Mental health problems

Mental health problems in the Black and Ethnic Minority Communities

Over the years many research papers have commented on the ‘above-average’ levels of mental health problems within the Afro-Caribbean community. It has even made it into the mainstream media.

That most responsible of journalists, Melanie Philips wrote during the 2009 controversy [1] surrounding Professor David Nutt’s recommendations (as the Government’s chief adviser on drugs) that:

  • Other scientists have also come out against Nutt. According to experts such as psychiatrist Dr Robin Murray, there is significant evidence that cannabis triggers psychosis and schizophrenia.

Cannabis, once a recreational drug of the Caribbean community has in the past 40 year increased in strength and found new users in the younger generation in the UK.

And it is this younger generation – people who take Ecstasy, for instance, every weekend – that suffers from “. . . low moods, fatigue, disrupted sleep, mid-week depression and other ailments”, according to Professor Andrew Parrott.  

It is this younger generation that appears with a regularity that must be addressed in the specialist domestic violence Magistrates’ courts (though it has to be said most appearances are for minor infraction of being drunk and disorderly and not worthy of the description domestic violence).

Given this preamble it comes as something of a shock to then discover that it is not the young or the Afro-Caribbean community that suffer most from episodes of mental ill health but the Irish community in Britain (according to the Mental Health Foundation). [2] 

The Foundation claims to be Britain’s leading mental health research, policy and service improvement charity (see Annex A). 

In their website article they state that: 

  • “ . . . Irish people living in the UK have much higher hospital admission rates for mental health problems than other ethnic groups. In particular they have higher rates of depression and alcohol problems and are at greater risk of suicide.
  • These higher rates may, in part, be caused by social disadvantage among Irish people in theUK, including poor housing and social isolation.
  • Despite these high rates, the particular needs of Irish people are rarely taken into account in planning and delivering mental health services.”

Popular culture finds it easy to identify heavy drinking with those from Ireland and Irish ancestry but this stereotyping is not scientific enough to comment upon further and could in any event be seen as a slur.

What should catch the reader’s eye is the reference to the ‘higher rates being partly due to ‘social disadvantage’ among Irish people in the UK, ‘poor housing and social isolation.’

This is difficult to comprehend given the century or more of England- Irish migration for employment etc.

It was more than 50 years ago that landladies in London, when the capital was still under severe housing shortages from the Blitz, would display signs saying “No dogs, No blacks and No Irish.” Though this has been used as a totem by the Left, the truth of the matter is that married couples were also discriminated against. Single men or single women – as I can personally vouch for – were then the most prized of tenants in those days.

Integration of the Irish into mainstream British society was completed many years ago and they now live in their own homes or in local council properties – for which there was often a very long (20 year) waiting list.

The Irish suffer form no language differences, no cultural abnormalities or practices, and their skin colour all makes for easier assimilation compared with the other ethnic communities. The only problem over the last 30 years has been the terrorism of the IRA and the killings of The Troubles inUlster spilling over into the British mainland.

To speak blandly of “risk of suicide” is to draw a veil over a multiple of very distinct sub-sets. For instance, the suicide rate for men might be said to be only slightly worse than 50 years ago but analysis shows key factors, such those experiencing redundancy, marriage break-up and facing false accusation, as far more highly suicidal then ‘the average’ might infer.

Black and Minority Ethnic Communities

The following is taken straight from the Mental Health Foundation webpage:

  • Different ethnic groups have different rates and experiences of mental health problems, reflecting their different cultural and socio-economic contexts and access to culturally appropriate treatments.
  • In general, people from black and minority ethnic groups living in the UK are:
  • * more likely to be diagnosed with mental health problems
  • * more likely to be diagnosed and admitted to hospital  
  • * more likely to experience a poor outcome from treatment 
  • * more likely to disengage from mainstream mental health services, leading to social exclusion and a deterioration in their mental health.
  • These differences may be explained by a number of factors, including poverty and racism. They may also be because mainstream mental health services often fail to understand or provide services thatare acceptable and accessible to non-white British communities and meet their particular cultural and other needs.
  • It is likely that mental health problems go unreported and untreated because people in some ethnic minority groups are reluctant to engage with mainstream health services. It is also likely thatmental health problems are over-diagnosed in people whose first language is not English. 

It is difficult to agree unreservedly that mental health problems among the Black and Ethnic Minority can be explained away in whole or in part by racism. All sectors of society, black, white, even those with no mental health issues etc all face poverty, so it is difficult to see it as a decisive factor.

What is more likely is the assertion that mental health problems go unreported and untreated because people in some ethnic minority groups are reluctant to engage with mainstream health services.

However, this could also be said of all colours, including whites (mental ill health is still a taboo subject at cocktail parties). If this is the case then it makes the following statement ludicrous or at least incompatible  i.e. “ . . . mental health problems are over-diagnosed in people whose first language is not English.”

