Multicultural mental health services: projects for minority ethnic communities in England (original) (raw)
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Ethnic mental health inequalities and mental health policies in England 1999-2020
Journal of Public Mental Health, 2022
Purpose This paper presents a thematic synthesis of mental health policies published in England from 1999 to 2020. Design/methodology/approach This paper aims to present a thematic synthesis of mental health policies published in England from 1999 to 2020. The authors specifically focus on ethnicity-related mental health issues highlighted in policies, policy recommendations and performance measurements of policy implementation. Findings Findings from this synthesis demonstrate that ethnic mental health inequalities remain comparable over the past two decades. Ongoing issues include a lack of data on the ethnicity of mental health services users. Where data is available, these highlight ethnic inequalities in access to, experiences of and outcomes of mental health services, as well as a lack of cultural capability in health-care professionals. Policy recommendations have also remained the same during this time and include: collecting data on the ethnicity of service users, raising a...
Exploring Adult Mental Health in Minority Ethnic Groups in the Royal Borough of Greenwich: Implications of Partnership Working, 2019
This study examines the perception of the relationship between mental health and ethnicity and looks at partnership working within the adult mental health services in the Royal Borough of Greenwich. To explore these issues, semi-structured one-to-one interviews were conducted with gatekeepers. Secondary data of 212 service users were also collected to further investigate the relationship between ethnicity and mental health. Both qualitative and quantitative methods were used to carry out this research. Findings from this study revealed that people's perceptions of the relationship between mental health and ethnicity are often biased by society's opinion or their own ethnic heritage, and consequently these perceptions do not correspond with statistical data. Further findings also reveal that providers would need additional information/training to understand partnership working. Findings also highlight the importance of psychoeducation of the wider public in order to reduce the severity of mental health problems among minority ethnic groups, as it was identified by the interviewed gatekeepers that cultural issues (mental health is taboo and/or stigmatised) can hinder individuals from accessing the right services at the right time. This is an explorative study; therefore, further rigorous research approach is needed to establish association between mental health and ethnicity.
The British Journal of Psychiatry, 2007
Background Minority ethnic groups in the UK are reported to have a poor experience of mental health services, but comparative information is scarce. Aims To examine ethnic differences in patients' experience of community mental health services. Method Trusts providing mental health services in England conducted surveys in 2004 and 2005 of users of community mental health services. Multiple regression was used to examine ethnic differences in responses. Results About 27 000 patients responded to each of the surveys, of whom 10% were of minority ethnic origin. In the 2004 survey, age, living alone, detention and hospital admissions were stronger predictors of patient experience than ethnicity Self-reported mental health status had the strongest explanatory effect. In the 2005 survey, the main negative differences relative to the White British were for Asians. Conclusions Ethnicity had a smaller effect on patient experience than other variables. Relative to the White British, the B...
2023
Background Long-standing ethnic inequalities in access and mental healthcare were worsened by the COVID-19 pandemic. Objectives Stakeholders coproduced local and national implementation plans to improve mental healthcare for people from minority ethnic groups. Methods Experience-based codesign conducted in four areas covered by National Health Service (NHS) mental health trusts: Coventry and Warwickshire, Greater Manchester, East London and Sheffield. Data were analysed using an interpretivist-constructivist approach, seeking validation from participants on their priority actions and implementation plans. Service users (n=29), carers (n=9) and health professionals (n=33) took part in interviews; focus groups (service users, n=15; carers, n=8; health professionals, n=24); and codesign workshops (service users, n=15; carers, n=5; health professionals, n=21) from July 2021 to July 2022. Findings Each study site identified 2-3 local priority actions. Three were consistent across areas: (1) reaching out to communities and collaborating with third sector organisations; (2) diversifying the mental healthcare offer to provide culturally appropriate therapeutic approaches and (3) enabling open discussions about ethnicity, culture and racism. National priority actions included: (1) coordination of a national hub to bring about system level change and (2) recognition of the centrality of service users and communities in the design and provision of services. Conclusions Stakeholder-led implementation plans highlight that substantial change is needed to increase equity in mental healthcare in England. Clinical implications Working with people with lived experience in leadership roles, and collaborations between NHS and community organisations will be essential. Future research avenues include comparison of the benefits of culturally specific versus generic therapeutic interventions. HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY ⇒ Substantial change is needed to increase equity in mental healthcare. ⇒ Our implementation plans for priority actions present many avenues for testing organisational and service-based changes.
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.
Global Mental Health
Although mental health (MH) services and psychological support are tailored to fit the MH needs of those requiring these services in the UK, underutilisation persists. Current evidence suggests that ethnic minorities underutilise MH services with culture implicated in this trend. However, there is limited evidence from systematic reviews integrating the findings of primary studies on the role of culture in MH service utilisation among ethnic minorities. This review aims to synthesise and summarise evidence on the role of culture in MH service utilisation among ethnic minorities in the UK. Two reviewers searched CINAHL, APA PsycINFO and Medline databases using the Preferred Reporting Items for Systematic Review and Meta-Analysis. Two other reviewers screened the abstracts and full text, while three conducted data extraction and assessed study quality using the Critical Appraisal Skills Programme checklist for qualitative studies. One's culture was repeatedly identified to play a ...
Ethnic inequalities in the use of health services for common mental disorders in England
Social Psychiatry and Psychiatric Epidemiology, 2013
Purpose The purpose of this study is to investigate whether minority ethnic people were less likely to receive treatment for mental health problems than the white population were, controlling for symptom severity. Method We analysed data from 23,917 participants in the 1993, 2000 and 2007 National Psychiatric Morbidity Surveys. Survey response rates were 79, 69 and 57 %, respectively. The revised Clinical Interview Schedule was used to adjust for symptom severity. Results Black people were less likely to be taking antidepressants than their white counterparts were (Odds ratio 0.4; 95 % confidence interval 0.2-0.9) after controlling for symptom severity. After controlling for symptom severity and socioeconomic status, people from black (0.7; 0.5-0.97) and South Asian (0.5; 0.3-0.8) ethnic groups were less likely to have contacted a GP about their mental health in the last year. Conclusions Interventions to reduce these inequalities are needed to ensure that NHS health care is delivered fairly according to need to all ethnic groups.
Ethnic variations in pathways to and use of specialist mental health services in the UK
British Journal of Psychiatry, 2003
BackgroundInequalities of service use across ethnic groups are important to policy makers, service providers and service users.AimsTo identify ethnic variations in pathways to specialist mental health care, continuity of contact, voluntary and compulsory psychiatric in-patient admissions; to assess the methodological strength of the findings.MethodA systematic review of all quantitative studies comparing use of mental health services by more than one ethnic group in the UK. Narrative analysis supplemented by meta-analysis, where appropriate.ResultsMost studies compared Black and White patients, finding higher rates of in-patient admission among Black patients. The pooled odds ratio for compulsory admission, Black patients compared with White patients, was 4.31 (95% CI 3.33–5.58). Black patients had more complex pathways to specialist care, with some evidence of ethnic variations in primary care assessments.ConclusionsThere is strong evidence of variation between ethnic groups for vo...