[MUSIC PLAYING] This podcast is brought to you by the Association for Child and Adolescent Mental Health-- ACAMH, for short. You can find more podcasts and other resources on our website, www.acamh.org. And follow us on social media by searching ACAMH. Hello. Welcome to In Conversation podcast series for the Association for Child and Adolescent Mental Health or ACAMH for short. I'm Jo Carlow, a freelance journalist with a specialism in psychology. Today I'm interviewing student researchers Hannah Abdullah, Malaika Okundi, and Car Semilla. All three have been working on TRADE, which stands for Transmission of experiences of Racism, Anxiety, and Depression in families. TRADE is a collaboration between researchers at the Center for Mental health and King's College London. If you're a fan of our In Conversation series, please subscribe on your preferred streaming platform. Let us know how we did with a rating or review, and do share with friends and colleagues. Hannah, Malaika, and Carl, thank you for joining me. Can you each start with a brief introduction about who you are and what you do? Hello, everyone. My name is Carl Semilla. I'm a final year medical student at King's College London. And at the moment I am one of the undergraduate research assistants on the TRADE project. Hello. My name is Hannah Abdullah. I am a final year Global Health and Social Medicine Student at King's College London. I am also a research assistant on the TRADE project. Hi, everyone. I'm Malaika Okundi. I am a final year student on Global Health and Social Medicine bachelors of science program, on the neuroscience track. I'm an undergraduate researcher on the TRADE project. Brilliant. Thank you, all of you. You're all young researchers. How does research differ from university work? I think one of the main things is that it's very independent compared to university work. I feel that university work-- you've got your set modules to do and it's very timetabled, whereas research I feel is way more fluid and requires the ability to adapt to the ever changing results that you're getting and the ever changing situations. I feel like for me, personally, it's giving me this practical element to my studies. I am able to apply things quite quickly and actually see the process of how things happen. I'm able to discuss and collaborate with colleagues . I think the main difference for me would be in terms of impact. My work in university, whilst was important to me, is not necessarily having an impact on the world at large, whereas research work it has an impact on myself, on my research colleagues, on the research participants, funders, a myriad of people. And so I really felt, in both a positive and negative way, how much my work and my success or failure impacts other people. Let's turn to the research itself. What is TRADE? How did you gather your data, and what are its aims? Malaika. So as you mentioned before, the TRADE project stands for the Transmission of experiences of Racism, Anxiety and Depression in families intergenerationally. There are three parts to the TRADE project. It begins with a literature review where, we looked at all the available data on intergenerational trauma from racism. A lot of the data ended up coming from the United States of America, which was interesting, but also expected considering the Civil Rights movements and all sorts of other events that have happened over there. The second part of the TRADE project is to consult with the community. So we're hosting focus groups. And we want to talk to teenagers and their parents, and understand their lived experiences. We want to understand what they go through, and what they would like to change, and what they would like to happen, how they think the government institutions, health care, and other stakeholders could make things better. Third is dissemination. That is perhaps the most complicated part. We want to get our research into the right ears. We want to talk to people. We want to let people know what we've heard, what we've found, what we've read, and get them to understand what the lived experience of ethnic minorities really is in the UK, and how we as a society can change that, how we can improve that, how those in government can improve that, how those in research can improve that, and so on and so forth. The fourth stage, which is I guess kind of like a pseudo-stage, is to help our participants on their journey into academia. So we hosted a couple of workshops with the teenagers who participated in our focus groups to talk to them about university, about what it's like to be a university student, about research, about what it's like to become a doctor, psychologist, how they can get there. We spoke to them about how to write a CV, how to write a personal statement, and just what it's like to really go into university and academia. So that's really what the TRADE project is. It's a multi-pronged approach to creating change. Our true aim is to be a catalyst for change not just for ourselves, but for the community at large, in such a way that we incorporate the community's opinions as well as our own. We don't want the research to be separated from the people. We want them to have a voice, and we want to be a voice for the voiceless. Why do you think there has been so little focus until now on the UK experience? And what impact do you feel this relative silence has had on the mental health of young people affected by this? One of the main reasons that this hasn't been happening in the UK-- I think it's because we're behind America in the terms of America has had guidelines for some time now to ensure that there is representation of ethnic minorities in clinical research. So it is quite a disservice to these communities here in the UK that we don't have that. And it prevents us generalizing research from psychiatry studies. I think it also prevents culturally competent clinical practice. Because if you are not considering such a massive element such as racial trauma-- specifically intergenerational, as well-- then that is race is a large part of someone's identity, and I really do think it's preventing good culturally competent practice. Just to add to that, I think there's a common misconception