I can vividly recall the setting. I sat on an uncomfortable plastic chair against the wall of a nondescript hospital meeting room. The light was blocked by a blind so we would be able to see the slightly out-of-focus slides projected to illustrate our weekly psychiatry lectures. That week’s topic was psychosis, and it was there I learned that any children that I, as a Black Caribbean migrant, might one day have would face an exceptionally high risk of developing schizophrenia.
Black Caribbean people born in the UK had a nine times higher risk than their white British counterparts of developing schizophrenia, I was told. The life expectancy for any person diagnosed with a psychotic illness was 15 years shorter than the UK average. I was shaken and outraged.
Of the devastating swathe of facts that the lecturer continued to share, a further snippet burned itself deeply into my mind. Living in a city was a critical factor, almost doubling the risk of psychotic illness. This felt important – I had no control over my children’s potential genes, but the environment into which any second-generation Black Caribbean child of mine might be born could entirely alter the course, and even the length of their life.
The memory of the moment faded over time. I was in no rush to have children, and did not encounter many Black Caribbean patients in the parts of the UK where I completed my training and came to work as a consultant medical psychotherapist. But those seemingly long-forgotten facts resurfaced when I became a mother.
At the time, we lived in a tiny terrace house in Oxford with no garden, on a tangle of backstreets, in a perpetual twilight of streetlights. My first-born son slept fitfully, lulled by the noise of buses and the sirens of ambulances attending the nearby hospital.
I had never imagined myself living in the countryside. In Trinidad, I had what might now be considered a mythical, somewhat feral childhood, roaming mostly outdoors free from adult supervision while contained by a tight-knit suburban community. But I had always been thrilled by big cities.
When I visited New York for the first time I was besotted with the throb and gritty pulse of urban life. I fantasised about living in a chic apartment in Paris. As the years passed, and I put down real roots in the UK, I always imagined settling in a city. It was not simply that city life appealed, it was also that the countryside, which seemed to represent the pure ideal of Englishness, seemed very much not meant for the likes of me.
But my children’s futures overrode childhood fantasy and fears of potential hostility. When life provided us with an unexpected opportunity to move to a small village in Somerset, with the words of that years-past lecture resounding in my head, I leaped at the chance. There would be so much about the maddening experience of growing up in the UK as a Black person that I would be unable to improve for my wide-eyed, sensitive, curious children, but how urban a childhood they had was one crucial factor that I could influence.
The evidence has grown since that lecture many years ago, and it now seems that the risk factor for psychosis is not as simple as whether or not you live in a city. The more nuanced story seems to be about how much someone belongs, feels rooted in a place, and is accepted by the community in which they live.
I had been worried that the countryside might feel hostile and strange, but our family has been embraced. In this landscape, seemingly so different from the one that I knew as a child, my children are having a deeply familiar childhood. They spend most of their time outdoors, roaming to their den in the nearby woods free from adult supervision, but safer than they have ever felt before. Despite the turmoil of the last few years, they have grown happier, more confident and secure.
I hope that they continue to feel an unquestioned sense of belonging as they grow, and that this protects them from any unnecessary pain. I hope that they come to feel a sense of home, grounded in love for this new landscape, just as I have.
Uprooting: From the Caribbean to the Countryside – Finding Home in an English Country Garden by Marchelle Farrell is published by Canongate
