Roma inclusion post-2020: we need to talk about racism and mental health
19 September 2019
Among the failures of the EU Roma Framework up to 2020, is the complete neglect of the impact racism has on the mental health and wellbeing of children and young people. Health in general was one more policy priority area where no discernible progress was made in closing the gap between Roma and non-Roma; and for all the worthy gestures about recognising antigypsyism, there hasn’t been a whisper about the toll everyday racism takes on the mental health of Romani children and young people. This must change: for Roma inclusion post-2020, we need to talk about how to remedy the damage done.
In its last report under the Roma Framework, the European Commission itemised some of the national strategy deficits with regards to health: “a notable lack of reference to antidiscrimination efforts; improving hygienic living conditions; and access to healthy food.” Other challenges included the ubiquitous lack of coordination between the national and local levels; concern about low vaccination rates and the lack of health insurance coverage among Roma; and an “insufficient knowledge of health professionals on Roma issues.” But again, not a word about what could or should be done to get the measure of or alleviate the crisis concerning the wellbeing of young Roma.
Racism is a direct cause of illness, and countering the impacts of racism must become a public health issue. The cumulative impact of racism and discrimination is especially damaging to children and adolescents. If combating antigypsyism is a serious commitment for a post-2020 Roma inclusion agenda, we need to talk about mental health.
Chronic racism, chronic stress and ‘embodied inequality’
It’s not as if there is any secret or lack of evidence of the damage racism does to the health of those at the receiving end. As Olivia Campbell wrote, a major contributor to the persistent and pervasive health disparities between black and white Americans is racism in various forms, and racist experiences in childhood are particularly damaging and the impact long-lasting in terms of health and wellbeing.
"A large and growing body of evidence indicates that experiences of racial discrimination ... can lead to adverse changes in health," according to David R. Williams, a professor of public health, sociology, and African-American studies at Harvard University. Chronic discrimination can cause chronic stress, which has been shown to disrupt almost all of the body's processes, leading to an increase in the risk of heart disease, anxiety, depression, and digestive, sleep, and cognitive problems. Higher rates of chronic stress are observed in minority populations across all socioeconomic levels.
Research focusing on young people discovered that racial discrimination during adolescence can produce long-lasting negative health effects by altering the body's natural cortisol rhythms. Dysfunctional cortisol levels are linked to fatigue, cardiovascular disease, and early mortality, as well as poor mental health and other cognitive problems. As researchers from the Center for Family Research at the University of Georgia explain “Coping with cumulative stressors elicits a cascade of biological responses that may be functional in the short term, but over time 'weather' or damage the systems that regulate the body's stress response.” The substantial body of research requires us to understand how racism becomes what social epidemiologist Nancy Krieger terms "embodied inequality."
What kind of hell?
If being on the receiving end of overt or subtle racism creates intense and constant stress, which boosts the risk of depression, anxiety and anger, what kind of hell on earth is endured by tens of thousands of Romani children in shacks, squats, and camps, vulnerable to the elements, exposed to random cruelties and deliberate discrimination right across the well-ordered democracies that comprise this continent of plenty? How do children fare, whose communities have come under mob attack, whose homes have been firebombed, whose parents have been assaulted or murdered? What must it be like for those Romani children in Italy, living in squalid segregated camps across the country, still victims of a state of emergency long suspended and ruled illegitimate by the courts?
Back in 2014, ERRC drew attention to the human cost of apartheid EU-style, where authorities place Romani people in camps on remote and inaccessible sites in squalid conditions, isolated from society. Our submission to the UN Human Rights Council in 2014, revealed how children raised in these camps - often under guard or video surveillance - were prone to a number of severe and debilitating conditions.
The report detailed how these children were more frequently born underweight than other children, and become ill with respiratory disease in greater numbers than their Italian peers. They suffer more often from poisoning, burns and accidents at home. There was a greater incidence of “diseases of poverty”, such as tuberculosis, scabies, and lice. The children exhibited high incidences of anxiety and sleep disorders, suffer from phobias, are hyperactive and have attention deficits, and have learning difficulties - conditions which “are also predictive of more serious disorders in adolescence and adulthood.”
