Tackling Mental Health Inequalities for Roma Communities in the UK - MHI

ISSUE NO. 6 OCTOBER

THE MARIWALA HEALTH INITIATIVE JOURNAL

Re-Vision

Contesting Global Mental Health

World Mental Health Day, Medicalised Mental Health Awareness, and Psychiatric Subjectivation

Authoritarian Neoliberal Regimes and Global Mental Health

Enough Politeness: Decolonising Mental Health in a Society Oblivious to Its Colonial Wounds

Work with Us, Not against Us

Context

Mental Health in the Time of Genocide

Reshaping Narratives: Reproductive Justice among Women in Kashmir

Mental Health and Marginalisation

Warriors Within: Decoding the Paradox of Strength and Vulnerability among the Naga Tribe

Redefining Queerscapes through Poetry

The Impact of AFSPA on the Mental Health of the Naga People

Engage

Collective Healing and Trauma-Informed Approaches for the Mental Health of Survivors of Trafficking

Assessing the Effectiveness of the Mental Health Equity Global Agenda for Low- and Middle-Income Countries 

Fostering Mental Healthcare in a Postcolonial Continent with Digital Medicine

Tackling Mental Health Inequalities for Roma Communities in the UK

Behind Bars

ENGAGE

15

ADVOCACY

Tackling Mental Health Inequalities
for Roma Communities in the UK



This Article Examines Tackling Mental
Health Inequalities for Roma Communities
in the UK Through the Mental Health Advocacy
and Research Work of the Roma Support Group.

Simina Neagu and and Mihai Calin Bica

AUTHOR

author’s bio

Simina Neagu and and Mihai Calin Bica

Simina Neagu is Roma Support Group’s Mental Health Project Coordinator and works on the VCSE Health & Well-being Alliance project.

Mihai Calin Bica is Roma Support Groups’ Campaigns and Policy Coordinator and coordinates the organisation’s work on the VCSE Health & Well-being Alliance project.

illustrator’s bio

Amreeta Banerjee

Alice A. Barwa completed her MA in Education from Dr. B.R. Ambedkar Univerity, Delhi (AUD), in 2022, and is from the Oraon Adivasi community, a native of Chhotanagpur Plateau, Chhattisgarh. She has been an advocate for Adivasi rights and voices as a member of an Adivasi youth collective @TheAdivasiPost, and has been an Adivasi youth representative at UN Climate Change Conference in Glasgow, Scotland, in 2021. Her research interests include education, culture, sociology, and linguistics.

Context

In response to “Global Mental Health from the Margins,” we write from the Global North, focusing on a migrant community from the Global South. The Roma Support Group (RSG) aids those who1 arrived in the UK as asylum seekers in the 1990s and as economic migrants after the 2004 and 2007 European Union accessions.


We write from London, home to one of the most diverse Roma communities and the 1971 First World Romani Congress, where the Roma flag and International Day were adopted. London is also notable for hosting the world’s first mental health asylum, the Priory of St. Mary of Bethlehem, established in 1247. Thus, we write from a place of community empowerment and self-determination, as well as a foundational site for Western psychiatry, with all of its limitations and problems. One issue is the context of Global Mental Health (GMH) – which invisibilises Roma mental health access and equity due to the simplistic presumption that ‘vulnerable populations’ are only present in low and middle-income countries (LMICs). In addition, the GMH focus on scale rather than rights poses particular challenges in addressing mental health gaps for Roma and other marginalised communities in high-income countries (HICs).

The Roma Community

To understand this group’s mental health, we must acknowledge the Roma community’s ethnic identity, migrant profile, and restricted access to public services in their countries of origin. ‘Roma‘ refers to a diverse population of 10–12 million people globally. They originate from the Indian subcontinent, with the largest populations in Bulgaria, Hungary, Romania, and Slovakia. A 2012 genetic study by Indian and Estonian geneticists confirmed their link to traditional scheduled caste and tribe groups in Northwestern India.2 Parallels have been drawn between the Roma in Europe and Dalits in India, including the Dalit-Roma Initiative by Dr Margareta Matache and Dr Suraj Yengde.3 

Roma communities across Europe have distinct tribal affiliations, speak various languages, and follow different religions. They are the largest ethnic group without their own state, often leading to a lack of recognition as an ethnic minority.4

Throughout their history, the Roma have endured marginalisation and oppression as they encountered various societies. Often viewed with suspicion by non-Roma, they have suffered enslavement, abuse, and forced expulsion during their extensive migration across Europe. Notably, Roma Slavery in present-day Romania spanned over 500 years,5 predating the Trans-Atlantic Slave Trade by a century. This shared history draws parallels between the Roma experience in Eastern Europe and African Americans in the US.6 Moreover, the Roma faced persecution under the Nazi regime, resulting in an estimated 600,000 murders during the Holocaust. Additionally, coercive sterilisation targeted Roma women in Eastern Europe, who were either offered monetary incentives for voluntary sterilisation or were subjected to sterilised without consent during other medical procedures.7

In addition to direct deprivation of rights, Roma face disadvantages due to discriminatory governmental policies or institutional operating frameworks. For instance, the criminalisation of nomadism in Czechoslovakia in 1958, and Poland in 1964, forced Roma into permanent settlements depriving them of their traditional lifestyle and cultural expression rights. Subsequent physical segregation often leaves Roma residing in substandard housing without access to basic sanitation. Additionally, schools in Eastern Europe engage in systematic misdiagnosis of learning disabilities to justify the disproportionate placement of Roma children in special needs classes, regardless of actual needs.8

In the UK context, it is crucial to acknowledge that the Roma are a migrant community. Consequently, Roma encounters specific challenges such as language barriers, navigating UK public service systems, and ensuring the security of their immigration status. These factors can significantly impact the mental health of Roma community members. 

