- Sketch - (Government Policies on Mental Health Care Bill - UK)
Historical facts revealed that, there has been a lack of reliable ethnicity data relating to mental health care services. Inspite of this, there is significant and local anecdotal evidence of the disproportionate impact of services upon ethnic minority communities. These evidences were generated by independent Commissions including , Health Care Commission and Mental Health Act Commission.
A comprehensive quantitative and as well as qualitative research method was initiated in obtaining live data models whereby, the results are currently used and been perceived as the factual representation of service used to date cited in Parliamentary Briefing for Mental Health Bill.(16th April,2007). Source:[Internet] [Last Accessed: 21st March, 2007.]
Also, in recent years key findings in the “Count Me In Census” exposed what many people had long suspected, especially people from a number of Black Minority Ethnic Communities had very different experience in mental health services. Key findings of the “Count Me in Census “ in 2005 – 2007
See Appendix 1.1
- Determinants of Health for Minority Ethnic Communities
It is evidently clear that that BME’s Community are directly affected by the above health factors which quite worrying for parents and relatives of affected victims of Poor Mental Health Care services. Therefore, raising awareness on key factors such as Poverty, Unemployment, Bad-housing, Social-isolation, Pollution, Ethnic-minority status and gender - have for too long been regarded as peripheral to health policy.
In regards to Mental Health, there are other contributory factors that are quite related to the above mentioned determinants in the BME Communities such as Alcohol and Drugs, Immigration regulatory policies, Lack of Adult Education Programs, Cultural differences, Socio-economic issues and Inequality. One of the main determinants is the draconian migration control policies which has created a vacuum in the BME communities. See Appendix 1.5
As a result of these inconsistencies with migrant worker’s and asylum seeker’s regulatory policies, it h has influenced the degradation of Socio-economic status and access to quality health care in the UK. This has vacuum has left BME communities with limited options, rather that been productive i.e improve their living standards through community projects and self- help initiatives
Therefore, most black ethnic minority youth, young adults, women and men subsequently ended up depressed and became much more vulnerable to the abuse of street drugs and crime.
- Critical Evaluation – Mental Health Care Services in BME Communities.
Contemporary issues involved in providing quality health care in Black Minority Health Care, varies across all sort of ill health issues, which we can now say its been perceived as a mockery to the victims and relatives who are directly affected. These policies cannot be ignored, due to the biased delivery and disproportionateness of mental health services to Black Minority Communities.
Research analysis and fact finding initiatives conducted by various independent and non-governmental practitioners’ reveals that, there are still more Health concerns, especially the delivery methodologies of Mental Health Services to the Black Minority Ethnic Communities. Whereby raising the awareness of cultural and ethnic practices in those communities that are contrary to an effective mental health care and the good practices in the UK.
Also, the legal arrangements in addressing mental health and crime has been defect, which raises the question regarding the implementation of the race equality duty and the degree to which the individuals concerned would be covered by the duty and the approval of mental health professional whom should be subject to race equality duties. Other secondary finding reveals that inpatients at admitted at mental health center are been misdiagnosed and also victims of stereotype. Cited in Parliamentary Briefing for Mental Health Bill. Source: [Internet] [Last Accessed: 21st March, 2007.] See Appendix 1.6
Therefore, the Commission for Race Equality(CRE) has recommended and also pinpointed their views on the proposed Mental Health Bill that should put firm legal provision in place to prevent ongoing disproportional of ethnic minorities in mental health services. See Appendix 1.2
- Conclusion
The government has recognized the importance of the mental wellbeing of Black Minority Ethnics in the UK and these concerns needed participation in raising the awareness of the need to improve Mental Health Services for individuals with mental health issues. Recent development indicated that, there have been numerous strategic amendments to the mental health bill in an effort to address the ongoing problems that have arisen within the mental health system. However, Implementation of these strategies has begun, but there has been little evidence to determine how effective they are or how it will be in time to come.
Therefore, the underlying factors that affect fairness in the delivery of mental health services will still remain in the UK health system, if health policy makers failed to acknowledge the problems of mental health care as it is experienced by black and minority ethnic groups. See Appendix 1.3
In order to conclude this topic, I will like to reinforce my research findings with this quotation
“Coming events cast their shadows before them” Anonymous.
7. Bibliography
World Health Organization (WHO), 1986, Health and Welfare, Canada: Canadian Public Health Association.
Acheson, D, 1998, Independent Inquiry into Inequalities in Health Report, London: The Stationery Office.
Parliamentary Briefing for Mental Health Bill. (16th April, 2007).
Count Me In Census 2005, Mental Health Act Commission & Healthcare Commission.
Hiro, D, 1991, Black British, White British: A History of Race Relations in Britain, London: Grafton.
Sainsbury Centre for Mental Health (2002) “Breaking the Circles of Fear”
Nero, J.Y, Ethnicity and Mental Health, findings from a National Community Survey, Policy Studies Institute, London
8. References
-
World Health Organisation (WHO), 1986, Health and Welfare, Canada: Canadian Public Health Association. Source: [Internet] [Last Accessed: 20th March, 2007].
-
Acheson, D, 1998, Independent Inquiry into Inequalities in Health Report, London: The Stationery Office. Source: [Internet] [Last Accessed: 21th March, 2007].
-
Parliamentary Briefing for Mental Health Bill. (16th April, 2007). Source: [Internet] [Last Accessed: 21st March, 2007.]
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Count Me In Census 2005, Mental Health Act Commission & Healthcare Commission. Source: [Internet] [Last Accessed: 21st March, 2007.]
