Issues relating to being from a BAME background within clinical practice

4.1.2.1 Working relationships.

Participants spoke about their working relationships with colleagues and supervisors and how being from a BAME background had an impact on these relationships. The majority of participants reflected on feeling more connected to other senior BAME professionals and how they were able to gain more support from these relationships than supervisory

relationships, which tended to be with White British individuals. This may have been in relation to the power imbalance present in terms of differing histories, privileges and oppression which is experienced by both parties (Patel, 2004). In addition to feeling more connected to BAME professionals, participants also spoke of how they felt little or no connection with their White peers, which has also been documented previously (Rajan & Shaw, 2008). This lack of connection may affect the way participants interacted with colleagues and may be linked to participants feeling isolated within the profession. These issues arose in varying degrees for participants and correspond with previous research (Shah et al., 2012) where trainees felt disconnected and isolated within the profession. These findings may suggest that current policies may not be effective in the way the profession attempts to attract and integrate BAME applicants. Therefore, these are important issues to consider if the profession wishes to diversify and attract more applicants from BAME backgrounds.

Some participants raised instances of not feeling comfortable raising issues related to “race” with their White supervisors. It could be argued that White supervisors may avoid

these topics with BAME supervisees for fear of being viewed or labelled as being racist, fears around recognition and realisation of their own racism, fears around acknowledging and managing their White privilege or a fear to take more responsibility to end racism (Sue, 2013). However, avoiding these conversations within a politeness or academic protocol (Sue, 2013), may perpetuate and maintain the colour-blindness and silence which people from BAME groups often experience (Sullivan, 2014). This silence is then internalised by BAME groups who then sit with the uncertainty of knowing whether interactions are racially charged and thus making them more susceptible to micro-aggressions within working relationships (Sue, 2013).

Whilst these ideas may provide some understanding to why participants felt less connection with their White superiors, the stronger connection with BAME superiors may be explained by social psychology theories such as the “homophily” principle (Lazarsfeld & Merton, 1954), which suggests that connections are formed between those who are alike, which in this instance would be people who are from BAME backgrounds. It could be argued that people from BAME backgrounds feel more connection to those, with whom they identify their social identities and are able to feel safer within these relationships (LeDoux, 1998; McHarg, Mattick & Knight, 2007).

The “optimal distinctiveness model” (Brewer, 1991) may also provide an explanation for why participants felt more connected to BAME colleagues and less connected to White colleagues. This model posits that individuals seek two opposing needs- assimilation and inclusion in social groups, but also differentiation from others. The model suggests that there needs to be a balance between inclusion and differentiation in order to meet one’s social needs within groups. Within this study, participants found they were more different to the majority group, and therefore the need for inclusion was activated and the differentiation

need was reduced. Thus, perhaps participants sought out groups in which they felt more included.

Interestingly, some participants made assumptions about “a room full of White psychologists” being a homogeneous group. Social identity theory and Tajfel’s In and Out groups theory (Tajfel, 1979) can be used to explain this. Social identity theory suggests that groups provide a sense of belonging to the social world. It is hypothesised that people divide the world into social groups and create in-groups and out-groups. Tajfel also proposed that by creating these groups, people tend to exaggerate the differences between groups and the similarities of things in the same group (Tajfel & Turner, 1979). Participants in this study tended to make assumptions that all White psychologists were from middle class

backgrounds and that they would think about things from the same perspective. Social identity theory may explain these exaggerated similarities.

4.1.2.2 Relationships with service users.

In addition to describing their relationships with colleagues and supervisors, participants also spoke about the working relationships they had with service users. They spoke about how service users often felt more connected to them because they assumed that people from BAME backgrounds would have experienced adversity and marginalisation, similarly to what some people with mental health difficulties may have experienced. Research has also indicated that service users from BAME communities may feel “safer” with professionals who are able to identify better with their cultural background and beliefs (Jones & Devlin, 2009). Although power differences still remained within these

relationships, common ground may have been accessed via different aspects of the Social Graces (Burnham, 2012). The Social Graces is an acronym which represents facets of

and service users may have shared similarities in relation to one of these aspects which created space to develop meaningful relationships, which participants spoke about. Participants spoke about how this connection with service users allowed them to be better clinicians. The above experience is one which has not previously been detailed within the literature and this study therefore adds to the knowledge base in this area. Although

participants spoke of feeling connected to service users, it is also important to note that some White service users were experienced as racist. This was also highlighted within the 2016 Workforce Race Equality Data Standard Report (Kline et al., 2017), whereby BME staff are still more likely to experience bullying and harassment from patients.