Aggrey Burke

Aggrey Washington Burke (FRCPsych, born 1943) is a British retired psychiatrist and academic who spent the majority of his medical career at St George's Hospital in London, UK, specialising in transcultural psychiatry and writing literature on changing attitudes towards black people and mental health. He has carried out extensive research on racism and mental illness and is the first black consultant psychiatrist appointed by Britain's National Health Service (NHS).

Aggrey Burke

FRCPsych
Aggrey Burke in 2006 at New Beacon Books
Born
Aggrey Washington Burke

1943 (age 77–78)
Saint Elizabeth, Jamaica
NationalityBritish
EducationUniversity of Birmingham
OccupationPsychiatrist
RelativesSyd Burke (brother)
Medical career
Institutions
Sub-specialtiesTranscultural psychiatry
Research
Notable works"Racial and Sexual Discrimination in the Selection of Students for London Medical Schools" (1986)

During his early career, Burke conducted studies on the mental health of repatriates at Bellevue Hospital, Jamaica, and concluded that repatriation caused significant psychological harm. While in Jamaica, he authored the earliest epidemiological report on schizophrenia in the Caribbean. In 1976, having returned to the UK, Burke published works on attempted suicide in immigrant Irish, West Indian and Asian people in Birmingham. In the early 1980s he carried out psychotherapeutic work with bereaved families following the fire at a house in New Cross in which 13 young black people died.

Burke's work throughout the 1980s demonstrated how deprivation is associated with mental illness in some black communities, and revealed prejudices that affect mental health care in these groups. He questioned the significant number of young black males in some locked secure hospital wards, a number who he said require treatment rather than restraint, and he looked at the role of the families of black and Asian people with mental illness.

In 1986, together with Joe Collier, they wrote a "groundbreaking" paper for the journal Medical Education, which concluded that "racial and sexual discrimination operate when students are selected for medical education at London colleges".[1] It was followed by an enquiry by the Commission for Racial Equality (CRE) and the publication of its report in 1988, which led to changes in admissions processes.

Early life and education

Aggrey Burke was born in 1943 in Saint Elizabeth, Jamaica,[2][3] where he had his early education.[4] His father was Revd Eddie Burke[5] and his grandmother was Emily Watts, who ran a kindergarten.[2] He is one of six siblings, the eldest of which was Syd Burke, who became a renowned photographer and journalist.[2][6] In 1959, while still a teenager, Burke moved to Britain. Subsequently he gained admission to study medicine at the University of Birmingham, where he was captain of athletics, and from where he graduated in 1968.[3][4]

Early career
University of the West Indies; Mona Campus

In 1968 Burke returned to Jamaica to complete his early clinical training.[4] That year, the political activist and academic Walter Rodney noted in his memoirs, that Burke was posted at the University Hospital, Mona, Jamaica.[7] After one year he moved to Port of Spain, Trinidad and Tobago, as part of a psychiatry training programme.[4] In 1971, he was noted to be back at the University Hospital in Mona as a registrar and elected member of the Psychotherapy and Social Psychiatry Section.[8]

During his time in Jamaica, Burke conducted studies on the mental health of repatriates at the psychiatric hospital Bellevue Hospital, noting that a significant number of admissions were repatriates from England.[9][10] He reported that 20 per cent had been sent from the high-security psychiatric unit Broadmoor Hospital, the majority had not wished to return to Jamaica and most were diagnosed with paranoia, despite Burke noting that they lacked any delusions with regards to discrimination based on skin colour. He described the stigma of failed migration and the "feelings of persecution and negative behaviours" associated with repatriation as a specific psychological event, and as a result coined the term "repatriate syndrome".[10][11] Burke calculated that one in four would die, and concluded that repatriation was a "gross social insult", caused significant psychological harm and had no therapeutic benefit.[10] He wrote about suicide in Trinidad and authored the earliest epidemiological report on schizophrenia in the Caribbean.[12] One of his studies looked at venereal disease at the Bellevue Hospital, with particular concern for those people with previous inadequate treatment with penicillin.[13]

