Senior Occupational Therapist in Stroke, Imperial College Healthcare NHS Trust
For those who did not catch my Equity Diversity and Belonging (EBD) Insight session on EDB incident reporting, the core concept of my project highlights the under reporting of racist and discriminative incidents within the NHS. Whilst there are many factors that underpin the barriers to formal incident reporting, not reporting these incidents gives a false picture of the realities of how frequent these incidents occur. It is my belief that with increased reporting, the data will do the talking for itself in becoming a driving factor for cultural change and a wrecking ball to dismantle institutional barriers.
Whilst it is evident that EDB incidents occur across the protected characteristics the focus of this blog will be on the Black experience in tribute to Black History Month. Here, I have provided my personal reflections of barriers to achieving true equity, diversity and belonging as a Black Occupational Therapist.
Equity of Opportunity
It will not come as a surprise, that Allied Health Professionals (AHP) have one of the lowest percentage of non-white workforce within the NHS. It is important to note that many institutions have begun work to dismantle barriers that may prevent prospective Black students from applying for courses such as occupational therapy, but there is still work to be done. Reflecting on my own journey into occupational therapy, I was confronted with stereotypes of it being a profession for “the white middle class woman”.
Whilst this perspective was not necessarily coming directly from other occupational therapists, its diversity profile did not provide a strong counter argument. Subsequently, at the start of my career I had limited interaction with other Black occupational therapists at any seniority level. This resulted in little availability of role models who looked like me to look up to. Therefore, my understanding of the Black occupational therapy experience was largely limited to my own experiences.
I landed an opportunity to participate in a talk for Black occupational students on the realities of the profession. This was my first opportunity to be in a space where I could reflect on the collective experience of life as a Black occupational therapist. In this space, I was confronted with multiple accounts of direct racism within the placement setting largely against students with non-British accents.
The main theme that unpinned their experiences was that they felt largely unsupported by the placement educators which created an unsafe learning environment with a negatively skewed power dynamic. Whilst I have experienced racism directly in my career, mainly coming from the patient population, I also acknowledge my privilege compared to other occupational therapists from the Black community-particularly those who have a non-British accent. Whilst it is positive that institutions are actively encouraging students from diverse ethnic background, it is counterproductive if we do not dismantle the institutional racist structures that oppose equity of opportunities for our Black students.
Black is diverse
The Black experience within itself is diverse. It is not accent alone that provides diversity of the Black experience but also cultural backgrounds and heritage. The experience of racism and the impact of institutional events does create a sense of shared experience within the Black community however, I personally feel that being “Black” should not only be limited to this. The diversity of Black culture should be celebrated and embraced.
Those from direct African heritage have a diverse history in comparison to those from a direct Caribbean heritage and even within those regions there are variations of cultural norms and traditional practises. Whilst it would be difficult to explore every single Black cultural background, at a minimum it is imperative to appreciate that the Black experience is not singular. Whilst Black history should not be limited to colonialism and slavery it is important to be self-educated on this history from the perspective of those who were colonised and not the colonisers. If we educate ourselves on this perspective, we will better understand the foundations of institutional racism and how to challenge the privilege that it gave to many non-Black communities.
Furthermore, the experience of “Black and Minority Ethnic (BME)” individuals is also diverse. Personally, I feel the term can be counterproductive to equity of opportunity. Here, the collective experience of everyone who does not identify as white is often swept together under the same umbrella which dampens the differentials of the Black experience. For example, if we look at the data for BME healthcare workers in senior roles, it is widely accepted that there is a discrepancy.
However, if you break down the data into separate ethnic groups it tells a very different story. If we look at the data for healthcare workers of Asian ethnic background compared to Black ethnic background, there are further discrepancies. This relates back to my previous point that interventions by institutions that explore these issues need to understand the specific challenges that each community is facing. It should also understand that power imbalance is not just exclusive to white vs “BME” communities but can also exist between different ethnic minorities.
Black does Belong
The general message that I have attempted to portray throughout my blog can easily be summed up into two points. The first is that the Black experience is diverse and the second is that more needs to be done to dismantle institutional barriers. By acknowledging these two concepts are the first steps in ensuring that we create a strong foundation of belonging for our Black occupational therapy colleagues.
By appreciating diversity and breaking down cultural and institutionally racist barriers will subsequently lead to a safer environment for Black occupational therapists to belong and be their authentic selves. A space that promotes belonging should be synonymous with one that is accepting of positive change and embraces differences.
Is Allyship the missing piece to the puzzle?
Most definitions of allyship generally lend themselves to a person in a position of power actively advancing the interests of marginalised groups in society. Whilst there are debates on the impact of allyship, I feel that it is important to reflect on how we define it as a term to ensure that it also does not reinforce power balance between ally and individual. The definition also should enforce the accountability of individuals to act against repressive systems but to also to act on personal bias and privilege.