As we enter the next phase of austerity, pressure will continue to build on the NHS and other resources that treat mental health problems will also be strained. Tackling this will not be easy. Mental health issues require multiple, connected strategies, and cannot be addressed with singular, disjointed policies. This is because in the United Kingdom, different communities are at differing points in regard to their views on mental health. It is important to understand the subject positions, histories and cultures of those suffering from mental health issues if progress is to made.
For example, South Asian communities are acting in the condition of post-colonialism in which their subjectivity is shaped by many structures of oppression. This is true for the Punjabi diaspora in the United Kingdom which has been shaped through its experience of migration, settlement and integration. There are now over 200,000 Punjabi people in the UK, predominantly in areas like Southall and Handsworth. The bulk of these people migrated to the UK in the aftermath of World War II and the subsequent partition of India.
Partition caused a deep sense of trans-generational trauma with the event displacing more than fourteen million people (over five million of whom were Punjabis) and violently dividing the region into what we now know as India and Pakistan. This violence led to the disappearance of two million people and the largest mass migration in human history; the trauma from this event still lingers heavily over the heads of British Punjabis. As a result, events such as the partition of India need to be considered when addressing mental health issues within Punjabi communities, particularly in regards to the older generation.
Whilst settling, first generation immigrant families faced extreme racism and hostility in the United Kingdom. Being placed at the bottom of Britain’s class hierarchy, many made their livings in factories and through manual labour. My nana (grandfather) worked as a carpenter, his family and his brothers’ families all lived in one house – children shared beds, adults worked multiple jobs and money was sparse. My family now find themselves in a better financial situation, and a lot of this is success is based on the hard-work of the first generation of adults living and working in the United Kingdom. The diligence of previous generations has shaped a distinct Punjabi identity, and an idyllic Punjabi masculinity that is deeply intertwined with traits such as perseverance, determination and fulfilling provider roles.
Similarly, over time, hegemonic forms of masculinity in the United Kingdom have largely prided themselves on rationality, control and stability – defining themselves against the feminine, which is perceived to be emotional, uncontrolled and unstable. Discourse around illness, both physical and mental, currently fit into this gendered framework so as to champion health, and feminise illness. Within current cultural discourse, someone hoping to legitimise their manliness in such a society is unlikely to acknowledge, diagnose and engage with treatment for mental health issues. It is within this gender context that Punjabi diaspora operates. Here, cultural notions of hard-work and providing for one’s family combine themselves with British structures of masculinity. A Punjabi who is physically or mentally ill can be viewed from the outside as someone who is not providing for their family, and mental illness is continually marginalised due to its lack of “physical” impact.
Historically, Punjabi people have been painted in a militaristic light; they were labelled as a “martial” race by the British which encouraged their participation in very violent, and emotionless masculine performance. When speaking about mental health issues, many are implicitly told to “get over” what ever is bothering them, or their experiences are belittled and often compared to elders’ lives who “went through more hardship” than they ever could. The reality is that the first generation went through different hardships to those who are growing up in twenty-first century Britain which presents its own problems and challenges. No good can come of the different generations within the Punjabi diaspora competing over who suffered more and why; each has had to face many obstacles here in the UK.
Despite few studies being conducted on the mental health of Punjabi males, members of the diaspora are well aware of how common alcoholism and suicide are amongst Sikh men. For men of all cultures living in the UK, suicide is the most common cause of death for those aged eighteen to forty nine; one of the reasons for this is the emotionally closed and insular conceptions of masculinity they are presented with and thus see themselves and legitimise their maleness. Punjabi men experience this because they are shaped by more culturally Punjabi notions of masculinity, particularly in the post-colonial context. This double-burden of both notions of masculinity in Britain, and a diligent, unwavering work-ethic needs to be considered within the Punjabi context. The subjectivity of such people, the nuances of their pasts and how this affects their present lived experience are all factors which require understanding when offering services that combat mental health issues.
Outside of the Punjabi diaspora a prominent strategy to combat mental health stigma has been the discussion of mental health issues by celebrities. These celebrities speak about their own experiences in an effort to normalise, encourage and provoke discussion around a subject that had been considered taboo for many years. I found one commonality with most of the media and its presentation of celebrities discussing mental health: whiteness. In general, only white women have spoken of mental health in an open and informative way, some white men have also involved themselves in such discussions. However, there was very little space occupied by people of colour – which limits the potential effectiveness of this approach, particularly as people of colour are more likely to be affected by mental health problems. Lena Dunham, or even Steven Fry, speaking about their mental health issues, will do very little to combat stigma in South Asian and Punjabi communities.
Step forward Mudhsuden Singh Panesar, better known as Monty Panesar, a British Punjabi cricketer who has represented England at international level. Last year Monty Panesar was interviewed about his life, and a large portion of this discussion was around the mental health issues that he was going through towards the end of his playing career. Panesar touched on the taboo around mental illness within South Asian communities and noted the ways in which conceptions of gender and masculinity play an important role in mental health discourse. Following his interview, Panesar said he had a lot of young Asians coming forward to discuss the stigmatised topic. Such young people perhaps wouldn’t have been so willing to reach out after hearing w white person speak about depression. The position Panesar occupies as a Sikh male makes him a more accessible gatekeeper for discussions surrounding mental health for Punjabi males. Further examples of South Asians speaking openly about mental health include musician Apache Indian and public figures Manisha Tailor and Kal Dhindsa.
In conclusion, more needs to be done to get prominent Punjabis (and people of colour more generally) to speak about their mental health and actively try to destigmatise a topic that is bound up within a complex web of cultural identities and post-colonial nuances. Mental health treatment is very complex but from the outset it should be noted that mental health issues affect different communities in different ways; the variety of human subjectivities has to shape mental health discussion, diagnosis and treatment.
This article first appeared in the winter ’17 edition of Consented’s quarterly print magazine which you can buy online now.