Psychiatry in the UK
St George's Hospital, London

In 1976, having returned to the UK to complete his psychotherapy and psychiatry training as a research fellow in the Department of Psychiatry at the University of Birmingham, he wrote a series of papers on attempted suicide in immigrant Irish, West Indian and Asian people in Birmingham, comparing the rates to the local population and to that in the countries of origin of these groups.[4][14][15] Subsequently, he presented his findings at the 6th World Congress of Social Psychiatry.[16] In 1977, he was appointed senior lecturer in psychiatry at St George's Hospital in Tooting, London.[17] He later became the first black British person to be appointed by the NHS as a consultant psychiatrist.[3] In 1985, he was noted to be Britain's only "leading" black psychiatrist.[18] By 1988, there were two Caribbean psychiatrists in the NHS.[19] He is a Fellow of the Royal College of Psychiatrists.[17]

Burke's work has included writing on changing attitudes towards black people and mental health,[20] research on the role of racial discrimination in psychiatric disorders,[21] and how racism can lead to mental illness.[21][22][23] At an oral history seminar in 1981, organised by Lambeth Community Relations Council, Burke stated: "If you are black, and working class, there are much greater chances of being compulsorily admitted to hospital under a section of the Mental Health Act, going to a special hospital and sometimes being repatriated."[24] In April of that year, following the Brixton riots,[25] he co-founded "The Ethnic Study Group", which dismissed diagnoses of "Balham psychosis, New Cross psychosis, West Indian psychosis and Migration psychosis".[26]

His work has shown how deprivation is associated with mental illness in some black communities, and revealed prejudices that affect mental health care in these groups.[27] Later, he addressed the notion that psychiatric reports for courts show an "obsession with blacks being bad, big blacks somewhat worse, and big black males – particularly those that have had any contact with the police – as the most dangerous of all cases".[28] He simultaneously questioned the significant number of young black males in some locked secure hospital wards, a number who he says require treatment rather than restraint, stating in one interview that "this is partly due to seeing blacks as dangerous. There is this mind-set that the black population is tricky, difficult to deal with. The Government has not attempted to understand the root issues which are poverty and deprivation."[29]

In the early 1980s Burke carried out psychotherapeutic work with bereaved families following the New Cross house fire[30] that killed 13 young black people on 18 January 1981, with one survivor committing suicide two years later.[31] Burke has also looked at the role of families of black and Asian people with mental illness, and advocated the importance of treatment within a family context.[32] When treating West Indian people with mental illness, he used his familiarity with key Jamaican role models including Marcus Garvey, Bob Marley and the Rastafarian movement.[27] In one study concerning black people in Birmingham, he reported a 100 per cent response rate once it was made aware that the research team were also black.[28] He wrote on the limitations of one-to-one counselling in Afro-Caribbean people with mental illness when a significant contributory factor to their condition was family stress, and that a positive outcome was strongly influenced by the family-patient interaction.[32]

His 1984 study of West Indians in Aston, Birmingham, showed they experienced a high percentage of psychosomatic symptoms and an underdiagnois of depression.[33] In the same year, he demonstrated that African Americans who experienced racism also reported feelings of "intrusion and avoidance".[34]

Medical school admissions

In 1986, together with clinical pharmacologist Joe Collier, when both were senior lecturers at St George's, wrote a "groundbreaking" paper for the journal Medical Education, entitled "Racial and sexual discrimination in the selection of students for London medical schools".[35][36][37] After examining the female to male ratio and the names of students taking final examinations at 11 London medical schools, they concluded that "the results of this survey suggest that racial and sexual discrimination operate when students are selected for medical education at London colleges".[1][38]

The Commission for Racial Equality (CRE) was subsequently made aware that software used for medical-school admissions selection at St George's was creating a lower score for women and those with non-European names so reducing their chance of being called for interview.[37][39] Following an enquiry, the official CRE report (1988) confirmed Burke and Collier's findings and also questioned what might be happening in other London medical schools; St. George's already had a higher than average intake of students with non-European names.[1][36][37] As a result of their work, both Burke and Collier were initially shunned within their institution, but changes were subsequently made to admissions policies.[35][37][40]

Later life

Unlike others of his experience Burke never received a professorship.[35] He remained at St George's until his retirement, following which he continues with work in psychiatry, writing on black mental health issues and assisting the General Medical Council.[3][35] He also continues to speak and lecture in the UK and abroad.