-
Hiro, D, 1991, Black British, White British: A History of Race Relations in Britain, London: Grafton. Source: [Internet] [Last Accessed: 20th June, 2007.]
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NHS – National Institute for Mental Health (Inside Outside) Improving Mental Health for Black Minority Ethnic Communities in England [Internet]Http://www.nimhe.org.uk[Last Accessed: 19th June 2007.
9. Appendixes
Appendix 1.1 Key findings of the “Count Me in Census “in 2005 – 2007
a). Health Commission – Count me in Census - 2005.
- 70% of ethnic minority services users are in just 23 of 212 sites. 184 of the 212 organizations had less than 50 inpatients from ethnic minority communities.
- Ethnic communities which are over-represented in the system are White Irish, White Other, Black-Caribbean, Black African, Other Black, Mixed and Bangladeshi
- 33-44% higher than average rates of detention for Black males (different groups)
- Rates of seclusion were 50% higher in African-Caribbean males
- Control and restraint rates were 30% higher for African-Caribbean males
- The three principal South Asian communities have very different experiences - Indians are under-represented, Pakistani are representative and Bangladeshis are over-represented in the system.
Source: Count Me In Census 2005, Mental Health Act Commission & Healthcare Commission. Source: [Internet] [Last Accessed: 21st March, 2007.]
b). Health Care Commission “Count Me In Census” - 2007.
- In March 2007, the results of the second annual 'Count Me In Census', carried out in March 2006, were published. These results reaffirmed the findings from the initial census. The Census collected ethnicity data relating to 98.9% of inpatients within 328 mental health units. Headline findings include:
- 21% of inpatients were from ethnic minority backgrounds
- 70% of black and minority ethnic patients were in 23 of the 238 organizations
- 5% of inpatients reported that their first language was not English
- Rates of admission were highest in Black and White/Black Mixed groups (three or more times higher than average). Highest admission rates were among men from the Other Black group at 18 times higher than average (this category may include a number of 'second generation' Black British people)
- Black Caribbean, Black African and Other Black people were between 35% and 53% less likely to have been referred to services by their GP
- Black Caribbean (48%), Black African (45%) and Other Black groups (41%) were all much more likely to be referred to services via the Criminal Justice System, rather than general practice or other community based services
- Black Caribbean, Black African, Black Other, White/Black Caribbean Mixed, and White/Black African Mixed groups were between 19% and 38% more likely than average to be detained
- The rate of hands-on restraint was highest in the White/Black Caribbean Mixed group
- The Black Caribbean group had the highest median duration of stay.
Source: Count Me In Census 2006, Mental Health Act Commission and the Healthcare Commission. Source:[Internet] [Last Accessed: 21st March, 2007.]
Appendix 1.2
Recommended By Commission for Race Equality(CRE)
- Replace the principle of "avoidance of unlawful discrimination" with "elimination of unlawful discrimination'
- Introduce this principle to the face of the Bill rather than in a Code of Practice
- Guarantee that all Approved Mental Health Professionals are bound by the Race Equality Duty
- Strong safeguards are put in place to avoid disproportionate use of Supervised Community Treatment Orders towards ethnic minorities.
Appendix 1.3
Underlying factors that affect fairness in the delivery of mental health services
- The over–emphasis on institutional and coercive models of care
- Professionals and organizational requirements are given priority over individual needs and rights
- Institutional racism exists within the mental health care.
Source: NHS – National Institute for Mental Health (Inside Outside) Improving Mental Health for Black Minority Ethnic Communities in England [Internet]Http://www.nimhe.org.uk[Last Accessed: 19th June 2007.
Appendix 1.4
In 1986, the Ottawa Charter for Health Promotion identified
.
Nine pre-requisites for health care
- Peace
- Shelter
- Education
- Food
- Income
- A stable economic system
- Sustainable resources
- Social justice
- Equal opportunity for all.
World Health Organisation (WHO), 1986, Health and Welfare, Canada: Canadian Public Health Association. Source: [Internet] [Last Accessed: 20th March, 2007].
Appendix 1.5
Migration control policies
“…In this country, under the British Nationality Act 1948, large groups of post-war economic immigrants came from the poorer Commonwealth territories, which included the Caribbean. Under this Act, citizens of the British Commonwealth were allowed to enter Britain freely in order to find work and settle. Many chose to take this option as a result of employers and government-led recruitment schemes….
….Even when immigration was encouraged for economic reasons, attitudes towards the newly arrived African-Caribbean people were inconsistent….”
Cited in Hiro, D, 1991, Black British, White British: A History of Race Relations in Britain, London: Grafton. Source:[Internet][ Last Accessed: 20th June, 2007.]
Appendix 1.6
“…It is also well documented that African Caribbean users are more likely to be misdiagnosed with psychotic conditions and treated using medication, which is often of a higher dosage…”
Source: ‘Sainsbury Centre for Mental Health (2002) Breaking the Circles of Fear’
“ …Alongside this concern, there is also a perception that the introduction of Supervised Community Treatment Orders (SCTO) and the concentration of decision-making with regard to detention within the hands of a number of professionals could further lead to the excessive detention of people from particular ethnic backgrounds. A clear concern is that individuals, specifically African-Caribbean young men, who should be released from the mental health system will be subject to SCTOs simply because of stereotyping and a sense that the professional involved will be unnecessarily reluctant to release them, for fear of future actions…”
Parliamentary Briefing for Mental Health Bill. Source:[Internet] [Last Accessed: 21st March, 2007.]