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Westminster Debate ‘Suicide among Turkish, Kurdish, Cypriot Diasporas in Europe’
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Westminster Debate ‘Suicide among Turkish, Kurdish, Cypriot Diasporas in Europe’

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16 October 2017,

House of Commons

The Centre for Turkey Studies (CEFTUS) put on a public forum in the House of Commons on the issue of suicide among the Turkish, Kurdish and Turkish Cypriot diasporas of Europe. The event was hosted and chaired by Heidi Alexander MP and featured keynote speakers Ozlem Eylem of the Centre for Psychiatry Wolfson Institute of Preventive Medicine; Dr Aradhana Perry of East London NHS Foundation Trust, City & Hackney Directorate Department of Psychology, The Raybould Centre, Homerton Hospital; Dr Esra Caglar, Consultant Child Psychiatrist and Adolescent Psychiatrist of the Tavistock Clinic; Nursel Tas, Chief Executive Officer of DERMAN; Ertanc Hidayettin, Educationalist and Columnist; Dr Cemal Kavasogullari, General Practitioner at Woodstock Medical Center; and Dr Erminia Colucci, Senior Lecturer in Psychology, School of Science and Technology at Department of Psychology of Middlesex University.

Heidi Alexander MP opened the session by speaking of the importance of the topic and the need to gain a greater understanding of the causes of suicide in diaspora communities.  Dr Esra Caglar spoke about her experience in the NHS and how issues of integration are connected to issues around suicide. Dr Caglar said that parents within the Turkish, Kurdish and Turkish Cypriot communities are often over-protective and that this can lead to a lack of confidence and independence among the children. She explained how families often don’t trust healthcare professionals. The key idea was that children from the diaspora communities often face a dilemma – do they remain with their traditional-heritage culture or do they adapt and integrate further into the wider society? This dilemma, Dr Caglar explained, can lead to an alienating feeling of being “stuck between cultures”, and that teenagers in particular are left looking for external validation, lost on the quest for a sense of belonging and identity.

Dr Erminia Colucci followed, presenting her research regarding the cultural impact of suicide rates around the world. She contrasted the experiences of Italy and India, where suicide rates are low and high respectively. Dr Colucci spoke about how suicide is gendered, giving the examples of India again, where abuse against women is prominent, and Australia where a harmful culture of “macho” masculinity is prominent. She detailed how there is a higher risk of suicide among second generation immigrants and gave examples of gendered reasons for suicide among the Turkish diaspora, with one-quarter of female Turkish migrants in Switzerland saying that violence in the family was the main problem. Dr Colucci explained how migrant women are trapped by economic and cultural barriers, with less access to healthcare services and greater levels of social marginalisation. She concluded by calling for suicide prevention to go beyond simply clinical measures, with multi-sectoral, multi-component approaches needed.

Nursel Tas began her talk by giving a brief history of DERMAN, a centre that supports and promotes the well-being of the Kurdish and Turkish communities of London. The health advocacy organisation was established in 1991 and is now BACP (British Association for Counselling & Psychotherapy) accredited. The group gives advice and provides services free of charge. Among users of DERMAN’s services, unemployment and poverty are prominent. DERMAN mostly deals with first-generation people within the community, with over 40s making up the majority of the organisation’s service users. Common problems include PTSD, relating to time spent in Turkish prisons, and pressures from the changing dynamics of their community in a new setting. Nursel Tas detailed how between 2003 and 2017, around 48 people from the community committed suicide. She said that stressors include housing issues and racism. Nursel closed by calling for a holistic approach to suicide prevention, and made positive remarks about the House of Commons health committee’s recommendation that the community is involved as much as possible in prevention.

Dr Kavasogullari said that British GPs see the greatest challenge with the Turkish-speaking community is that of lack of trust in professionals, echoing earlier comments from Dr Caglar. He went over studies from Germany that showed the Turkish community is at an increased risk of obesity, smoking and other health issues, and that a similar set of issues faces the community here in the UK. Dr Kavasogullari said that the community is disadvantaged in terms of accessing and utilising NHS services, with barriers of language, education, beliefs and behaviour, and that funding cuts only exacerbate these problems. He suggested that one remedy would be training up more Turkish health care professionals within the NHS.

Ertanc Hidayettin gave a different perspective on the issue, looking at the role of the media relating to suicide. Mr Hidayettin posited that the media normalises suicidal behaviour. He looked at examples of copycat suicides and gave the example of the “first social media suicide”, as well as the phenomena of cyberbullying and ‘cyberbullycide’. Mr Hidayettin said that the Turkish media is particularly culpable here, with its graphic reports of the news and often violent soap operas and drama series (such as Kurtlar Vadisi), suggesting that TV can lead to negative thoughts and depression.