that occurs between the United States of America and the UK in that it seems as though racial tension is a lot more violent in the United States because there are visceral images that we see on the internet, on TV-- things like gang violence, things like what happened to George Floyd and police brutality, et cetera, et cetera. One thing that certainly came up in our findings was the prevalence of covert racism and microaggressions, which seems to be the tension of choice in the UK. So whereas perhaps you're not visually seeing young Black men being assaulted and killed on the streets on a regular basis, there is still racial tension. And because it is not as in-your-face as that in America, because we don't necessarily have the same histories of slavery and segregation and the Civil Rights movement, the UK has been overlooked. And with regard to the effect on the mental health of young people from ethnic minorities, it does make people feel as though their experience of tension, pain, racism is not as valid because it wasn't, perhaps, as violent or as visible. And part of the aim of this research is to highlight forms of racism that perhaps aren't as violent, aren't as visible, but are still felt viscerally and still cause mental health issues. I want to go into more detail and a bit about what you did here in those focus groups and through your research. But before we go there, I wanted to hear more about what has drawn you personally to this research project. When I was joining this research team I was planning my final year dissertation. And my dissertation was based on the community mental health approach in England, and looking at the impacts on the community, like the hard approach on the British Somali community. So I was focusing on cultural competency and structural competency in the ways in which mental health policies, mental health interventions in community health are structured, and in clinical settings and community mental health settings. I have always had an interest in intergenerational trauma, and how trauma is transmitted within families, within communities. I have always had an interest in mental health and being a mental health advocate. So a lot of my research interests all came together. And I was really, really happy that I found this opportunity to actually work on something that I have always had an interest in. I was drawn to this research because it has a quite personal slant for me. I am a young Black woman in London. And I wanted to be able to help people like me to make a difference with people like me. I think I was also drawn to the project because I have had little experience with people of color in academia. And so I was attracted to the experience of getting to work with people who were PhDs, postdocs, who were doing masters, who were people of color, who have had my experience and have gone on to excel and be great in academia. Absolutely, absolutely. And I agree with everything that Malaika and Hannah have said. And, for me, I was drawn to the project for several reasons as well, mainly because this is such a pertinent and underserved research area, particularly that under-representation of ethnic minorities in all areas of clinical research, but particularly in mental health research. It's something that really needs to be rectified. So that's one thing that really drew me to this project. And also, personally speaking as a second generation immigrant, I'm also aware of the terrible effects that racial discrimination can have on racialized groups in the UK. So this really motivated me to make a difference and get involved with such a project that is catering to these communities. And then also, as a medical student, for my psychiatry placements I've developed an interest in the impact of negative race-related experiences on mental health. And I've also learnt about the very unfortunate statistics that Black men, for example, have higher incidents of risk of psychotic disorders, and have poorer mental health outcomes. So the TRADE project really appealed to me because it's a way that we can perhaps uncover some of the mechanisms underlying this. In the course of your research you met with parents and teenagers to talk through their experiences. What were the key findings? What stood out for you? As every movie predicts, teenagers and parents are quite at odds. They don't necessarily seem to have an understanding of each other at all times. And yet, despite the differing opinions, there was a collective hope in that the teenagers were the future, and that the young people would make things better. Across the different ethnicities that were present in the participants in our study, the experiences were strikingly similar. No matter where you came from, the experiences of isolation, being made to feel less than, of being asked to take up less space, et cetera, et cetera, were the same. And even the experiences of feeling unsafe with other groups of people were the same. And it was fascinating to me, as a Black person, to see that whereas maybe I feel unsafe with this group they feel unsafe with my group. And we all feel unsafe from this other group together. And these collective experiences that we didn't know each other were having was so similar, and were described in such similar terms, it was quite amazing to me how people from different parts of the globe who ended up in London for various reasons all had the same similar experience despite radically different cultures, languages, and practices. I think looking at it from an intergenerational perspective, the parents commented that they would often reflect on their parents' parenting style and the sort of anxieties, and emotions, and sort of survival techniques that they picked up from their parents' parenting styles, and their active approach to minimize the impact of their parents' anxieties and insecurities about the world, and how they're actively working with their children to build a more confident and holistic approach to living in a world in which is changing rapidly. There are still things that are happening in our society that their children are visibly watching, some are experiencing, and sort of working together to build this confidence in