Editorial
| Pages | 154-156 |
| Date | 05 September 2019 |
| Published date | 05 September 2019 |
| DOI | https://doi.org/10.1108/JPMH-09-2019-084 |
| Author | Woody Caan |
| Subject Matter | Health & social care,Mental health,Public mental health |
Woody Caan
The inspiration for this special issue is a trans-Atlantic mental health initiative, for Citizenship,
Recovery and Inclusive Society Partnership. My colleagues are covering recovery, social
inclusion and partnerships in this issue, but here I hope to reflect on citizenship. The catalyst for
this has been the suggestion by US President Donald Trump that the constitutional protection of
birthright citizenship, for all people born in the USA, should be removed ( Jardina, 2018). The UK
has also seen recent restrictions on people previously assumed to have a right to maintain or gain
“Britishness,”as in the Windrush scandal (when migrants from former UK territories have been
expelled to the West Indies after decades of residence) or Government thwarting the
Parliamentary Dubs Amendment (that allows child refugees with family connections in the UK, to
enter and settle here). There is also a growing climate of hostility to “migrants”in general –even
though many areas of the economy including health and social care are dependent on overseas
workers (Iacobucci, 2018).
Without the defined status and protected rights associated with citizenship, overseas workers
and their families can easily become subject to exploitation or even enslavement (Wilkinson,
2014). Criminal gangs are becoming very proficient at turning debt into servitude, and it is the
most marginal, weak and friendless who easily fall into debt. Out of the turmoil and ruins of the
Second World War, there arose many new perspectives on citizenship, including the civil
rights of people with mental illness (Rees, 1947). This tradition continues in the World Health
Organization’s rights-based approach to protect the dignity of people with mental health
problems, Countdown Global Mental Health (Saxena et al., 2019). However, in contemporary
Britain and America, we see a narrowing of civil rights, typified by Theresa May’s chilling
statements “that citizenship is a privilege not a right”(Bridle, 2019). At the US Southern Border,
migrating children are currently seen “as a threat to be controlled by military force”(Gee and
Cohodes, 2019).
I have long admired the psychiatrist Dinesh Bhugra (now President of the British Medical
Association)who is trying to rally healthprofessionals behindcitizens’threatened “rightto health”–
before the “moral contract”between the public and professions is lost forever (Horton, 2019).
Respect for rights needs to be monitored across populations, and at the UK’s Office for National
Statistics,there is now a Centre for Equalities and Inclusion(www.ons.gov.uk/aboutus/whatwedo/
programmesandprojects/centreforequalitiesandinclusion). Your income, property and status
should not bear on your right to healthcare, and I hope UK readers will consider sending their
evidenceto the new Commission for Equality in MentalHealth (www.centreformentalhealth.org.uk/
commission-equality-call-evidence-january-2019). Today, me ntal illness shows a steep social
gradient,with the poorest residentsin the poorest communitiesmuch more likely to be unwell.Only
today, the impactof children breathing poor quality air on their riskof developing psychotic illness
has been revealed (Carrington, 2019). Seeing young children poisoned by slum air can only be
tolerated if your country relegates many families to the status of second-class citizens, or
even aliens?
In most countries, place of birth or parent’s nationality determine citizenship. My own mother
gave birth shortly after she landed in America, but I have tried to find out the flag of the ship on
which her labor began, wondering if a quicker delivery might have meant another passport?
Sadly, neither place of birth nor family history protects the rights of some ethnic and religious
minorities, like the Rohinga in Myanmar. Released after years of imprisonment under apartheid,
at his inauguration as President of South Africa in 1994, Nelson Mandela gave this vision of
citizenship: “To my compatriots, I have no hesitation in saying that each one of us is as intimately
Woody Caan is based at
Royal Society of Public Health,
Duxford, UK.
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JOURNAL OF PUBLIC MENTAL HEALTH
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VOL. 18 NO. 3 2019, pp. 154-156, © Emerald Publishing Limited, ISSN 1746-5729 DOI 10.1108/JPMH-09-2019-084
Editorial
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