Diversity In Mental Healthcare Provision

By Author: Henry Ford
Total Articles: 189
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There are many people in the UK who are marginalized and discriminated against and these people are over represented in the mental health services. The majority of these people are the Blacks and the Ethnic minority communities. Consequently, their needs are not met. Research has shown that there is a difference between Blacks and the ethnic minority communities and the majority White people on access to mental health care, utilization of mental healthcare resources and treatments prescribed by the mental health services (Lloyd, 95-101). Access and utilization of mental health care is important for the mentally handicapped in the whole community. But the full utilization of these services in any culture depends on various factors e.g. attractiveness of the services delivered, cultural appropriateness of the services offered, previous experiences in a mental health facility, cultural attitudes of the community towards mental health services, and culturally defined lay referral systems.

Due to inaccessibility of modern psychiatric treatment and discrimination most ethnic minority communities have resulted to traditional ...
... healers (Goldberg, 23-28). This may also be caused by the persistence of these communities to traditional pre immigration beliefs on health. Research has shown that Asians seek primary care frequently but not with mental disorders (Gillam et al, 953-957). These are least likely to be referred to specialist services. The blacks are least likely to be recognized with a mental disorder in primary care but are most likely to be referred to specialist care when the mental disorders are detected (Commander et al, 312-316). The whites are the most likely to be recognized with mental disorders in primary care. Black people are overrepresented in mental health care centers and in psychiatric hospitals. Their need for psychiatric help, compared to their white counterparts, is more often revealed through crisis services and the Mental Health Act (Bhui, 1997).

Detention for assessment which is found in the mental health Act is more common among the Asian communities and the Blacks (Davies, et al, 533-553). The blacks are also many among the detained absconders from in patient units compared to other communities (Falkowski et al, 488-490). Most of the detained black patients view psychiatric services offered as being unhelpful and unattractive (Parkman et al, 1997). Most admission among the blacks to in patient and forensic care is mostly from referral from the police and criminal justice agencies and is rarely voluntary (Moodley, 1991). Most mental illnesses are not recognized by health care professionals especially those affecting the ethnic minority groups. This may be due to the mismatch between the signs and symptoms sought by the mental health professional and the patient’s cultural expression of the mental disorder. This may lead to the conclusion of Paranoia by the clinician.

The majority of mentally disabled patients in the minority ethnic communities are least satisfied with the in patient services that are offered in UK. The non detection of this disorder is very high. This has resulted into most patients coming into contact with the non health related agencies that include the police and forensic services (Parkman et al, 260-264).

In general, British psychiatry is a racist field. The psychiatric practice has for many years discriminated against Irish, Blacks and the Asians. It is only in recent years that the psychiatrist has acknowledged that there is a problem. This is after much has been written about Blacks and other ethnic minority experiences in psychiatric hospitals and mental health centers. As a result, attempts have been made to make these centers and other mental health service providers more sensitive and culturally aware. Even though, the perception and the experience of Blacks and Asian communities on the British psychiatric services remain largely aversive and negative. The Blacks and the Asians are disadvantaged in all aspects of contemporary psychiatric care and therefore there is a huge disparity in service usage, service satisfaction and outcome between the ethnic minority groups and the white majority (Sashidharan, 244-247).

The root of the debate on racialism in mental health centers and psychiatric hospitals is based on differences of representation in offering of psychiatric services. Observations, experiences of the ethnic minority and research studies carried out have shown that black people are overrepresented in mental health settings while Asians are underrepresented in a typical psychiatric setting. Though the most recent studies on this issue have shown a more uniform pattern of representation from the ethnic minority communities in a psychiatric care, the argument remains essentially the same (King, et al, 1115-1119). The fact that the ethnic minority are differentially represented in psychiatry lies in the differential affinity towards psychiatric services between the ethnic groups and the increased risk especially in the minority groups, of diagnostic misattribution as compared to the white majority.

The minority groups are viewed as being deviant from the White norms within the psychiatric practice and therefore they are viewed as requiring too much or too little psychiatry services. The overrepresentation of Black people and other minority groups in a psychiatric setting can be explained from two perspectives. The first is that the minority groups are more prone to mental illnesses compared to the white majority. The second perspective is that the psychiatric setting in UK racially discriminates against black people. Ethnic vulnerability has been termed as the major variable for the discrepancies in psychiatric care. This mentality has prevented a thorough examination in the practices, procedures and theoretical underpinning of modern psychiatry. For the past 50 years or so, the academic agenda within psychiatry has been pinned around the study of race differences. This has led to the inability of mental health care practitioners and psychiatrists in addressing and changing the unjust nature of psychiatric practice experienced by the blacks and other ethnic minority groups (Callan, 253–256).

Despite a lot of money being spent for the search of Black Schizophrenia, there is no evidence that ethnic factors contribute to mental illness. Even though, the professional preoccupation that Black people and ethnic minority groups suffer most from mental illnesses is not diminishing soon. Because of little yields on the research on Black Schizophrenia, and on the ethnic minority groups experience, psychiatrists in UK continue to hold the that Black people are more vulnerable to developing schizophrenia as compare to normative White people. There is no psychiatric care in UK that favors the blacks as compared to the whites and this is in line with other sectors like educational institutions, policing, and the criminal justice which all militates against the black people. The issue at hand is not why the blacks and other ethnic minority groups are over represented or underrepresented in the psychiatric practice but it is about how these groups experience psychiatry and why their experience is usually discriminatory and negative in nature.

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