In 1994, he gave the Martin Luther King Memorial Lecture entitled "In Search of Freedom".[4]

In February 2010 he was the keynote speaker at the 5th Annual Huntley Conference, which was on the theme "Young, Black and British: Identity and Community through the generations" and was held at London Metropolitan Archives, where he explained how the supplementary school movement gave new immigrants a sense of being Caribbean.[41][42]

In April 2016 Burke looked back at some of his own work at a public meeting at London's Learie Constantine Centre (sponsored by Brent Patient Voice and Brent MIND) on the topic "Race and Mental Health: are black communities getting a fair deal?" and, in the context of race, ethnicity, class and trauma, reflected on the statistics that show that young black men may be five times more likely than young men from other groups to be diagnosed with severe schizophrenia. In light of his figures on the wide differences between the various Caribbean islanders, collectively referred to as Afro-Caribbean, he has questioned this categorisation.[43]

Other roles and honours

Burke's other roles have included being the president of the Transcultural Psychiatry Society (TCPS), which focused on issues of culture and race in British mental health services.[3] The society expanded under his leadership and that of Suman Fernando.[44][45] In 1984 Burke chaired a symposium organised by the TCPS on the theme "Mental Health and Apartheid".[46]

He was also appointed the vice-chair and a trustee of the George Padmore Institute,[47][48] an archive, educational, research and information centre that was founded in 1991 by John La Rose together with a group of political and cultural activists connected to New Beacon Books.[49]

Burke is an active member of the International Association for Suicide Prevention and teaches on suicide awareness programmes.[17]

In October 2019, he was one of three psychiatrists to appear on a Royal College of Psychiatrists poster for Black History Month.[35]

Burke was named on the 2020 list of 100 Great Black Britons.[50][51][52]

Also in 2020, Burke was one of the seven recipients of the President's Medal from the Royal College of Psychiatrists,[53][54] awarded at a virtual ceremony in November.[55]

Family

Burke's eldest brother was the pioneering photographer, broadcaster and journalist Syd Burke (1938–2010).[6] Their father Revd Eddie Burke, who died on 3 July 2000 at the age of 91, was described in the Newsletter of the George Padmore Institute as a "a leading figure in the modern history of Jamaica".[5]