their identities to ensure that they are not suffering. I think the one thing that I have taken from the research is parents are making sure that their children are not suffering in the way that they have suffered. Yes. And just to add to Malaika and Hannah's points, also there seem to be a consistent theme across both the parents and the teenagers that the parents were very eager to protect their children against the risk of racial trauma or racist experiences. And sometimes teenagers could potentially view this as overprotective. But that was really a consistent theme-- that desire to protect and educate their children. You've described some of the findings was surprising. What did you expect when you started the project? And are there any other surprises you could highlight? And were your expectations met? I think following from Malaika's point in the previous question, I was expecting sort of distinct differences and experiences from the ethnic minorities who took part in the study. That is primarily because my knowledge of cultural competency and my initial goal of ensuring that approaches within health care have to be culture competent in terms of looking at an individual culture, and individual belief systems, and encompassing that in all approaches and the policy. But what I have picked up on is that there are some approaches that can be utilized for the collective majority in order to make progressive, practical change. And it doesn't have to be this specific targeting. If we're able to utilize a better approach in future, in the next two months when we're actually putting all the pieces together and reflecting on what we've actually found, I think people will actually start to see a way in which we can actually find more of a approach that fits. One of the things that surprised me was the willingness of the people to discuss racism and mental health, which have been historically quite personal and stigmatized topics. I was really quite inspired by the participants' willingness and vulnerability to divulge some of these personal experiences, perhaps in terms of genders expecting more from equal make up, but we actually didn't have Black men in the parent group. And that raised questions as to why. These are just extra things that have come out and have been quite interesting and surprising. I didn't have many expectations. I went into this experience thinking it was going to be new. I was going to learn, be challenged, and all of those came true. In terms of surprises, I think I was surprised by how much I enjoyed researching, how much I enjoyed the conversations, the planning stages, seeing it all come to fruition. And even now, being here on the other side where we're doing analyses and looking at results, I'm surprised by how fulfilling it's all been. I realized that nobody is asking much. What is being asked for is that institutions are culturally competent, that they're aware of the experiences and the impact experiences have had on the Black, multi-ethnic community, the laws that are in place to protect Black ethnic minorities. Because there was an incident when it came to hair and hairstyles in school, and the issues that some schools have with certain hairstyles. And teachers and some staff were not aware that there are actually laws in place to protect discrimination of hairstyles. And that is something that I learned in the research. And I actually sat down I thought why isn't this general knowledge. Why aren't we aware of these protections that are in place? Why are things so silenced? And it's just coming to an understanding that there are things in place. Some things are more vocalized than others. The expectations of communities are not high. They're actually quite reasonable. And I think there needs to be more of an eager response to the wants and needs of the communities that are discriminated against and marginalized. I mean that comes to really why the research is so important. Can you say some more, each of you, about the importance of this research? The importance of this research is to ensure that the voices of those who have not had a voice have a pathway to have their ideas, have their experiences, and have their voice amplified for it to reach the clinicians, the policymakers, and to ensure that the response is that there is no response. There can't be an argument that these people have not spoken. There cannot be a response where there is no research to support the claims that these people are making, when there is, when we've actually sat down over the past six months and have spoken to parents, spoken to children about their lived experiences and what they want in place. In all, this research is amplifying the voices of those who have not had a voice to speak with. And if they did have the voice to speak with they were shut down. There is no coming back from this. Report will actually demonstrate that there is a need for a more proactive and eager response from those in charge. I also think another reason why this is so important is just to try and create a more level playing field, and try and reduce the mental health disparities that exist between different ethnic groups. So firstly to understand is intergenerational trauma a factor in this, and then if it is, is it something that we can target to help reduce these disparities. And as Hannah's said so wonderfully, just to really give these people a voice. I couldn't agree more. The purpose of the trade project is to give a voice to the voiceless. I mean, it can't be overstated how important the research is. Because often policy, health care, et cetera, looks at a very statistical cost of things, of numbers, and metrics, et cetera. But we're trying to focus on the human cost. Because there are really human lives at stake and human experiences. Anxiety, depression-- they do affect your life in ways that can't be overstated. It makes life so much more difficult when those are transmitted intergenerationally because of things you can't control, because of something as simple as your skin color, your accent, which part of the city you grew up in, and so on and so forth. These small things, such as walking into a store and not being followed around by a security