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The scandal of BAME mental health inequality

May 17, 2019 2:01 PM
Originally published by UK Liberal Democrats

When I began to look into the topic of BAME mental health, what surprised me was how little research had been done into it. There is even less when it comes to intersectional groupings. Even with the information that there is, it's not widely accessible or 'showcased'. I got the impression, from an initial trawl of the Internet, that the subject isn't deemed to be particularly 'headline grabbing.'

PTSD is higher in women of black ethnic origin and this is related to the higher levels of sexual assaults that they experience

However, I know, from anecdotal evidence and my engagement with some of the key thought leaders in the realm of mental health, that there is inequity that needs to be evaluated and addressed.

I've heard from people like:

Ameen Marquis, a Head Teacher who is a regular speaker on male BAME and child migrant/refugee mental health

Patrick Regan, founder of urban youth work charity XLP and mental health charity, Kintsugi Hope

Aasiyah Faryal, a presenter and producer who speaks about her experiences of mental health in the Arab and Asian community

In addition, after many hours of reading research papers, Government reports and statistical analyses, I've come up with some facts that should be 'headline grabbing' but are nowhere near the front page*.

  1. PTSD is higher in women of black ethnic origin and this is related to the higher levels of sexual assaults that they experience[1]; however, women of black ethnic origin are less likely to report or seek help for assaults or trauma.[2]
  2. Women of Pakistani and Bangladeshi origin are at an elevated risk of schizophrenia.[3]
  3. BAME people are more frequently subjected to involuntary psychiatric hospitalisation than others, particularly young, black men.[4]
  4. Black adults have the lowest treatment rate of any ethnic group, at 6.2% (compared to 13.3% in the white British group).[5]
  5. People from black ethnic minority backgrounds to have a higher prevalence of psychosis compared with the white majority population.[6]
  6. More than one in five Black, Asian and minority ethnic LGBT people (22 per cent) have experienced an eating disorder in the last year compared to 11 per cent of white LGBT people.[7]
  7. Particular communities at higher risk of attempting to take their own lives include 8 per cent of Black, Asian and minority ethnic LGBT people, 11 per cent of non-binary people and 8 per cent of LGBT disabled people (compared to one in twenty within the general adult population).[8]
  8. Asylum seekers and refugees are more likely to experience poor mental health than the local population, including higher rates of depression, PTSD and other anxiety disorders.[9]
  9. Asylum seekers are five times more likely to have mental health needs than the general population and more than 61% will experience serious mental distress.[10]
  10. More than half of trafficked children (56%) screen positive for depression, a third (33%) for an anxiety disorder and a quarter (26%) for PTSD.

The Liberal Democrats have been fighting for parity between physical and mental health services for a long time and our pledge is to fund mental health provision through adding 1p in the pound to income tax.

This is core to our beliefs.

So, as voters, members, supporters and candidates, what can we do to make a difference when it comes to the treatment of BAME groups within the mental healthcare system?

As Liberal Democrats, let's be the ones exposing the scandal of BAME mental health inequality and leading change in this area.

Here are some ideas:

  1. Join the Liberal Democrats - we are committed to improving mental health provision and are committed to ending the stigma and shame that too often surround discussions on mental health. If you're already a member consider joining Liberal Democrat Campaign for Race Equality and benefit from being part of a team that is committed to change making in this area.
  2. If you have any expertise in this area, contribute to policy making by joining a policy working group or working on a Motion on this subject.
  3. Connect with mental health charities and activists in your area and support their cause by campaigning on local BAME mental health issues.
  4. Write to your local newspaper about how this has affected you or people you know.
  5. Contribute to radio and telephone call-in shows and comment on the subject.
  6. Contact me to participate in/attend a panel discussion I'm organising in relation to migrant women this Summer (details to be announced shortly).

When I've spoken to people who've been personally affected by the 'patchy' levels of quality in BAME mental healthcare, I've been struck by three things that seem to affect BAME groups more than others:

  1. The social isolation they've experienced within their own communities
  2. The stigma attached to having a mental illness from their own communities
  3. The perception, by healthcare professionals, that they would largely '…be looked after by their own'.

Something has to be done about this - and it has to be done now.

As Liberal Democrats, let's be the ones exposing the scandal of BAME mental health inequality and leading change in this area.

[1] Black, M.C., Basile, K.C., Breiding, M.J., Smith, M.J., Walters, S.G., Merrick, M.T., & Stevens, M.R. (2011). The National Intimate Partner and Sexual Violence Survey (NISVS): 2010 summary report. US Department of Health and Human Services, National Center for Injury Prevention and Control, & Centers for Disease Control and Prevention. Retrieved from cdc.gov/violenceprevention/nisvs/ [Accessed 23/08/16].

[2] Ullman, S.E., & Filipas, H.H. (2001). Predictors of PTSD symptom severity and social reactions in sexual assault victims. Journal of Traumatic Stress, 14, 369-389.

[3] Kirkbride, J.B., Barker, D., Cowden, F., Stamps, R., Yang, M., Jones, P.B. & Coid, J.W.(2008). Psychoses, ethnicity and socio-economic status. The British Journal of Psychiatry, 193(1), 18-24.

[4] Modernising the Mental Health Act Increasing choice, reducing compulsion: Final report of the Independent Review of the Mental Health Act 1983 - December 2018

[5] Lubian, K., Weich, S., Stansfeld, S., Bebbington, P., Brugha, T., Spiers, N. … & Cooper, C. (2016). Chapter 3: Mental health treatment and services. In S. McManus, P. Bebbington, R. Jenkins, & T. Brugha (Eds.), Mental health and wellbeing in England: Adult Psychiatric Morbidity Survey 2014. Leeds: NHS Digital.

[6] Qassem, T., Bebbington, P., Spiers, N., McManus, S., Jenkins, R., & Dean, S. (2015). Prevalence of psychosis in black ethnic minorities in Britain: Analysis based on three national surveys. Social Psychiatry and Psychiatric Epidemiology, 50(7), 1057-1064.

[7] LGBT in Britain: Health Report - Stonewall, 2018

[8] LGBT in Britain: Health Report - Stonewall, 2018

[9] Fazel, M., Wheeler, J., & Danesh, J. (2005). Prevalence of serious mental disorder in 7,000 refugees resettled in Western countries: A systematic review. The Lancet, 365, 1309-1314. Tempany, M. (2009). What research tells us about the mental health and psychosocial wellbeing of Sudanese refugees: A literature review. Transcultural Psychiatry, 46, 300-315.

[10] Eaton, V., Ward, C., Womack, J., & Taylor, A. (2011). Mental Health and Wellbeing in Leeds: An Assessment of Need in the Adult Population. NHS Leeds.