Engaging with mental health services
Communication problems
For a growing number of people in the UK, English is not their first language. The diagnosis process relies largely on talking to the person with mental illness and their carers, yet few health services providing consultations in languages other than English. As a result of such language barriers, doctors may uncover insufficient information during consultations which may lead to an inaccurate diagnosis.
- Cultural differences in seeking help
People from some cultures are more willing to go to professionals to seek help than others. This can be for a number of reasons. In some cultures professionals place a low priority on mental illness and so resulting treatment is poor and people do not see the point of putting effort into getting such help. In other cultures mental illness may be seen as bringing shame on the family, who may because of this, be reluctant to share what is seen as a private problem outside immediate family.
- Different views about mental illness
The psychiatric system in the UK is based on a westernised model of illness. This sees mental illness as something that is wrong with a person and that must be cured. However, mental illness in other parts of the world is seen in a more holistic way taking into account the mental and spiritual difficulties experienced by a person with mental illness. The inability to engage with people on these levels often discourages people from bme communities from seeking help while those that do seek help may be poorly diagnosed.
- Inappropriate services
Mainstream psychiatric services were set up to deal with mental illness experienced by the ‘population majority’ of the time - largely being white British individuals with mental illness. These services deal mainly with the person's mental illness and largely ignore the mental and spiritual wellbeing seen as important in other cultures. In this way, some services may be inappropriate to people from Asian and afro-Caribbean communities who experience and relate to mental illness in a more holistic sense.
- Poor risk assessment
The Inside/Outside report in 2003 highlighted that risk assessment was a key point of racist practice. People from BME communities are much more likely to be assessed as presenting a concern to the public and as a result, detained under the Mental Health Act. When receiving treatment, black individuals were more likely to be given drugs by depot (injection) or given electro-convulsive therapy (ECT) than offered other options such as oral medication. Even within hospitals the risk that BME patients present is often over estimated with restraint techniques being over used on this particular group.
- Poor access to alternatives to medication
While BME groups are over represented in many psychiatric hospitals where medication is the primary form of treatment, few individuals from these communities get access to any other forms of therapy. Access to talking therapies (cognitive behavioural therapy, psychotherapy, family therapy etc) and complementary therapies (acupuncture, relaxation techniques, creative therapies) is poor among BME communities.
- Lack of BME staff
Being in hospital can be a difficult and frightening experience. However, it can be made easier if there are people there who understand your cultural background and needs – to be culturally sensitive. Few psychiatric hospitals outside of London have many mental heath workers from BME communities and this can be to the detriment of patients and families.
