Three and a half years ago I faced a dilemma. Should I stay in Edinburgh, a city I had fallen in love with and come to call home, to complete my doctorate training as a Clinical Psychologist, or relocate to London?
To some friends and colleagues, it seemed an obvious decision: stay in Edinburgh, as it was closer to my support network and with a cheaper cost of living than London. But lingering underneath my dilemma was the question of where I would best feel supported as a black woman within the profession of psychology.
As an undergraduate psychology student in Edinburgh, I had known of only one other black student on my course – and he was an African American exchange student, joining us for just one semester. This was significant because for four years I had sat among mainly white peers, listening to white lecturers, discussing a catalogue of predominately white Western, male psychologists.
In such surroundings it was hard not to feel alone, an outsider. And so, although Edinburgh was a place I considered home, it was also a place where I often felt alienated from those around me. I had idealised London, as many people do, as a melting pot of multiculturalism.
Professionally, I had hoped my experience there would be an opportunity to explore alternative understandings of mental distress which acknowledge the effects of social inequalities, such as racism and sexism. I remember these hopes being at the forefront of my mind as I weighed up the pros and cons of the two cities and, after much thought, I chose to relocate.
One of the first things that struck me as I walked into my class on my first day at a London university was that I wasn’t the only black person in the room, which was unbelievably comforting but such a rare experience for me. Even more startling, given my previous experiences in education, was the presence of black lecturers and Experts by Experience, delivering the training.
However, I soon learned that my romanticised ideal of the London bubble was untrue as, in reality, inequalities still prevailed. For one, although our cohort was more ethnically mixed than my undergraduate lecture theatres in Edinburgh had been, it still did not reflect the diversity of the people in the university’s surrounding boroughs of East London.
Racism didn’t suddenly disappear, but became more covert; the subtle microaggressions that are hard to ‘prove’, particularly to those intent on denying that it is a reality today.
Psychology has a chequered history in relation to racism, and unfortunately it is not all in the past, but at least in London I had a network of other black and Asian trainees to discuss these experiences with. I had new opportunities to work alongside service users from diverse backgrounds, not just in terms of ethnicity, but also gender identity, sexuality, religion and spirituality.
Nearly four years later, I still vividly remember the first black person I worked with, a young woman who spoke about the impact of colourism on her mental health, a conversation that may not have happened had I been a white therapist sat opposite her. It was moments like these that reaffirmed my decision to relocate to London.
During those three years, I nurtured my interest in the links between racism and poor mental health, an area of interest that I would have struggled to pursue in the predominately white mental health services of Edinburgh.
Outside of work, London offered many other opportunities too. Socially, I was introduced to cultural networks such as Black Girl Book Club, gal-dem and the Black Theatre Club, all groups led by amazing young women, dedicated to opening doors to areas of the arts not typically enjoyed by people of colour.
I’m aware of the hugely positive impact these groups have had on my own mental health, and this was a topic often explored with other women I met. Being part of these networks was an opportunity to feel seen and understood in ways that Edinburgh never truly offered. And yet, despite these opportunities, last year I chose to move back to Edinburgh. This time it felt like less of a dilemma as I was keen to return with my new skills, knowledge and the confidence I developed during my growth period in London.
Since returning to Edinburgh, I am even more struck by the lack of diversity. This year’s International Women’s Day theme #EachForEqual has led me to reflect on how unequal access is to important healthcare, as well as cultural and social opportunities for women across the UK. As a Psychologist, I am not the first to argue that access to mental health services is unequal, and even harder for those from black, Asian and minority ethnic backgrounds.
However, what I am acutely aware of is how unequal that access is across the UK. In my experience, the few mental health groups dedicated to addressing these racial inequalities, whether they are NHS services or voluntary sector initiatives, are concentrated in and around London.
It seems the further North one moves, the more these ethnically and culturally inclusive opportunities tail off, becoming a postcode lottery where people are disadvantaged simply for living further afield.
Leaving my London bubble, where so many opportunities were on my doorstep, just heightens my awareness of inequalities. Although I now feel settled in Edinburgh, I also face new dilemmas, about how to implement my passion to understand mental health inequalities within systems. Within the systems in which I work, and where these inequalities feel insurmountable.
On my optimistic days, I’m encouraged by the knowledge that there are amazing women with similar passions like myself, making great strides on tackling ethnic inequalities within systems outside of London. My next job is to find and connect with them.
Cassandra Addai is a newly qualified clinical psychologist, having recently completed her training at the University of East London. You can read her full bio here.