Ethnicity & Mental Health
Ethnicity
Britain is a multicultural society with 6% of the total population representing black and ethnic minorities. The subjective imprecise nature of ethnicity makes it difficult to define and measure. Ethnicity encompasses physical appearance, self-identification, sense of belonging, values and attitudes, language, behaviour, and knowledge of ethnic history. It is important to highlight that skin colours alone do not mark genetic differences, as human beings are not colour-coded.
According to the Commission for Racial Equality, people with diverse histories, cultures, beliefs and languages have settled here since the beginning of recorded time. People from South Asia, Africa and the Caribbean arrived in substantial numbers after the Second World War to meet severe labour shortages. More recent arrivals include refugees and asylum seekers from Vietnam, Somalia, Turkey, the Middle East and the former Yugoslavia.
Melba Wilson (1997) Mind's race and mental health adviser attempted to go behind the statistics of Minds “Raised Voices” survey, to report the responses from African-Caribbean and African mental health service users, about their experiences of the UK mental health system. Of the 1000 questionnaires sent out, only 100 responded.
In a total of 72 responses, 27 out of the 49 male respondents had been given a diagnosis of schizophrenia, and 17 of the 23 female respondents had been given a diagnosis of schizophrenia. One respondent wrote that he was diagnosed with schizophrenia, but was not told this for a long time. Another said she was not diagnosed as being mentally ill, but had been in a psychiatric hospital for two years. At least five respondents said they did not know their diagnosis.
Fifty three per cent said their first contact with mental health services was through their GP, which contradicts previous findings. However this figure is still less than the general population. Eight women and 19 men said they entered the mental health system through the criminal justice system, either police, the prison service or by the courts.
More than 85% of people said they had not received treatment in a psychiatric ward or hospital. Some respondents ticked more than one box for this question and said they had been treated as a community outpatient. Seventy one per cent of women said they had received out patient treatment at some point, only 31% of men said this was the case. Four women and 15 men had received treatment in a medium secure unit or special hospital.
The majority of respondents (95%) were treated with psychiatric drugs. Only 32% has received counseling, and only 17% received psychotherapy. Fourteen people said they had received electro-convulsive therapy.
The majority (85%) of those currently in treatment said they had a named keyworker, and over half regarded the relationship as favourable. However this leaves 15% with no keyworker. Comments from those who did not find their keyworker helpful suggested their workload was to heavy.
Two thirds (65%) of respondents said their treatment had been discussed with them. Of these, 79% reported that their psychiatrist had discussed their treatment with them. Others who had discussed treatment with them included GP’s, nurses, and social workers.
More than half (58%) of respondents had reported personal experience of racism in general life, not connected with their mental health care. Incidents included being called names (75%), experiencing hostility (58%) and being threatened (34%). Sixty two percent of women compared with 56% of men experienced some form of racism. Half of the sample felt others treated them differently in general because they were black and were known to have mental health problems. Comments included: “People are not willing to listen to your problems;” “Treated like second class citizens;” “I feel I am not trusted,” and “I wonder if they expect me to attack them sometimes.”
The main reason for discrimination suggested by 41 respondents was a lack of public education about racist attitudes and racist stereotypes. Furthermore, 39 respondents suggested personal prejudice was the reason, and 26 respondents felt stories in the media contributed to racial discrimination. This suggests that black mental health users see public education as the key to challenge racial stereotypes and discrimination. Over a quarter (26%) said they felt mental health professionals treated them differently because they were black.
Responses included: “Being mixed race and in hospital meant that I was ignored, so I used to do mad things to gain attention;” “They ignore us as hopeless cases as if we are more crazy,” and “Black people are treated as if they are not intelligent.” The respondents also found that psychiatric staff ignored their culture, as a respondent highlighted that staff need to “be aware that what may be considered mad in one culture may not in another.” Sadly a respondent said “differences were seen as negative; felt I had to disown my culture and “act white,” and felt guilty for making professionals feel uncomfortable or awkward for not understanding my culture.” Furthermore, 52% said they did not think most health professionals took their culture into account.
Dr. Nazroo’s (1997) findings based on interviews with 5,196 Caribbean and Asian people and 2,867 white people, found that both Caribbean men and white men’s rates of psychosis are around one in a hundred, but young Caribbean men are more likely to be admitted to hospital for treatment. Meanwhile Caribbean women’s rate of psychosis is nearly twice that recorded among white women. Furthermore, around 7% of young Caribbean people aged 16 to 24 years said their lives were not worth living compared to 2.5% of their white peers, and those less likely to display symptoms of mental illness were Asian. Other studies have shown that more elderly people from ethnic minorities may be at risk of suffering from dementia and depression.
Overall Caribbean people were found to have the highest rates of mental illness. However other studies claim the Irish out of all the ethnic minorities in the UK have the poorest record of both physical and mental health.
References
Wilson, A (1997) African-Caribbean and African people's experiences of the UK mental health services. Mental Health Care, 1(3), p. 88-90.
Nazroo, J.Y. (1997) Ethnicity and Mental Health. Policy Studies Institute London.
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Ethnicity and Mental Health
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Maudsley Discussion PapersPaper
No.8
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