Multicultural Mental Health Services: Projects for Minority Ethnic Communities in England

Abstract

Black and minority ethnic (BME) communities form 7.8% of the total population of the U.K. Many of these communities face a variety of disadvantages when they access, or are forced to access, statutory mental health services under the National Health Service. Efforts have been made to address these problems by developing projects both within statutory mental health services and in the non-governmental ('voluntary') sector. This article describes some of these projects located in England, drawing out the themes and models that underlie their approaches, and discusses the lessons that can be learned from the U.K. experience.

At the crossroads of anthropology and epidemiology: Current research in cultural psychiatry in the UK

“…Efforts have been made to resolve these issues by developing projects both within statutory mental health services and in the nongovernmental (“voluntary”) sector. Fernando (2005) has provided a useful overview of the voluntary sector services in the UK although to date there is little work examining their effectiveness. Since the early 1980s many counselling and psychotherapy services have come on the scene in what is generally called the “Black voluntary sector.” Some examples include Nafsyat in London set up in 1983 to provide psychotherapy for Black and ethnic minority (BME) patients (Kareem& Littlewood, 2000), the Qualb Centre in London providing counselling and complementary therapies for Asian people (Gorman, 1995), and the Nile Centre in London, offering crisis support for Afro-Caribbean and African people with mental health problems.…”

“…At least two edited text books on “cultural psychiatry” have appeared in the past 2 years— Clinical Topics in Cultural Psychiatry (Bhattacharya, Cross,& Bhugra, 2011) which presents an excellent overview of the impact of culture on symptom presentation, competency, and clinical management, and Textbook of Cultural Psychiatry (Bhugra& Bhui, 2010) which integrates both practical and theoretical knowledge and provides a framework for the provision of mental healthcare in a multicultural/multiracial society and global economy. More general books, often containing critical reviews of specific topics—for example Sewell (2009) Working With Ethnicity, Race and Culture in Mental Health ; Fernando and Keating (2009) ( Mental Health in a Multi-Ethnic Society ) and Fernando (2003, 2010b) Cultural Diversity, Mental Health and Psychiatry and Mental Health, Race and Culture —explore the complexity of what “culture” means in relation to mental health and the nuances in the meanings of “race.” We have also consulted policy documents such as EPIC , DRE , UK700 , Count Me in Census (Bhui, 2009; Bhui et al., 2012; Healthcare Commission, Mental Health Act Commission,& National Institute for Mental Health in England, 2007; McKenzie et al, 2001) and Breaking the Cycles of Fear (Sainsbury Centre for Mental Health, 2002) which have had some impact nationally and internationally, and reports of deaths of ethnic minority men in psychiatric institutions in the UK such as Broadmoor Hospital ( Report of the Committee of Inquiry Into the Death in Broadmoor Hospital of Orville Blackwood and a Review of the Deaths of Two Other Afro-Caribbean Patients: “Big, Black and Dangerous?” ; Special Hospitals Service Authority, 1993). …”

Clinical approaches to cultural diversity in mental health care and specificities of French transcultural consultations: A narrative review.

“…The adaptation of mental health care to a context of cultural diversity began in English-speaking countries in the 1970s and in France in the 1980s (12,14).…”

“…Healthcare systems can adapt in several ways: using interpreters and cultural mediators, training professionals in cultural competence ( Table 1) and supervision, making innovations in the therapeutic framework of general mental health services, and developing specialized clinics for ethnic minorities (8,10,(12)(13)(14)(15)(16)(17)(18)(19). In France, a complete psychotherapeutic method was conceived in the 1980s by T. Nathan and then expanded by MR Moro (one of the authors) for the management of migrant families facing issues that cannot be solved in standard psychotherapy: Transcultural Psychotherapy (TPT).…”

More than being against it: Anti-racism and anti-oppression in mental health services

“…Accordingly, it is important to understand the meanings of anti-racist and anti-oppressive claims and their implications for service provision (Across Boundaries, 2007Derman-Sparks & Phillips, 1997;Fernando, 2003Fernando, , 2005King, 2000;Peacock & Daniels, 2006). This article presents a comprehensive literature review on anti-racism and antioppression philosophies of practice in mental health.…”