have seen the black majority, and its elected officials ridiculed by the racist black face and accent mocking accent of on Leon Schuster in his movies which have historically been made in bad, and racist taste at the expense of black people from all sectors of society, be it rich, poor or successful.
We witnessed abroad, Oprah Winfrey have her fiscal ability questioned at a clothing store, simply because the saleswoman at the store did not recognize her and she was black. We see it across the corporate sector, the competency and abilities of black emerging professionals is questioned due to legislative measures that seek to undo the skewed representation in the echelons of power.
We see it in the education sector, where scores of black students either drop out, fail predominantly, do not finish their degrees and in the most extreme cases commit suicide due to a lack of sense of belonging in the institution. We see it due to them not understanding their curricula because they come from underprivileged schools, they suffer depression and stress due to the high pressure of expectation from their families and the realities of black tax. With black graduates who struggle for employment and end up as interns, then unemployed canvassing their degrees on the side of the road. With a middle class that is on the cliff of poverty on a whim due to much of their wealth being based on accumulated debt.
When one is black, even the perceived heights of success equal a precarious position, a fickle position, one that can be lost at any moment. It is these pressures, the fact that the black professional exists constantly on the back foot that give rise to anxiety. It is these face-value successes that stop these supposedly successful people from reaching out to anyone. It is not the norm to be mentally ill when studying at a prestigious institution such as Wits for a black community of Soweto. It makes no sense to be depressed as a world-renowned rugby player for the communities of Eldorado Park. It is not normal to be depressed for the community of the Eastern Cape or Pretoria, to be depressed as a successful academic. Hence many of our people suffer in silence. They suffer at the hands of structures that constantly undermine them, exclude and ridicule them because they were not created to include them. While they suffer the burden of carrying the hopes, dignities of scores of underprivileged societies.
This can never be assumed to be a healthy state of existence. So, whether rich or poor, to be black is a state of anxiousness, depression, stress and a constant battle for existence. This is all a battle each black person wages, whether as a collective or individual. It is automatically a state of mental discord.
***Sinawo Thambo is the EFFSC Western Cape Chairperson