Black and minority ethnic people and mental health in Britain: an holistic approach (original) (raw)

Ethnicity and the Mental Health Act 1983

The British Journal of …, 2007

Background Black and minority ethnic (BME) patients are disproportionately detained under the Mental Health Act 1983. There has been no systematic exploration of differences within and between ethnic groups, nor of the explanations put forward for this excess. Aims To systematically review detention and ethnicity, with meta-analyses of detention rates for BME groups, and to explore the explanations offered for ethnic differences in detention rates. Method Literature search and meta-analysis. Explanations offered were categorised, supporting literature was accessed and the strength of the evidence evaluated. Results In all, 49 studies met inclusion criteria; of these, 19 were included in the meta-analyses. Compared with White patients, Black patients were 3.83 times, BME patients 3.35 times and Asian patients 2.06 times more likely to be detained. The most common explanations related to misdiagnosis and discrimination against BME patients, higher incidence of psychosis and differences in illness expression. Many explanations, including that of racism within mental health services, were not supported by clear evidence. Conclusions Although BME status predicts psychiatric detention in the UK, most explanations offered for the excess detention of BME patients are largely unsupported.

Mixed ethnicity, health and healthcare experiences

2001

Conventions and definitions The word 'race' is used within single quotes to emphasise that it is a contested term, a constructed rather than biological category. Black is used with an initial capital letter where it refers to people of Asian or African-Caribbean descent who share a common experience of racism because of their skin colour (Donovan 1984: 363). It is also used to indicate the shared experience, in a political sense, of all non-white individuals, population sectors and communities who may be visibly identified in Britain today. However, the term 'Black' is fluid and contested and must be used with caution; it may, for example, suit Sikhs from the Punjab to describe themselves as 'Black' under some circumstances or as 'Asian' or even 'Indian' under others (Smaje 1995: 26). I acknowledge that there is a risk of homogenising 'Black' and losing important geographical and cultural distinctions, though I have striven to avoid this. Quotations using these terms appear as in the original text. 'Phenotype' is defined in the Oxford English Dictionary as: A type of organism distinguishable from others by observable features. 'Phenotypical' refers to the observable differences between organisms. The term is frequently used in debates concerning 'race' and ethnicity to distinguish so-called 'races'. In contrast, 'genotype' and 'genotypical' refer to the genetic composition of an individual organism, which can only be discovered by sophisticated scientific analysis, and does not necessarily relate to appearance. The definitions of 'racism' used in this thesis include Bhavnani's contention that it is: 11 … a system of domination and subordination based on spurious biological notions that human beings can be fitted into racially distinct groups. … both 'race' and racism come to be economic, political, ideological and social expressions. In other words, 'race' is not a social category which is empirically defined: rather, it is created, reproduced and challenged through economic, political and ideological institutions. (Bhavnani, 1997: 28.) Henley's practical definition (1991: 2), has also been useful. It states that racism occurs when patients receive unequal treatment because of their skin colour or ethnic origin. It indicates that racism arises when individuals are in positions that give them the power to operationalise their prejudices. Other definitions have also been of use, for example: Racism by our account constitutes a set of practices which exclude or in some way disadvantage black people. (Knowles and Mercer (1992: 115.) … the dogma that one ethnic group is condemned by nature to congenital inferiority and another group is destined to congenital superiority … (Benedict (1943: 97.) What is 'race'? Migration has always been a part of human history. It has led to meetings and interaction between people from different locations who have different cultures and beliefs. Miles (1989: 11) suggests that this led to the construction and reproduction of a set of beliefs about the 'other', partly to explain differences in appearance and partly to form the basis for interaction. These constructions of the 'other' also represent the construction of 'race'. However, this does not particularly facilitate an understanding of 'race' and Malik notes that: One of the striking aspects of the study of race is that everyone knows what 'race' is, but no-one can quite define it. (1996: 2.) Dominelli extends the debate, arguing that: 12 Relationships between black and white people have been characterised by notions of white supremacy in which white people refuse to accept the human worth of black people and structure social interaction between them accordingly. … Black people have been portrayed as 'naturally inferior and dangerous', making difference-whether expressed through physical or social attributes-a basis for the justification of unequal social relations which privilege white people. (1997:2) (Original emphasis.) The concept and representation of the 'other', and therefore of 'race', has changed and developed over time. Miles noting that the common Eurocentric definitions of the 'other', and of Western Europe as having a powerful economic, cultural and political being, began in medieval times: The notion of Europe as an entity began to emerge only in the Eighth Century and, until at least the Twelfth Century, it was subordinate to the economic and politico-military power of the Islamic world. (1989: 13.) In this medieval period, the 'other' in Britain was represented as phenotypically and culturally deviant from the norm and took a variety of monstrous forms often being described as the result of interbreeding with apes. 'Black' people, especially males, were portrayed as being invested with a wild and aggressive sexuality and were represented as anthropophagi, savages and barbarians. For examples of reports supporting these statements see Hakluyt (1972), though it is noteworthy that the various reports and descriptions are neither self-consistent nor stable. In many ways, the way in which non-white people were perceived in Britain changed little for almost 500 years. The oppression continued, perhaps best characterised by the slave trade which was well-established by the late middle ages and, as early as the middle of the 15 th Century, slaves from Africa were regularly transported to mainland Europe (Banton, 1967: 101). However, by 1837 there was some evidence of changing attitudes with the 13 establishment of the Aborigines Protection Society (Bolt, 1971:1) and the subsequent abolitionist movement. Concurrently, there is some evidence (see for example, Rex, 1970 or Bolt, 1971) that the stereotype of black males is changing so that they are represented as being of lower intelligence that white people, but without the monstrous dangers portrayed in earlier descriptions. Darwin published Origin of Species in 1859 showing that all humans were of the same 'stock' or species. People from anywhere in the world can breed and produce viable, fertile offspring. This should have confirmed that 'race' does not exist in humankind and put an end to the debate, though Fyfe (1994: 73) believes that, due to pressure from the Established Church, Darwin hinted in subsequent work that human sub-species might exist. 'Scientific race' Historians trace the concept of 'race' back to antiquity. Creationists and many Religious fundamentalists argue that humans are all descended from one individual, Adam in Jewish, Christian and some other religions. Subsequent phenotypical differences are attributed to migration, climate and environment, though it is not clear why or how rapidly these differences were supposed to manifest. Banton (1983: 38) argues that some see it as 'God's will' that people in different locations should be physically different. It is also possible to argue that, for example, Europeans, Asians and Inuit people, had separate ancestors and that Genesis is, simply, an incomplete account. Acceptance of this argument ignores an inherent difficulty; if disparate groups of humans originated in isolation, how is it that all humanity belongs to the same species? The foundations of 'race', as we experience it today, are to be found both in the Enlightenment and in the religious revivals of the eighteenth century (Mosse 1985: 3). They