Selected publications

Articles

Book chapters

References
  1. "Introduction". Medical School Admissions: Report of a Formal Investigation Into St. George's Hospital Medical School. Commission for Racial Equality. 1988. p. 5. ISBN 978-0-907920-94-6.
  2. Harris, Roxy; Sarah White, eds. (1999). Changing Britannia: Life Experience with Britain. New Beacon Books. p. 99. ISBN 9781873201152.
  3. Vernon, Patrick. "Celebrating 9 Overlooked Figures From Black British History". Black Cultural Archives. Retrieved 23 June 2020.
  4. "2019 IASP CaribbeanRegional Symposium; Speakers". www.ivvy.com.au. Hilton Trinidad and Conference Center. 2 May 2019. Retrieved 2 July 2020.
  5. "The George Padmore Institute" (PDF). George Padmore Institute Newsletter. 5 December 2000. Retrieved 29 June 2020.
  6. Zamani, Kubara (29 August 2010). "Nubiart Diary – Arts Obituaries". Ligali. Retrieved 29 June 2020.
  7. Lewis, Rupert (1994). "Walter Rodney: 1968 Revisited". Social and Economic Studies. 43 (3): 44. ISSN 0037-7651. JSTOR 27865974.
  8. "Report of the Psychotherapy and Social Psychiatry Section" (PDF). The British Journalisms of Psychiatry; Supplement: 20. April 1971.
  9. Burke, A. W. (July 1973). The British Journal of Psychiatry. pp. 110–111.
  10. Bailkin, Jordanna (2012). "1. The birth of the migrant; pathology and postwar mobility". Afterlife of Empire. University of California Press. p. 42. ISBN 978-0-520-28947-5.
  11. Bagley, Christopher (1975). "Sequels of Alienation; West Indian Migrants in Britain". In Willem Adriaan Veenhoven (ed.). Case Studies on Human Rights and Fundamental Freedoms Volume Two: A World Survey. 2. Martinus Nijhoff Publishers. p. 63. ISBN 90-247-1779-5.
  12. Hickling, Frederick W. (November 2005). "The epidemiology of schizophrenia and other common mental health disorders in the English-speaking Caribbean". Revista Panamericana de Salud Pública. 18 (4–5): 256–262. doi:10.1590/S1020-49892005000900005. ISSN 1020-4989. PMID 16354422.
  13. Current Literature on Venereal Disease. Center for Disease Control, Bureau of State Services, Venereal Disease Control Division. 1973.
  14. John Royer (1977). Black Britain's dilemma: a medico-social transcultural study of West Indians. Tropical Printers. p. 167.
  15. Helman, Cecil G. (2014). Culture, Health and Illness: An Introduction for Health Professionals. Butterworth-Heinemann. ISBN 978-1-4831-4139-8.
  16. Burke, Aggrey W. (April 1980). "Classification of Attempted Suicide From Hospital Admission Data: A follow-up study among Asian and West Indian patients in Birmingham Paper read at: 6th World Congress of Social Psychiatry Opatija, October 4-10 1976". International Journal of Social Psychiatry. 26 (1): 27–34. doi:10.1177/002076408002600104. ISSN 0020-7640. PMID 7399821.
  17. "Plenary and Special Lecturers' Biographies". Book of Abstracts, Programme and Presentation Speakers. 3rd IASP Caribbean Regional Symposium, Port of Spain, Trinidad.
  18. Lister, John (Ed). "Chapter 4. The Victims". Cutting the Lifeline. New York; Journeyman (1988). p. 89. ISBN I85172026X
  19. Richard Skellington (1996). "5.5. Racial inequalities in the NHS: doctors, nurses and ancillary staff". 'Race' in Britain Today. London: SAGE Publications. p. 118. ISBN 0-7619-5049-4.
  20. Mckenzie-Mavinga, Isha (2020). "28. Engaging with Radicalized Process in Clinical Supervision: Political or Personal". In Majors, Richard; Carberry, Karen; Ransaw, Theodore (eds.). The International Handbook of Black Community Mental Health. Emerald Group Publishing. ISBN 978-1-83909-965-6.
  21. Brown, T. N.; Williams, D. R.; Jackson, J. S.; Neighbors, H. W.; Torres, M.; Sellers, S. L.; Brown, K. T. (2000). "Being Black and Feeling Blue: The Mental Health Consequences of Racial Discrimination" (PDF). Race & Society. 2 (2): 117–131. doi:10.1016/S1090-9524(00)00010-3.
  22. Kabir, Shameem (2016). "6. lesbians come out on Celluloid; Rage and Trauma as Subtext". Daughters of Desire: Lesbian Representations in Film. Bloomsbury Academic. pp. 151–152. ISBN 978-1-4742-9047-0.
  23. Lewis, Glyn; Caroline Croft-Jeffreys; David Anthony (September 1990). "Are British Psychiatrists Racist?". The British Journal of Psychiatry. London. 157 (3): 410–415. doi:10.1192/bjp.157.3.410. PMID 2245273. Retrieved 24 June 2020 – via ProQuest.
  24. "Oral Histories; Mental Health and Black People". The Struggle For Race Equality: An Oral History of the Runnymede Trust, 1968–1988. Runnymede Trust. Retrieved 28 June 2020.
  25. A. Bhat; A. Burke; W. Falkowski; et al. (1 March 1984). "The Causes of and Solutions for Rioting in Britain in the Summer of 1981". International Journal of Social Psychiatry. 30 (1–2): 4–8. doi:10.1177/002076408403000102. PMID 6706493. S2CID 29857591.
  26. Maharajah, Hari D. (2000). "Afro-Saxon psychosis or cultural schizophrenia in African--Caribbeans? What next?" (PDF). Psychiatric Bulletin. 24: 96–97. doi:10.1192/pb.24.3.96.