African Caribbean people

The following is again taken straight from the Mental Health Foundation webpage (and so is the title which looks curiously stilted):

  • “. . African Caribbean people living in the UK have lower rates of common mental disorders than other ethnic groups but are more likely to be diagnosed with severe mental illness. African Caribbean people are three to five times more likely than any other group to be diagnosed and admitted to hospital for schizophrenia.
  • However, most of the research in this area has been based on service use statistics. Some research suggests thatthe actual numbers of African Caribbean people with schizophrenia is much lower than originally thought.
  • African Caribbean people are also more likely to enter the mental health services via the courts or the police, rather than from primary care, which is the main route to treatment for most people. They are also more likely to be treated under a section of the Mental Health Act, are more likely to receive medication, rather than be offered talking treatments such as psychotherapy, and are over-represented in high and medium secure units and prisons.”

Reference here to ‘the courts or the police’ is apropos since there is a strong suspicion that many ‘small time criminals’ for minor offences held in jail are suffering from some form of psychiatric illness e.g. Bipolar, Borderline Personality Disorder, Narcissistic Personality Disorder, Schizophrenia etc.

‘Dangerous criminals’ need of necessity to be held prisons or highly ‘secure hospital units’ to receive medication but for the average Joe focus should be on therapies might yield the cell space Ken Clarke, the Justice Minister, is looking for in Britain’s overcrowded prisons.

Asian community

MHF finds that‘Asian people’, as it puts it, offer an alternative not only in the lack of openness but also in the recovery rates. By Asian community in the British context it is taken to mean of Indian and Pakistani descent, as distinct from the rest of the Far East and Asia (though it does include those Indians and Pakistanis deported from Uganda).

  • The statistics on the numbers of Asian people in the United Kingdom with mental health problems are inconsistent, although it has been suggested that mental health problems are often unrecognised or not diagnosed in this ethnic group.
  • Asian people have better rates of recovery from schizophrenia, which may be linked to the level of family support.
  • Suicide is low among Asian men and older people, but high in young Asian women compared with other ethnic groups. Indian men have a high rate of alcohol related problems.
  • Research has suggested that Western approaches to mental health treatment are often unsuitable and culturally inappropriate to the needs of Asian communities. Asian people tend to view the individual in a holistic way, as a physical, emotional, mental and spiritual being.

One possible reason why levels of suicide are low among Asian men is because they have, compared with all other communities, less divorce and more stable marriages. The ‘higher’ levels of suicide among Asian women is interesting. Levels of suicide among White women used to be high – roughly prior to the 1970s – and has decreased as various social legislation have brought changes to benefit them.  The ‘holistic way’ argument may have some merit among, say, among Buddhists, but in every day life Asian men and women can be found in pharmacies every bit as much as their White and Caribbean counterparts (and Indians and Pakistanis tend not to be Buddhists).

Over the years multi-culturalism has lead to the unfortunate development of parallel societies (social systems) within towns. Asians tend to inhabit these ghettoes and adopt attitudes, dress and social mores more appropriate to their native lands.

And finally, speaking of the ethnic Chinese in Britain, MHF states:

  • ‘Chinese people’
  • There is very little knowledge of the extent of mental health problems in the Chinese community.
  • It has been suggested that the close-knit family structure of the Chinese community provides strong support for its members. While this may be beneficial, it may generate feelings of guilt and shame, resulting in people feeling stigmatised and unable to seek help.

If being close knit and cut off from the mainstream are the hallmarks of some of these ethnic communities then we might be able to learn from Jaffe’s writings of Israeli Social Servicesattempting to deliver ‘services’ to a hostile Palestinian community in the Occupied Lands replete with all their cultural differences.[3]

 

Annex A

Mental Health Foundation (statement)

We are committed to reducing the suffering caused by mental ill health and to help everyone lead mentally healthier lives. We help people to survive, recover from and prevent mental health problems.
 
We do this by:

  • carrying out research
  • developing practical solutions for better mental health services
  • campaigning to reduce stigma and discrimination
  • promoting better mental health for us all.

We work across all age ranges and all aspects of mental health. We are the charity for everyone’s mental wellbeing.

END

Reference:
See also http://genderviolence.wordpress.com/ for how female and male gender violence can arise from mental illness.

[1]  ‘Fatuous, dangerous, utterly irresponsible – the Nutty professor who’s distorting the truth about drugs.’ Nov 2009 http://www.dailymail.co.uk/debate/article-1224578/MELANIE-PHILLIPS-Fatuous-dangerous-utterly-irresponsible–Nutty-professor-whos-distorting-truth-drugs.html

[2] MHF http://www.mentalhealth.org.uk/help-information/mental-health-a-z/B/BME-communities/

[3] “Father and Child Welfare Services: the forgotten clients ?”, (1983),  Eliezer D Jaffe, Hebrew University of Jerusalem.

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2 responses to “Mental health problems

  1. Pingback: Bipolar Relationship Problems | Is Bipolar Hereditary

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