Roma Mental Health

Roma communities are classified as an inclusion health group due to their social exclusion and multiple overlapping risk factors for poor health. According to a study by the European Public Health Alliance, Roma life expectancy in the UK is reported to be up to 10 years lower compared to non-Roma communities.9

Although protected under the Equality Act 2010, Roma individuals in the UK face obstacles in accessing health services, such as registration refusal, discrimination, digital exclusion, language and literacy barriers, administrative hurdles, lack of cultural sensitivity, and stigma.

Mental health services must build trust by tailoring their approach, including cultural awareness, interpreters, non-digital options, collaboration with community organisations, and integrated support throughout treatment.

It is vital to ensure non-Roma professionals, whether mental health practitioners or interpreters, do not hold discriminatory views, as these affect therapeutic relationships.

Limited contact with health services could result in many Roma individuals having little information about prevention, often seeking help only in crisis. Poor housing or environmental conditions can exacerbate physical and mental health concerns, including stress, anxiety and depression.10 Consequently, the tools, questionnaires, scales, and language used in global mental health may be as inappropriate for Roma communities as for those in LMICs.

Mental health issues among Roma are worsened by social exclusion, discrimination, stigma, or racist attacks. Many needing support live in families facing complex problems, requiring holistic approaches and additional support. 
 
A persistent cultural stigma surrounds mental health in the Roma community11 discouraging open discussion. Many rely on relating daily issues to well-being or expressing stress and worry. Mental health remains taboo, hindering open discourse and prompting fear of institutionalisation or discrimination when seeking professional help. Awareness of mental health shifts among youth but has not yet translated to open discussions in the community.

Simultaneously, in their countries of origin, there is a lack of disaggregated data on Roma people’s access to mental health services. Nonetheless, research indicates that ‘the Roma are often at higher risk of experiencing poor mental health and suffering from stress, depression, or anxiety, given their ongoing state of poverty, deprivation, and marginalisation’.12

Although there is increasing recognition of what Roma populations suffered before, during, and after the Holocaust, a historical perspective exploring the legacy of these experiences for Roma is largely absent from research.13 The presence of intergenerational approaches would help to unpack the trauma and its mental and physical health impacts as it has been transmitted over decades.14 As Eamon M. Anderson observed, ‘the impacts of massive group trauma may be transmitted inter-generationally through learned adaptive behaviour (survival coping), through genetic/epigenetic means, and through power-imbalanced systems which replicate groups’ low social status,’15 and that historical trauma has effects on multiple levels, from individual, family, to community levels. Ironically, trauma research is overwhelmingly HIC research even as they leave out the Roma community’s experiences of trauma and oppression that are historical, intergenerational and parallel day by day.

Hence, creating trauma-informed, culturally sensitive, and historically aware mental health services is essential for Roma, migrant, and traveller communities across the UK and globally.

For more details about Roma health, please see RSG’s Roma Health Guide.16

Cite this Article View all References

references

  • Founded in 1998, the Roma Support Group is a Roma-led Registered Charity working with East European Roma refugees and migrants and has offered a variety of services, from support with welfare benefits, financial inclusion, housing, education, health advocacy, campaigning and policy and promoting an understanding of Roma culture in the UK. Roma Support Group works predominantly with members of Polish, Slovak and Romanian communities
  • Rai, N., et al. “The Phylogeography of Y-Chromosome Haplogroup H1a1a-M82 Reveals the Likely Indian Origin of the European Romani Populations.” PLoS ONE, vol. 7, no. 11, 2012, e48477.
  • Matache, Margareta, and Suraj Yengde. “Roma and Dalit Experiences of Persecution Pave Way for Solidarity.” Open Democracy, 2017.
  • Silverman, Carol. “Persecution and Politicization: Roma (Gypsies) of Eastern Europe.” Cultural Survival, vol. 19, no. 2, Nationalism in Eastern Europe, 1995.
  • Matache, Margareta. “It Is Time Reparations Are Paid for Roma Slavery.” Al Jazeera, 2020.
  • Matache, Margareta, and Cornel West. “Roma and African Americans Share a Common Struggle.” The Guardian, 2018.
  • Silverman, Carol. “Persecution and Politicization: Roma (Gypsies) of Eastern Europe.” Cultural Survival, no. 19.2, Nationalism in Eastern Europe, 1995.
  • European Union Agency for Fundamental Rights. A Persisting Concern: Anti-Gypsyism as a Barrier to Roma Inclusion, 2018. 
  • European Public Health Alliance. Closing the Life Expectancy Gap of Roma in Europe, 2018.
  • Office for Health Improvement and Disparities. “Improving Roma health: a guide for health and care professionals”. 2022.
  • Roma Support Group. Mental Health Guide. 2022.
  • ERGO Network. Roma Access to Adequate Healthcare and Long-term Care in Bulgaria, the Czech Republic, Hungary, Romania, Slovakia, and Spain. 2021.
  • Orton, L., de Cuevas, R. A., Stojanovski, K., Gamella, J. F., Greenfields, M., La Parra, D., … Whitehead, M. (2019). Roma populations and health inequalities: a new perspective. International Journal of Human Rights in Healthcare, 12(5), 319-327. 
  • Orton, L., de Cuevas, R. A., Stojanovski, K., Gamella, J. F., Greenfields, M., La Parra, D., … Whitehead, M. (2019). Roma populations and health inequalities: a new perspective. International Journal of Human Rights in Healthcare, 12(5), 319-327.
  • Anderson, E. M. (2018). Roma Slavery is Historical Trauma. FXB Center for Health and Human Rights at Harvard University.
  • Roma Support Group. Roma Health Guide. 2022.

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