If, as the science tells us, the anticipation of racism is enough to trigger a stress response, what must it be like for these kids five years on, after Matteo Salvini’s reign of hate and racist spite? What kind of mental stress must these kids have endured under the constant threat of racism, when the Roma community was singled out and scapegoated, ridiculed, threatened and disparaged by those who govern? What will be the long-term impact on these youngsters of the fear caused by far-right mobs screaming that they should be raped and burned? What will be the cumulative damage done by hate speech, racist disparagement and hostile media in blighting their young lives?
Everyday racism and mental distress
Beyond the atrocities, what threatens to destroy a young person’s self-esteem, what causes so much damage to their well-being, is the everyday racism, the routine segregation in schools, towns and villages; the policies that push Roma beyond the city limits, out of sight and out of mind. This everyday racism is legitimated by bigoted political mainstream politicians who regularly dis the Roma as the inherently criminal and permanently burdensome undeserving poor; or as Victor Orbán put it, a historically inherited burden ‘we’ have to live with.
Some sense of the crisis that is not being discussed, can be garnered from the situation in Ireland where desperation and feelings of hopelessness take a terrible toll on the mental health of the Traveller community. The extent of mental distress in Ireland is evident by the fact that the suicide rate among Travellers is six-times higher than that of wider society, with over 65 per cent of Traveller suicides occurring among those aged under 30. Dr Sindy Joyce, Traveller activist and member of the Council of State tweeted earlier this year:
“There is a deafening silence across this country on Mincéirí suicide. The intolerable pain of these young people, who saw death as their only option is being ignored. We are in a crisis, an epidemic that has been ignored for decades. Our trauma cannot continue to be dismissed.”
This sense of crisis is shared by the National Traveller Mental Health Network, launched in March 2019. Vice-chair Mags Casey said “the issues that affect all Travellers - such as racism and exclusion, matters relating to identity, sexuality, addiction, as well as employment, education and accommodation - have a profound impact on the community's mental health.” She pointed out that recommendations made over a decade ago for culturally inclusive mental health service provision have been ignored, and the situation has continued to escalate without any clear government plan to address this tragic crisis.
What is to be done post-2020?
The research would suggest there is a crisis around mental health and racism across Europe, and the national strategies that comprise the EU Roma Framework have been completely silent about the terrible toll of anti-Roma racism on the largest and youngest ethnic minority population in Europe.
A recent UN report found unsurprisingly that inequality remains a key obstacle to mental health globally: “Many risk factors for poor mental health are closely associated with discrimination and inequalities in the conditions of daily life. Many risk factors are also linked to the corrosive impact of seeing life as something unfair.”
So what is to be done? As psychiatrist Kwame McKenzie put it: “Despite general agreement that racism is wrong, there is little evidence of concerted initiatives to decrease its prevalence … Considering racism as a cause of ill health is an important step in developing the research agenda and response from health services.” This first step has yet to be taken by the architects of the EU Framework. For the post-2020 Roma inclusion agenda, the impact of anti-Roma racism on the mental health and wellbeing of Europe’s young and vulnerable citizens must rank as a priority.
Thirty years on, it’s worth recalling the 1989 UN Convention of the Rights of the Child, which proclaimed "the child shall enjoy special protection ... to enable him to develop physically, mentally, morally, spiritually and socially in a healthy and normal manner and in conditions of freedom and dignity." It is worth recalling precisely because the gap between the rhetoric and the reality is nothing short of obscene, and what is especially worrying is that things are even getting worse for many Romani children inside the European Union.
National governments who have ratified this legally binding convention, and signed up to the EU Roma Framework stand accused of failing in their obligations. The struggle to make a reality of these rights needs to be stepped up to prevent the loss of more young lives, and urgent policy responses are required to repair the damage caused to countless others by direct and indirect discrimination.
Post-2020 we need to deal with the cumulative impact of everyday racism on the mental health and wellbeing of Europe’s Roma. Recognition of antigypsyism as a specific form of racism by European institutions and national authorities, however belated, is a start; but beyond recognition there is a need for reparation, and that means making amends and taking concrete steps to deal with the damage done.