Transcript What is Mental Health? - London Safeguarding Children Board

MENTAL HEALTH AND BLACK & MINORITY
ETHNIC CHILDREN & YOUNG PEOPLE
OUTCOMES
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How to reach and engage with young people
from black and minority ethnic groups who may
require help from mental health services
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What needs to happen to aid the development of
effective service provision for young people from
black and minority ethnic groups.
NATIONAL CENSUS 2001
Minority ethnic population of the UK: 4.5 million (7.6%)
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Indians
Pakistanis
Black Caribbeans
Black Africans
Mixed ethnic backgrounds
ETHNICITY
VISIBLE ETHNIC MINORITIES
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Black Caribbean
Pakistani
Indian
Bangladeshi
Chinese
Travellers
OTHER GROUPS
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Iraqis
Somalis
Yemenis
Iranians
Kurds
Bosnians
Algerians
Tamils
Vietnamese
UNDERSTANDING ETHNICITY
Ethnicity is…
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A process by which people create and
maintain a sense of identity
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Something that we all have
Barriers to access
HELP SEEKING BEHAVIOUR
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Determined by a variety of factors:
Level of psychological distress
Personal problem-solving skills
Environmental factors
Negative attitudes towards mental health
professionals
Preferences for informal sources of help (friends,
family members)
Religious coping strategies
ENGAGEMENT WITH MENTAL HEALTH SERVICES
 Use
of GP services
 Referrals for severe problems
 Misunderstandings about the
structures of services
RESEARCH ON RISK FACTORS
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Exclusion from school
Being looked after
Homelessness
Institutionalised racism
Lower income
Unemployed
Overcrowding
Bad housing
Poverty
LANGUAGE BARRIERS
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Communicational difficulties
GP consultations not conducted
Level of participation by the patient reduced
RACISM
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Discrimination
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Racial stereotyping
STIGMA
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Shame-orientated
Liable to adapt their behaviour to ‘save face’
Reluctant to seek help outside the family
Fearful of criticism and losing face in society
Conflict between the service user and the
family
IDENTIFICATION OF MENTAL HEALTH NEEDS
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Psychological problems not identified
Nature of GP-patient interaction
Poor communication
Greater somatisation/presentation of physical
illness to GPs
Lack of trusts in services/professionals
Issues raised by young people in black and
minority ethnic groups
WIDE RANGE OF WORRIES AND CONCERNS
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Diversity of needs
Education and employment
Physical health
Discrimination and racism
Family relationships
Inclusion in local community
Money and finances
YOUNG REFUGEES AND ASYLUM SEEKERS
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Past traumatic experiences
Worries about legal status
How long they might stay in UK
Losses and grief
AWARENESS OF MENTAL HEALTH AND
MENTAL HEALTH SERVICE PROVISION/CAMHS
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Fears of stigma and general reluctance to
talk
Difficulties in finding out where to go
Long waiting times
Having to travel some distance
No interpreter
Sense of being ‘passed around’
Having to re-tell their story
Service times not convenient
CONFIDENTIALITY
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Stigma of being in contact with services
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Worried that friends and family would find out
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Concerns those in close-knit community
would find out
LACK OF LOCAL PROVISION
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Lack of knowledge of local area
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Lack of knowledge of transport system
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Not being able to self-refer
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Not able to get help promptly
CONTINUITY OF TREATMENT
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Information sharing
Trusting relationships
Staff changes
Constantly referred on
Unfamiliar with how UK health system works
CHOICE
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Having some choice in own care
Choice of gender of staff member
Cultural background of staff member
Staff interested and aware of
differences
AGE-APPROPRIATE PROVISION
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Care through adult mental health services
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Inpatient care on adult wards
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Failure of inpatient CAMHS to meet dietary
requirements
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Day-to-day social interaction
ROLE AND INFLUENCE OF PARENTS
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Different dynamics and roles within
families
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Different attitudes towards being
asked questions
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Worried about views of parents
CONFUSION OVER CULTURAL IDENTITY
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Professionals making assumptions on
basis of ethnic group
Responding to questions about
ethnicity
Appreciate the diversity of needs and
situations
Why the question about ethnicity is
being asked
What information is actually required
STAFF UNDERSTANDING OF RACIAL AND CULTURAL
NEEDS
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Develop an understanding
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Take account of needs
Suggestions for improving access to and the
delivery of services for the mental health of
young people from black and minority ethnic
groups
STYLE OF SERVICE DELIVERY
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Greater range of settings including drop-in
resources
More flexible hours of operation
Support from referring professional
Services in other settings
Choice about ethnicity of professional
User involvement
INFORMATION SHARING
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Outreach work
Work in schools
Non-traditional routes
SERVICE PROMOTION AND TARGETING
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More awareness-raising
Promotion through frontline
professionals
Use of audio-visual materials
Changing referral structures
Information for parents, family and
community
‘Open days’
INTERPRETING SUPPORT
Interpreters to receive training about
mental health
 Services to work with same interpreters to
facilitate continuity
 Simultaneous translations and interpreting
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STAFF RECRUITMENT:
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Identified training needs:
Cross-cultural communication of
distress
Engagement skills
Challenging personal views and
attitudes
Information on adapting models
and approaches
Information about client contexts
Information about local services
FACTORS THAT ENABLE SERVICES TO REFLECT A
MULTI-ETHNIC CONTEXT
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Having a diverse staff group able to communicate in
a range of languages
Neutral décor or reflecting local community through
signs, posters and displays in different languages
Interpreter support
Reception staff from black and minority ethnic
groups
Celebrating religious and other cultural events
Space to accommodate extended family members
Translated materials in different languages (and
ideally ansaphone not only available in English)
INTER-AGENCY WORKING
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Need for different agencies to work in
partnership
Forge effective working links
Services that can meet diverse needs
CONTRIBUTION OF VOLUNTARY SECTOR
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Frontline access
Informal venues
Support across different areas or social
activities
Less obviously mental health focused.