Ozlem Eylem explained her work with the diaspora communities in both the UK and the Netherlands. She made the point that services need to be tailored to meet the needs of users and that social media can be used to access people in what is called ‘online intervention’. She said that rates of suicide among young women in Germany are as much as six times higher within the Turkish and Kurdish communities than the native German population. Ozlem outlined the work done by her Kiyma Canina (“don’t crush your life energy”) online self-help project, with its culturally adapted method to instil hope in desperate people. As with other projects, users tend to be female – confirming that women tend to seek out help earlier than men, who only tend to do so at the crisis stage.

Dr Aradhana Perry detailed how she runs a BME access service, mostly supporting Turkish, Kurdish and Turkish Cypriot people alongside Vietnamese, black and Orthodox Jewish patients. She spoke about the partnership project she collaborated on with Derman, culturally adapting ACT (a form of CBT, or cognitive behavioural therapy) to suit Turkish and Kurdish service users. Dr Perry explained how she encourages patients to live with their fears and move towards their values in order to combat anxiety. She also said that the platform encourages the sharing of stories and listening to others, facilitating positive emotions and empowerment, providing valuable coping skills. The collaboration project uses cultural metaphors, common sayings and esteemed cultural role models to tap into people’s hopes and ambitions; Mevlana, for example, has been used as the embodiment of kindness, openness and tolerance. Dr Perry agreed with previous speakers that funding cuts have made their task that little bit more difficult, but that overall the collaboration has been a success.

In the Q&A, panellists heard questions about mental health among members of the community in prison, differences in perceptions among men and women, parenting, financial issues and attachment therapy. Heidi Alexander MP closed by agreeing with speakers about the positive and negative role of the media, and that descriptions of methods of suicide should be avoided at all costs – something she had confirmed by evidence heard at the health select committee.

Speaker Biographies

Ozlem Eylem is a PhD student and researcher  at the Virje Universiteit Amsterdam at the Department of Clinical Psychology in the Netherlands and at Wolfson Institute at Queen Mary University of London. Her primary interest is in global mental health more specifically in tailoring mental health services according to the culturally and ethnically diverse populations. In this regard, her PhD project is on adapting an e-health intervention for suicidal thinking according to the Turkish, Kurdish and Cypriot diaspora in Europe and testing its acceptability and effectiveness in reducing suicidal thinking. She has been awarded with a grant to conduct this research by the European Commission and more recently she has been recently awarded with the full tuition scholarship by the Beck CBT Institute Philadelphia to present her work to Aeron T. Beck and Judith Beck. Overall, she has a passion in contributing to the improvement of the accessibility of the mental health services for diverse service-user populations beyond academia. There is more information through this link http://www.wolfson.qmul.ac.uk/a-z-staff-profiles/ozlem-eylem

Dr Cemal Kavasogullari is a Hacettepe University Faculty of Medicine Graduate and is currently practising as a GP in Glasgow. He also holds a PGCert in Aesthetic Medicine. He is the Deputy Chair of Royal College of General Practitioners’s Junior International Committee and the Treasurer of European Federation of Turkish Healthcare Professionals (ATSEF). Dr Kavasogullari’s special interests include mHealth, Tele-health and Electronic Health Record Systems and he is actively working on projects to increase patient engagement via new technologies.
Erminia Colucci is Senior lecturer at the Department of Psychology at Middlesex University London (UK). Prior to this she was a lecturer and academic lead at the Centre for Psychiatry at Queen Mary University of London (UK), where she co-developed and coordinated the MSc in Creative Arts and Mental Health and lead the MSc in Transcultural Mental Healthcare and the Research Methods in Mental Health module. From 2007 till 2015, she was a Research fellow and Lecturer at the Cultural and Global Mental Health Unit, University of Melbourne where she is currently Honorary Senior Research Fellow. Her main area of research and training is in Cultural and Global Mental Health and Applied Cross-Cultural Psychology with a focus on low-middle income countries and immigrant and refugee populations. Her key interests are human rights and mental health, suicide and suicide prevention, domestic violence against women and children, child neglect/exploitation, spirituality and faith-based and spiritual/traditional healing, and first-hand stories of people with lived-experience of ‘mental illness’ and suicidal behaviour. Erminia is passionate about using arts-based and visual methods, particularly photography and ethnographic film-documentary, in her research, teaching and advocacy activities. In 2015, she was awarded the International Association for Suicide Prevention Andrej Marusic Award which is dedicated to innovative research among young researchers. She recently was also awarded a Rotary International prize for her ethnographic documentary about human rights and mental health ‘Breaking the chains’ (https://movie-ment.org/breakingthechains).

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