  27. Blair, Thomas L. (25 November 2017). "AFIYA -- Nothing Black is Alien to Us | Chronicle World's Weblog". Retrieved 24 June 2020.
  28. Fernando, Suman (2015). "3. Cross-cultural Research". Race and Culture in Psychiatry (Psychology Revivals). London and New York: Routledge. pp. 80–84. ISBN 978-1-138-83958-8.
  29. Goodchild, Sophie (28 September 2003). "Blacks failed by our 'racist' system of care for mentally ill". The Independent. Retrieved 24 June 2020.
  30. Littlewood, Roland; Lipsedge, Maurice (1997). "12. The development of 'transcultural psychiatry' in Britain 1982–1996". Aliens and Alienists: Ethnic Minorities and Psychiatry. London and New York: Routledge. p. 264. ISBN 0-415-15724-2.
  31. Bowcott, Owen (3 February 2004). "Inquest begins into 14 victims of 1981 fire". The Guardian. Guardian News and Media. Retrieved 10 July 2020.
  32. Banks, Nick (2019). White Counsellors – Black Clients: Theory, Research and Practice. Routledge. p. 6. ISBN 978-0-367-07510-1.
  33. Smith, Barbara Fletchman (2018). Mental Slavery: Psychoanalytic Studies of Caribbean People. Routledge. p. 83. ISBN 978-0-429-90198-0.
  34. Alexander-Delpech, Paula (28 August 1997). "An investigation into the lived experiences of racism among African-American nurses". FIU Electronic Theses and Dissertations. doi:10.25148/etd.FI13101572.
  35. Gulliver, John (18 October 2019). "Psychiatrist who started a quiet revolution in medicine". CamdenNewJournal. Retrieved 23 June 2020.
  36. Lowry, Stella; Macpherson, Gordon (5 March 1988). "A blot on the profession". British Medical Journal. 296 (6623): 657–658. doi:10.1136/bmj.296.6623.657. PMC 2545288. PMID 3128356.
  37. Cassidy, Jane (1 August 2009). "Name and Shame" (PDF). British Medical Journal. 339: 267. doi:10.1136/bmj.b2693. PMID 19633039. S2CID 6830670.
  38. Collier, J.; Burke, A. (March 1986). "Racial and sexual discrimination in the selection of students for London medical schools". Medical Education. 20 (2): 86–90. doi:10.1111/j.1365-2923.1986.tb01052.x. ISSN 0308-0110. PMID 3959932.
  39. Paul Iganski; David Mason (2018). Ethnicity, Equality of Opportunity and the British National Health Service. Routledge. p. 135. ISBN 978-1-138-72873-8.
  40. Gulliver, John (20 February 2020). "Roots of racism in a hallowed profession". Islington Tribune.
  41. "Community Events – The 2010 Annual Huntley Conference: Young, Black and British: Identity and Community through the Generations". Ligali. Retrieved 10 July 2010.
  42. Foot, Tom (11 February 2010), "The campaign for classroom equality and ethnic identity". Archived 12 March 2016 at the Wayback Machine, Camden New Journal.
  43. Sharp, Robin (6 May 2016). "Race and mental health talk stirs emotions". Brent Patient Voice. Retrieved 10 July 2020.
  44. Moodley, Roy; Ocampo, Martha (2014). Critical Psychiatry and Mental Health: Exploring the work of Suman Fernando in clinical practice. Hove, East Sussex: Routledge. p. 249. ISBN 978-1-138-01658-3.
  45. Fernando, Suman (2004). Cultural Diversity, Mental Health and Psychiatry: The Struggle Against Racism. Routledge. ISBN 1-58391-253-3.
  46. Burke, A. W. (1985). "Mental Health and Apartheid: World Psychiatric Association Conference Report". The International Journal of Social Psychiatry. 31 (2): 144–148. CiteSeerX 10.1.1.915.9165. doi:10.1177/002076408503100208. PMID 2861171.. Downloaded from isp.sagepub.com at Pennsylvania State University 11 May 2016.
  47. "George Padmore blue Plaque Unveiling & Reception | George Padmore Institute". www.georgepadmoreinstitute.org. Retrieved 25 June 2020.
  48. Thomas Johnson, Amandla (21 July 2015). "Preserving Britain's Black Heroes". Institute of Race Relations. Retrieved 29 June 2020.
  49. "About the George Padmore Institute". LKJ Records. 17 December 2008. Retrieved 9 July 2020.
  50. "Black Britons who helped shape Britain – 100 Great Black Britons 2020". Patrick Vernon. Retrieved 7 December 2020.
  51. Lubin, Rhian (11 September 2020). "Black heroes who helped shape Britain - from Queen of the Ivories to a Tudor trumpeter". Daily Mirror.
  52. "100 GREAT BLACK BRITONS - THE BOOK". 100 Great Black Britons. Retrieved 7 December 2020.
  53. "Honorary Fellows and President's medal winners accept awards at virtual ceremony". Royal College of Psychiatrists. 19 November 2020. Retrieved 7 December 2020.
  54. "Roll of Honour July 2020" (PDF). Royal College of Psychiatrists. 2020. Retrieved 7 December 2020.
  55. "President's Medal and Honorary Fellows awards". Royal College of Psychiatrists. 2020. Retrieved 7 December 2020.
  56. Cited in Bailkin (2012), Bibliography, p. 316.
  57. "Book reviews; Transcultural Psychiatry" (PDF). Postgraduate Medical Journal: 317. 1 April 1987.

Further reading
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