guard-- it seems so minimal. But when that is your daily life-- when every day is mitigated by will I be approached by a policemen today, will I be seen as this-- if I wear this outfit, will I seem less than? Will I be too loud, and so on and so forth. The toll it takes is immeasurable. That needs to be recognized. It needs to be changed. What's the timescale on it? When will it be disseminated? So we have a public engagement event coming up on the 23rd of July where we will talk about our results. We do have a couple of workshops. There will be some poster presentations. We are aiming to write a paper, and we're in the process of that. We are in the thematic analysis stage of the research. And there are some really good insights coming out. We are active on Twitter, Instagram, and other places. And so there are places to see our research and see our results. And we will definitely keep ACAMH posted. What have you learned from the project? And what have you learned from each other? The different ways of working. Because when you bring together so many different people from different backgrounds with different personalities, different strengths and weaknesses, I think it really does lend itself to fantastic teamwork, to learn different ways. You pick up new ways of thinking even, that can really benefit you in the future. I think also in terms of teamwork skills, really learned how to listen and also to receive good constructive feedback. I think that's really something that's been really good on a personal level from this project. Particularly from the project itself, I've also learned qualitative research. Actually, learning thematic analysis and qualitative research has been really very interesting. It'll be good for the future, as well. I couldn't agree more with Carl. I think one of my biggest takeaways has been the ability to receive constructive criticism well. I think we've been really lucky in that the leaders of this research project are really great at giving constructive criticism, but also doing it in such a way that we're left learning and not being wounded. I've really learnt what it looks like to be a good leader. I've learned from Yasmin and Tolu what it looks like, how to delegate tasks, how to work well in a group of different people with different schedules, with different backgrounds and priorities. I've learned how to be more compassionate to people. I think my experience with the focus groups and participant groups really opened my eyes that people everywhere going through things. And you never know what happened in someone's day. It really awakened my empathy. I think, from a research standpoint, like Carl, I was mostly focused on quantitative research methods prior to this project. So seeing the qualitative side of research was daunting at first, but has been really interesting. I think I previously would shy away from interviews and focus groups. I much preferred questionnaires and looking at things, using graphs and numbers, et cetera. But the kind of data that comes out from focus groups is really rich, vivid, and it really describes people's experiences in ways that a questionnaire is not quite able to. And it's been quite a treat being able to see the opposite side of research to what I'm used to. It's been quite a large learning experience. It has taken up half of my academic year. It's something that I have been willing to learn throughout the entire process. I am actually quite familiar with qualitative science or the research, so I wasn't learning new things per se. It was more I was learning how to improve and adapt my skill set to this new data set, learning how to actually work in a group doing thematic analysis. Because I'm so used to doing things quite independently when it comes to research. I was actually allowing myself to take a step back and actually hear what my teammates are saying, what Yasmin and Tolu think, and actually learning that it's quite a reflexive process, and it takes time for you to actually come to a conclusion, and a conclusion that has been thought out and actually been well understood rather than it coming from your own perspective. So it's been quite enlightening. I've enjoyed the whole process. What advice would you give to other students embarking on their first research project? My best piece of advice would be ask questions. Be inquisitive. Be curious. If you don't know, ask. And, yes, at times for myself that was difficult and I had to work up the confidence to sort of get over my natural shyness. But I think you learn so much more by being open about what you don't know and what you do know. You never know by sharing one tidbit of information that, wow, it may open a door for you. I think also go for those opportunities. I found this opportunity through an email. I honestly wasn't expecting much from it when I applied, because I felt like I was quite underqualified. But here I am now on a podcast with a ACAMH. And so I think take those chances. Take those leaps, and ask as many questions as you can. I think my advice would be it's OK if you don't understand. And it's OK if you get things wrong. You're getting the opportunity means that they see the potential in you. So please take every moment to learn. Take every moment to be inquisitive. This is a learning process. This is research. So take the time you need. Give yourself any way to get things wrong. And it's OK, because you will have a supportive team. You will have those in management to help you understand. So take the opportunity and learn from it. Yes, absolutely. I think that's fantastic advice from everyone. I think to add to that I'd also say it's so important to identify a good supervisor or good project lead. I think their guidance is so important, as well as that project lead who cares about the project. With the TRADE project we've been very lucky. We've had Yasmin Ahmadzadeh, whose guidance and leadership has really been second to none, and also Tolu, the research assistant on the project there. They've both really led us well, and they've really offered us a lot of support. I think that's really fantastic when you're embarking on your first research project. It really, really does help you a lot. And just a