Race and Ethnicity in British Sociology Report - British Sociological Association

British Sociological Association, 2020

This report is concerned with the place of race and ethnicity in the teaching of British Sociology. More specifically, the report examines the place of race and ethnicity in undergraduate Sociology degree courses and considers the issues and barriers to the teaching of race and ethnicity.

Political Blackness in Multiracial Britain

Mohan Ambikaipaker's "Political Blackness in Multiracial Britain" is distinctive both for its setting and for its personal engagement. Ambikaipaker practiced "activist anthropology" by carrying out "observant participation" as a caseworker for the Newham Monitoring Project, a community activism organization, over the course of two years. The book alternates between anecdotal accounts of racism and the author's theoretical and historical framing of those accounts. Ambikaipaker's writing is compelling, his theoretical grounding is thorough, his empathy is apparent, and the fieldwork underpinning it is considerable and consequential.

Chapter 6 Racism and Mental Illness in the UK

2013

There is substantial evidence of differential outcomes for different racial and ethnic groups in many health, social and economic arenas in the United Kingdom today, ranging from dis‐ ease prevalence and outcome, hiring and promotion in the labour workforce, to loan appro‐ vals in mortgage lending, to rate of arrest and detention in the criminal justice system. These disparities – and others – describe social conditions that most Britons believe deserve some measure of attention. To understand such conditions and to fashion appropriate responses, it is important to assess whether and how racism and racial discrimination, along with other factors, may contribute to observed disparities in mental health outcomes among racial and ethnic groups.

Widespread racism in the UK's health and social care sector is a significant threat to public health

Population medicine, 2023

Population Medicine considers the following types of articles: • Research Papers-reports of data from original research or secondary dataset analyses. • Review Papers-comprehensive, authoritative, reviews within the journal's scope. These include both systematic reviews and narrative reviews. • Short Reports-brief reports of data from original research. • Policy Case Studies-brief articles on policy development at a regional or national level. • Study Protocols-articles describing a research protocol of a study. • Methodology Papers-papers that present different methodological approaches that can be used to investigate problems in a relevant scientific field and to encourage innovation. • Methodology Papers-papers that present different methodological approaches that can be used to investigate problems in a relevant scientific field and to encourage innovation. • Letters to the Editor-a response to authors of an original publication, or a very small article that may be relevant to readers. • Editorials-articles written by the Editorial Board or by invited experts on a specific topic. Research Papers Articles reporting research may be full length or brief reports. These should report original research findings within the journal's scope. Papers should generally be a maximum of 4000 words in length, excluding tables, references, and abstract and key points of the article, whilst it is recommended that the number of references should not exceed 36.

Research with black and minority ethnic people using social care services

This review addresses research methods with Black and Minority Ethnic (BME) people using adult social care and support in England. During the last decade there have been considerable changes in how ethnicity is understood. Among these are exciting developments in research sensitive to ethnicity and the further development of anti-racist policy, practice and outcomes in social care. The review summarises these developments and offers practical advice on applying their lessons. Material from other disciplines including health and other disciplines is also drawn on for methodological advances relevant to social care research. The review is designed to be useful not only for researchers who are new to social care (and health care in particular) and hoping to learn more about this important topic, but to seasoned researchers, social care practitioners and students as well.

Multicultural mental health services: projects for minority ethnic communities in England

Transcultural psychiatry, 2005

Black and minority ethnic (BME) communities form 7.8% of the total population of the UK. Many of these communities face a variety of disadvantages when they access, or are forced to access, statutory mental health services under the National Health Service. Efforts have been made to address these problems by developing projects both within statutory mental health services and in the non-governmental ('voluntary') sector. This article describes some of these projects located in England, drawing out the themes and models that underlie their approaches, and discusses the lessons that can be learned from the U.K. experience. Key words ethnic minorities • inequality • multicultural • NGOs • racism The UK, comprising England, Scotland, Wales and Northern Ireland, has seen waves of immigration over the centuries. Until recently, immigration had been largely from other parts of Europe, but many of the immigrants during the postwar period were from South Asia, Africa and the Caribbean islands of the 'West Indies.' The terminology used to describe the different racial, cultural and ethnic groups now permanently resident in the UK has varied from time to time. The concepts 'race' and 'culture' have given way to 'ethnicity' for the purpose of categorization, the standards being set by the categories used in the national census (White, 2002). Ethnicity is usually self-ascribed to reflect self-perception in a