In recent years, the way we understand and perceive mental health (and illnesses) has undergone major changes, mostly for the better. However, mental health is still, according to psychotherapist Olukemi Amala, very ‘individualised’. As a black bisexual disabled woman, Olukemi feels the system does not allow the experience of social oppression to be discussed as relevant to mental health. She proposes a radically new approach that acknowledges and takes into account social oppression when developing mental health services.

Firstly, I would like to start by considering how we all continuously create and recreate our self-identity throughout our lives. Numerous psychological studies have shown that we all learn our self-worth based on approval or disapproval from others. The messages from primary caregivers, and the mass media in babyhood and childhood through to adulthood, can validate, promote and value, or conversely dismiss, marginalise, ignore or criticise aspects of us and our lives. We can learn self-importance and value or conversely embarrassment, guilt and shame.

The hierarchies existing in society mean we are all put into compartments of worth. People thus exist in status positions from high to low based on factors like age, class, ability, gender, race, sexuality or body image. Because these various hierarchies exist, people can be oppressed in one system but not in another. People can also live with multiple oppressions working together. For some hierarchies there is the possibility of movement up or down, such as class or ability status but for other hierarchies, such as gender, race or age, it is difficult or impossible to move.

The result of these socially derived hierarchies means that we can have an elevated or a deflated self-identity. Those viewed as having less valued qualities can struggle to value in themselves what is socially criticised. As a psychotherapist I am interested in how people arrive at their self-image and identity.

Recently in a national newspaper personal ads section, I noticed how people dealt with social oppression when describing themselves to a prospective mate, such as – ‘50 year old woman young for my age; disabled male but not a wheelchair user; straight-acting gay man; slim looking size 18 lady; light-skinned Jamaican woman with good (meaning straight) hair, Beyoncé look alike’.

I am a black, bisexual, physically disabled, 48 year old woman and I know when people meet me they often come with a range of negative stereotypes. Throughout my life I have been judged negatively and I have feared for my personal safety because of the attitudes of others. I have felt vulnerable, frightened and unattractive because of these assumptions and criticisms.

I remember at the age of 10 (along with all of my black female friends) feeling unattractive because I didn’t have a fringe or silky hair like my white friends. We had all learnt from the media and our socialisation that our black hair was unacceptable. This is an example of self-hate based on oppressive forces.

It wasn’t until the start of my black feminist politicisation in my late teens that I began to view my African hair and facial features positively. These issues are still common place today for women of African descent because we rarely see ourselves with our African features viewed attractively or positively by society. People do not aspire (even with gallons of fake tan) to have non-European facial features. In the modelling world for example, the current phrase is: we want black women to look like white women dipped in chocolate; this is the standard for most black models today throughout the modelling world. Likewise in South-East Asia, the value given to people with round, large (Western eyes) has meant an explosion in double-eyelid surgery in these countries to attain the desired look.

I have been a qualified and accredited psychotherapist in private practice for 12 years. Throughout my various psychotherapy trainings and my own personal psychotherapy, I have never had the area of social oppression mentioned as a mental health stress factor. Like society in general, no one saw oppression and its expressions as causing psychological trauma and no one wanted to look at themselves and their positions of privilege within this social system. Consequently to ‘succeed’ in training I had to leave a large part of me outside the room.  I was marginalised, criticised, ridiculed or ignored if I brought all of me to my training or personal therapy.

This unfortunately was still the case when I chose to see a black female psychotherapist. She had learnt the rules about what was ‘psychologically based’ and oppression was not on her list. Often I contemplated leaving my course because I felt invisible and silenced. Other students were allowed to bring more of themselves to large and small group sessions but I was always watchful about how connected I could be to my pain and life struggles for fear of being trivialised, misunderstood or generating anger in others. I also wanted to protect the image of black people who are already viewed problematically in our society.  This was and is debilitating and very stressful.

European derived mental health professions, that is, psychotherapy, counselling and clinical/counselling psychology, for example, individualise mental illness by making mental illness a pathology of the person alone. People are mentally ill because they are not well and therefore need psychological treatment ranging from voluntary psychotherapy, counselling or/and GP prescribed medication to being forcibly detained under a mental health section with more harmful medication and ‘treatments’. From my experiences, often these are prescribed by oppression supporting, uninterested or phobic hospital psychiatrists on mental health wards or secure hospitals.

The mental health system throughout history has medicalised, condoned and ‘treated’ oppressed communities by assumed beliefs about our inherent inferior and unstable nature, for example  with regard to women, gay, black, working-class and disabled people. It is well documented in the UK, Europe and the USA, that oppressed communities, in particular black people, are over-represented and over medicated in psychiatric institutions. Professions would rather view oppressed groups as inherently pathological, rather than see social oppression as having any relevance to our personalities. I want the mental health system to change from the current model that mirrors society and therefore supports and sustains social injustice and human suffering.

A radically new approach where oppression in society is firstly acknowledged then understood as a central factor in our mental functioning should inform all mental health organisations and services ranging from GP surgeries, psychiatric institutions through to the counselling and psychotherapy consulting room.  My question is whether we want the current mental health system based on social control to continue or whether we want to work towards social liberation and justice for all.

Olukemi Amala ( currently lives and works in North East Scotland. She previously lived in London where she worked as a psychotherapist and has been employed in the mental health field for over 20 years. Her debut novel, Under an Emerald Sky (2011), addresses many themes relevant to mental health and social oppression. Next year, she will be undertaking postgraduate psychology study and research at Manchester Metropolitan University.

Alongside her studies she will be developing her private practice, the Amala Centre, which approaches psychotherapy, training and supervision with an understanding of the significance of social oppression on mental health. More information is available at: