**5. Attending to Western mental health sciences' existential crisis**

Even many interculturalists are concerned about the influx of non-Western migrants into Western civilisation. In 2015, the media began to report on a significant surge of migration throughout Europe because of, to quote Crastathis and colleagues, "...the accelerated conditions of war and state violence, which are inextricable from globalised capitalism, histories of colonialism, and contemporary imperialism" (p. 4) [34]. This particular influx of migrants and refugees was dubbed 'The Refugee Crisis' by the media. In Germany, Chancellor Angela Merkel's decision to extend an open-door policy was praiseworthy. Many people in many sections of German society exhibited welcoming, altruistic behaviour and attitudes. Meanwhile, *white* nationalist groups like The National Socialist Underground have already carried a series of racist murders of Persons of Colour, the Islamophobic Pegida movement gained popularity, and the rightist party Alternative für Deutschland (AfD) gained political ground in parliament [129, 130]. The emotive term 'crisis' in forced migration is not peculiar to this migration trend. Robinson questioned the term's use already in his 1995 article *The Changing Nature and European Perceptions of Europe's Refugee Crisis*. He believes that framing the concept of 'crisis' in the context of migration builds Europe up as the 'centre' of an imagined sanctuary, allowing European governments to enact draconian political control techniques under the guise of 'required security' [131, 132].

With this critique in mind, the declarative language of 'crisis' used in the context of migration is symptomatic of a political and existential crisis of privileged European citizenship [133]. In fact, the origins of the 'race' idea and the socially

constructed meaning of racism [134], as well as how ethnocentric theories have established methodological barriers to the care of racialised minorities [32], are at the heart of Western mental health sciences' existential crisis. The hegemony crisis is that the Western mental health sciences are openly biased. They favour quantification methodologies in a scientific paradigm that values positivism, causality, objectivism, and rationality. It fails to address that, in their attempts to distance themselves from philosophy and theology to be seen as a 'legitimate science', these disciplines neglect their own origin and have become positioned to produce and reproduce ethnocentric knowledge [91]. The crisis of legitimacy is the prevalent belief that these disciplines generate the most valid knowledge, with extended intercultural legitimacy and corresponding intercultural clinical utility, for all of humanity in their unadapted Western, academic, scientific formulations.

This existential crisis of ethnocentrism in the European-Europeanised American macro-culture of *whiteness*, that is, the Western mental health sciences, is a pervasive issue because: (1) for many people, *whiteness* is imperceptible, (2) the growth of capitalism required a *white*-racialised curriculum., (3) its cross-cutting nature lends itself too much to power, (4) we do not have to think since the *white* curriculum has already done it for us, (5) the academy's physical environment is based on *white* dominance, (6) *white* people are not the only ones 'included' in the *white* curriculum, (7) the *white* curriculum rests on a widely held belief, and (8) the *white* curriculum indoctrinates people into the belief that it is not proper if it is not *white* ([135], p. 643). The intercultural competency movement opposes the status quo by harnessing its conceptual nature, but it also needs a decolonial positionality in constructing an academic revolution against that *white* European and Europeanised American geopolitical milieu and its dominance. Western mental health science's existential crisis of conceptual problems impedes the cultivation of environments of belonging, for racialised students and employees, necessitating a resurgent and insurgent decolonisation of epistemological ethnocentrism [33].

The 'successes' or 'failures' of interculturalism lies outside the reach of sociodemographic methods to civic involvement without integrating a more deeply critical consciousness into a more socially engaged intercultural paradigm [136, 137]. As Bhattacharyya [138] reiterates, the problematic neglect of racism is embedded in many 'multicultural' approaches.

*"... is not about multiculturalism […] what this really is, is an attack on the claim that racism exists and shapes social outcomes, and as other (contributors) point out, this is a long-standing point of political debate and struggle. The most effective method of silencing a critique of racism is to argue that racism no longer exists. Those claiming to suffer from its consequences must be pursuing their own selfish agendas".*

*(cited in [136], p. 4).*

This statement alludes to the problem of colour-blindness among a majority of interculturalists positioned in normative *whiteness*, many of whom can understand and deal with concerns of gender and socioeconomic status outside of the topic of racism but cannot deal with the issue of racism. Colour-blindness refers to *white* people's denial, distortion, and minimisation of racism's reality and its negative impact on many aspects of neo-colonial/neoliberal democracy [139]. Colourblindness is a prevalent form of aversive racism that is part of "an epistemology of *white* ignorance" ([140], p. 37) [59, 141–145]. Aversive racism is a type of racism that is minor yet persistent and is often known as 'microaggressions'. The literature shows that microaggressions may have serious mental health repercussions for affected people [146]. Microaggressions such as colour blindness prevent persons

#### *Perspective Chapter: Cultivating Environments of Belonging in Psychiatry, Clinical Psychology… DOI: http://dx.doi.org/10.5772/intechopen.99925*

who are racialised Black and Of Colour from being heard. The erasure of Black and Brown knowledge and knowers in *white* institutional spaces is an epistemic injustice that excludes, represses, censors, abstracts, masks and conceals, which is why Gayatri C. Spivak posed the question "Can the Subaltern Speak?" [99]. People socially ascribed the subaltern position, that is, the racialised phenomenology of Black and Of Colour bodily experience, in other words, have long since struggled to have their voices heard, to have their experiences of racist injustices heard, all to no avail [99].

Feeling respected and treated correctly is fundamental to developing a sense of belonging in situations [147]. A sense of belonging and happiness are linked, and, unlike emotional alienation, belonging functions as a protective factor against mental health issues, including depression and anxiety [148]. Part of the efforts to eliminate structural racism is cultivating belonging settings on a structural level [149]. Workplace climate, which refers to a climate that encourages involvement with positive relationships, social connectedness, and mattering, is one of the most important aspects determining the ability of workplaces to cultivate settings of belonging on a structural level [150]. To this end, a decolonised workplace climate is a liberated space for ongoing learning, and it seeks a greater understanding of racialised employees' 'embodied feelings' [151]. In a decolonial framework, gaining a better understanding of racialised employees' 'embodied feelings' entails listening to their perspectives on ethnocentric mental health philosophy [152]. In epistemology, decoloniality is a fundamental questioning of a 'naturalised' and 'normalising' coloniality of knowledge/power/being/truth/freedom [153]. As concerns mount that evidence-based approaches established without proper embodied representation of those from the 'periphery' merely serves to reinforce structural racism. Belonging and inclusion are vital for performance-related outcomes at the service level:

*"...if there are no Black academics moving up, then you end up with a lot of precarious Black labour in universities, with no power and no ability to set an agenda or to even check an agenda that is being set" (Prof. Robbie Shilliams, cited in Richards [154]).*

On the one hand, decoloniality clarifies a shift in how coloniality is perceived: "from [the] occupation of land to [the] occupation of being", as Bulhan [109] puts it, but it also clarifies that the contemporary implications of structural racism from a historical point of view transcend time and place [155, 156]. As a result, recognising the impact of racism directed at the group to which people belong is at the heart of a decolonial framework of workplace belonging in mental health services. The most common unintended residue of modest but powerful political anti-racism advances in recent decades is the popularised, habitual dismissal of institutional racism as simply 'unconscious bias' [157–159]. In contrast, the phrase '(un)conscious bias' emphasises the fact that Western discourse frequently attempts to exploit the assumption that racism is a result of unconscious negative attitudes and behaviours. That in doing so it is hoped not to be held accountable through an "epistemology of *whit*e ignorance" ([140], p. 37). Thus, the term '(un)conscious bias' challenges the symbolic racism embedded in the language of non-responsibility [160]. Kilomba [161], in her book *Plantation Memories: Episodes of Everyday Racism*, explains how Western mental health science is a *white* space corrupted with deeply rooted and pervasive racism, all too often dismissed as simply '(un)conscious biases', and how this structural racism impacts the emotional safety of People of African heritage in a variety of everyday settings including in mental health services. Who gets published, gets funded, and sits on funding approval panels is influenced by these supposedly unintended '(un)conscious biases' [161].

Because mental health practices are evidence-based, '(un)conscious biases' in the generation of evidence result in '(un)conscious biases' persisting in the provision of mental health services [162]. Furthermore, it results in the diffusion of '(un)conscious biases' into the mainstream culture milieu. Because of the current popularity of political correctness, racist 'social imagination significations' psychically necessitate neglect of racism as epistemic and ontological '(un)conscious biases' which nevertheless still serves to oppress, control, and assimilate Black people and People of Colour [163]. It is not by chance that inappropriate and culturally insensitive instructions and curricula are developed, designed, and delivered; instead, the beneficiaries prescribe them [140]. The raison d'être of continued colonial pedagogical strategies is to socially engineer future generations of scholars and practitioners into a collective consciousness of '(un)conscious bias' to maintain the harmful effects of racist ontological order on structurally excluded, marginalised, and oppressed groups [164]. On the other hand, the eradication of imposed European ethnocentric identification of itself as the (political)intellectual, ideological standard defining global mental health is part of eliminating structural racism in Western mental health science [84, 165].

The mental health system is one structure within a network of national-level political institutions and political-cultural traditions that racialised individuals experience as sources of emotional suffering, humiliation, and intra-psychic conflict [166]. Structures they report that fails to recognise their worth regularly [167]. All too often, *white* mental health providers have rejected racialised patients' problems with racism as excessively sensitive impressions of events, rather than seeing these issues as a sign that something is wrong with the system [168]. At its core, colour-blindness is an epistemological weapon that obscures the connections between systemic racism, life chances, and mental health [169]. Aversive racism exists in a spectrum of structural racisms. However, it is less severe than more extreme racisms, such as ethnocentrism and biological racism [163, 170]. There is still a lot of mistrust, scepticism, resentment, and unhappiness among many racialised populations about mental health practitioner's ability to provide emotional safety in therapy. Threads of these emotions bind together to form significant hurdles to voluntary participation and early intervention for mental health problems [45].

#### **6. Conclusions**

Decoloniality is a framework for a more socially engaged intercultural paradigm that lays the groundwork for solidarity among postcolonial, indigenous, and decolonial alternatives to hegemonic Western epistemology in order to achieve a common purpose [171]. Makhubela [172] uses Zizek's Lacanian theory of ideology to apply European philosophy to South African scholarship to create culturally diversified intellectual capital in a powerful counter-hegemonic narrative. He warns against the complacency that comes with 'intellectual rebranding' in the name of decolonisation [173]. According to Makhubela [172], genuine decolonisation requires us to delve deeply into its many theorisations to understand how we can channel an 'embodied feeling for culture' to operationalise it as a long-term goal requiring more extensive, coordinated, and sustained political support. Because as Ratele et al. ([173], p. 5) has said,

*"...to paraphrase Audre Lorde [174], the coloniser's psychology cannot be used to decolonise the coloniser's psychology".*

#### *Perspective Chapter: Cultivating Environments of Belonging in Psychiatry, Clinical Psychology… DOI: http://dx.doi.org/10.5772/intechopen.99925*

In order to allow racialised people to have their voices heard in narratives about them, the quest for a genuinely global decolonial stance in mental health science must incorporate ideas presented by racialised people [84]. In what ways might interculturalist collaborators assist without adopting a saviour mentality or its trappings?


The dearth of decolonial intercultural competency, an issue connected to the provision of emotionally safe environments in mental health care for racialised people, is exacerbated by the underrepresentation of racialised professionals and the pervasive ethnocentric epistemology at all levels of academia. As many Black people and People of Colour perceive or experience, going into counselling and psychotherapy often entails relying on an ethnocentric culture for profound recognition of the most intimate components of the human situation. Decolonial interculturalism-informed orientations, theories, training practices and methodologies acknowledge the daily occurrences of racism at many levels, as well as the intersection of additional societal injustices, which forces Black people and People of Colour into a constant stressful state of "I am therefore I resist" in order to survive ([175], p. 208). When Black patients and Patients of Colour are supported to "discover, uncover and recover" their sense of humanity in counselling and psychotherapy, they find dignity ([176], p. 496). With decolonial intercultural competency and cultural humility, recognition entails seeing and understanding and strengthening positive connotations associated with positive racialised persons' identity consciousness [177, 178]. The effective elimination of structural racism is a moralised imperative within this decolonial intercultural perspective. Requiring a devotion to authenticity, humility and reflexivity.
