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Contribution short abstract

Drawing on racialised encounters within UK NHS mental health services, this paper asks why healthcare bureaucracies elicit affective responses between humour and fury. How can the anthropological response move beyond the black and white and attend to what lies in-between such affects?

Contribution long abstract

What is it about healthcare bureaucracies that elicit affective expressions between humour and fury, and who are ‘the others’? This paper recounts racialised encounters with service users and clinicians in UK NHS mental health services, drawing on ethnographic research conducted by a team of anthropologists and clinicians on the UK’s recent randomised controlled trial of the psychiatric intervention ‘Peer-supported Open Dialogue’. As examples, what of the white service user who mocks refugees for gaining easier access to social housing than psychiatric service users, with her immigrant clinicians in the room agreeing? Or the black service user who refuses to recount the incommunicabilities of her refugee journey to the white clinician she casts as ‘interrogating policeman’? Or the mildly intoxicated clinician who quips at another for having ‘white male privilege’ during a residential training party? Or the team manager who announces that she actively recruits clinicians from a specific minority ethnic group, which angers those from other minority groups?

This paper argues that attending to what is between the humour and fury within such claims gleans anthropological insights that reveal not only complex manifestations of racism, but their intersections with other clinical and gendered hierarchies. How might the anthropologist/practitioner move through these multiple polarisations to stay curious and caring? This author’s multiple positioning as anthropologist, Open Dialogue practitioner and peer support worker translated into an affective response that was necessarily not ‘black and white’ and further, as a person of colour, she was often directly drawn into racialised relational dynamics.