Contribution long abstract:

‘A panther lives in my body’. ‘An invisible force hit me and made me fall’. Strange sentences like these are common among migrant patients’ narratives: they express at once clinical issues and different ontologies. The aim of this contribution is to interrogate the political, epistemological, and clinical dimensions raised by mental suffering in the immigrant population.

The experience carried out at an ethnopsychiatric centre, the Frantz Fanon Centre (Turin-Naples, Italy) is a formidable laboratory for exploring what is revealed by other idioms of suffering and registers of traumatic memory. However, the encounter between immigrants and and health care institutions is often marked by a specific form of structural violence. We suggest calling it 'diagnostic racism.' This notion aims to highlight the use of diagnostic categories and therapeutic practices despite the clinicians’ ignorance of the patients’ histories, the cultural significance of certain behaviors, or simply their language. These acts can be interpreted as a particular expression of 'white ignorance' (Mills, 1997).

Such issues form the backdrop to a more general clinical-epistemic injustice, due to a double denial: the failure to acknowledge the role of social exclusion and institutional racism in the genealogy of crisis and alienation, and the denial of our ignorance. These remarks are meant to emphasize the importance of such critical epistemology for the agenda of radical ethnopsychiatry, but also for global mental health programs. They want to highlight a particular kind of ‘cultural-structural competency’ (Hansen & Metzl 2014), able to articulate political, historical-anthropological, and clinical dimensions of suffering.