second bit of advice-- I'd also say not to worry if you're not getting the data you're expected. If your results aren't matching your hypothesis, that's good. Negative data is still good data. It's still equally valid. It's still so important and will still be very valuable. What makes you hopeful for the future? Research is actually giving the younger generation a chance to participate in projects like this. I think it's quite a unique opportunity for three undergraduates to be put in research positions at such an amazing institution. I think young people being recognized that they have the ability to contribute, to actively make the changes they want to see. I think that gives me hope, and seeing how young people are willing to take these spaces, take up space, and to have their voices heard. So I'm looking forward to what the next few years brings. I'm hopeful that more research like this will be done. And our work has highlighted many areas that need more work. As I mentioned earlier, we didn't really have any Black men in our participants in the parents group. So that'll be very interesting in the future to focus on Black men. Also, I'm very hopeful we can make a difference-- not just us as members of the TRADE project team, but us collectively as human beings living in 2022 in the UK. I really am hopeful that we can make a difference. We've seen so much change has happened and so much has progressed and really heading towards better times. What makes me hopeful for the future is the teenagers we worked with. We did a couple of workshops talking to them about academia, , and how to get into research and how to get into university, and so on and so forth. And their enthusiasm for research-- their enthusiasm for university to go on-- they gave me hope for the future, that in the future there'll be more people that look like me in these kind of roles and positions in academia, as postdocs, as professors, as associate researchers, and so on and so forth, as there are a bunch of people coming after me who are enthusiastic and who are going to go far. Finally, what is your takeaway message for those listening to our conversation? I think my takeaway would be for any other early career researchers, any students, any people even looking to go into university take that chance. Apply for that job. You never know. And one day that leap of faith that you took may pay off into something that you could have never imagined. Academia can sometimes be an unfriendly place to people of color, but there is space for us here. And you should never feel diminished. You should never feel as though you're not worth it or you can't do it. Because we are. I never would have thought I would be here five years ago. But here I am on a podcast at ACAMH. Here I am doing impactful research. So take that chance. Take that leap and believe in yourself. I believe that your interests are your best friend. If you are passionate, if you have the drive and you have the ability to apply to pursue things, you are in no means going to have a problem. For you to actually be able to apply for you to demonstrate that you're passionate about research in the field that you want to go into is already amazing. And congratulations on the actual initial application process and trying. That is the main part, for you to actually believe you're worthy enough for these positions. Imposter syndrome is real, especially when you're at university and you're literally competing with everyone around you. But think of it as a competition with yourself. Think about as you're a toolbox for your own progression. Have faith. Apply. Go for it. And if you don't get in the first time, apply to get into another position. Don't give up. I think my takeaway message would be there is hope, even though we're researching things that are quite upsetting and shows the unfortunate reality that racism still does exist, and especially with the horrific events that have recently occurred, for example, with George Floyd. I still think that a takeaway message is that there is hope, and that the work that we are doing and many others are doing will really help better everyone-- racialized communities and also everyone else. It will create a better place for everyone to live, a better society. I believe that your interests are your best friend. If you are passionate, if you have the drive and you have the ability to apply to pursue things, you are in no means going to have a problem. For you to actually be able to apply for you to demonstrate that you're passionate about research in the field that you want to go into is already amazing. And congratulations on the actual initial application process and trying. That is the main part, for you to actually believe you are worthy enough for these positions. Imposter syndrome is real, especially when you're at university and you're literally competing with everyone around you. But think of it as a competition with yourself. Think about as a toolbox for your own progression. Have faith. Apply. Go for it. And if you don't get in the first time, apply again to another position. Don't give up. In terms of TRADE and the impact that TRADE hopes to bring is that we hope to see that our research is actually implemented in spaces that can create this large impact of change. We can write reports, and we can interview hundreds of people living in London, living in the UK. But we can only make impactful change if those in charge are willing to listen. I hope that this research reaches the right people and opens up the ears of those who have not been willing to listen in the past. And I hope that this project helps to inspire other projects in fields that have been neglected. Thank you so much. Thanks for your time, and good luck with all your endeavors. For more details on Hannah Abdullah, Malaika Okundi, and Carl Semilla, please visit the ACAMH website, www.acamh.org, and Twitter @ACAMH-- ACAMH is spelled A-C-A-M-H. And don't forget to follow us on your preferred streaming platform. Let us know if you enjoyed the podcast with a rating or review. And do share with friends and colleagues. This podcast was brought to you by the Association for Child and Adolescent Mental Health, ACAMH for short.