Weblog

A booklet entitled "Aspects of Mental Health in a Multi-Cultural Society" was published by the former Community Relations Commision in 1976. The forward by David (Lord) Pitt states:

" The aim of this booklet is to provide guidance for professionals, particularly doctors and social workers, to help them meet the needs of members of minority ethnic groups who have mental health problems. Two points are emphasised in the booklet. One is the importance of cultural background in the presentation of illness. The other is the stress to which ethnic minorities are exposed in the process of migration and particularly in their adjustment to life in this country.

Much of a psychiatrist's work, and certainly that of a social worker, is not concerned with formal mental illness, but with effects of socially determined conditions such as poor housing, unemployment and relative poverty. Any newcomer is exposed to social disadvantage, aggravated in the case of black immigrants by racial prejudice and discrimination.

Racial prejudice and discrimination are undoubtedly the most urgent and serious problems facing minority ethnic groups in this country. all the people we interviewed in the course of preparing this booklet stressed this. The effect of discrimination on mental health is uncertain, but the fact that its affects general well-being and happiness can hardly be doubted. This must be recognised by doctors and social workers, a task the National Health Service should find raltively easy because of the large numbers of members of minority ethnic groups working as prfessionals in the service."

Three decades on where have we been reached? Reports churned out annually repeat a problem with mental health higher than average among black groups, now not newly arrived and not a minority in an increasing number of cities in the UK. The statement emphasised in the first paragraph "the importance of cultural background in the presentation of illness" seems as little understood now as it was then. The consequences are alarming.

In addition a medical model of illness persists in medical circles, but particularly it seems in mental health, whereas the probable causes are likely to be socially determined. The idea that because many people from minority ethnic groups work as professionals in the health service is going to help has proved a great fallacy. While there is probably now a much greater number of those groups in the service their numbers in positions as consultants remains proportionally small, particularly so for the african and Caribbean communities. Fanon's work has a particular resonance in our present society.

Recent research has raised concerns about the effectiveness of drugs to treat depression. The need for talking therapies is put into sharp relief. However this becomes a problem for those whose language is not English and there is likely to be a need for cultural understanding too. That's where "Talk to Us" comes into play since it offers a wide range of organisations who have long experience of dealing with the needs of specific groups. They came into existence because of unmet need.

Although we are constantly told of the need to promote talking therapies, that there is a widespread need and that the Government is injecting cash into providing support, in practice the voluntary organisations wishing to offer such a service are finding many obstacles. Commissioning is here to stay we are constantly reminded yet how do small organisations compete. Established groups cornered the market for IMCA commissioning and the opportunity for community groups to be involved was limited. Except we managed to get 8 members of the organisations we work with onto a training course. The Depratment for Health said " no we couldn't go becauise those staff were not already employed as IMCA".

The Government constantly states that community groups need to be involved not least in meeting health and mental health needs and went so dar as to set up a "Delivering Race Equality" agenda. Once again experience tells us this appears empty rhetoric for many of us.

For anyone making decisions on behalf of someone without the mental capacity to decide improtant aspects of their lives it seems to me important that their cultural needs should be understood and taken into account. One organisation is unlikely to be able to cater for a wide range of diverse need. Now we wish to prepare ourselves for Independent Mental Health (IMHA) advocates - the purpose of this site.

In Birmingham expressions of interest in commissioning for the Wellbeing agenda have exceeded resources available tenfold. In reponse the City Council has announced it cannot decide for another 6 months instead of 1st April (an April fool joke?) although existing projects being funded will continue to be supported.

I don't know who else it will affect but it certainly puts this project in limbo, although a CSIP officer tells us that it is unique across Britain.

A number of reports have raised questions why primary aged children appear unhappy and anxious. The over use of testing and consequent lack of stimulating tesching in schools is one area identified and commercial pressures in their life in society another. Now teachers are asking for a Royal Commission to investigate

Child mental health services are over stretched and intrusive. Children in care have been identified as being particularly vulnerable to ineffective services. These can often add to their difficulties rather than resolve them.