The Essential Elements of Culturally Sensitive Psychiatric Services

Abstract

The recent re-structuring of the British National Health Service (NHS) involving a greater emphasis on community treatment has not specifically taken account of the unequal access to mental health services experienced by black people. The greater use amongst black people of compulsory orders, police involvement and reliance on psychotropic medication, although well established, has not influenced policy or led to a strategy to ensure that services appropriately meet the needs of the culturally diverse population in this country. We present the literature on service utilisation by black people and emphasise potential solutions in areas with which black people are dissatisfied. The service structures, ideology and mechanisms presented form the foundations of good practice.

Access to a community aged psychiatry service by elderly from non‐English‐speaking backgrounds

“…Although such a practice is essential when assessing and managing patients from diverse ethnic backgrounds, the complexities of mental health interpreting, and the lack of training for health professionals in working with interpreters, are limiting factors as compared with the clinical situation in which the clinician can communicate directly with the patient in a common language. In Australia, the lack of appropriate training programs in mental health interpreting is of concern to mental health professionals, and likely to be an increasing problem (Bhui et al, 1995).…”

Mental Health and Addiction State of Ethnocultural/Racial Communities

“…Difficulties in providing mental health services to ethno-cultural/racial groups are somewhat documented and include underutilization of services, communication barriers, and cultural differences in the understanding of illness and treatment (Bhui, Christie, & Bhugra, 1995;Health and Welfare Canada, 1988;Minas, Lambert, & Kostov, 1996;Moffic & Kinzie, 1996;. This underutilization and consequently underrepresentation have been attributed to many factors: language fluency, cultural differences, differences in recognition of mental health problems, and lower quality of mental health care.…”

Social Capital, Participation and the Perpetuation of Health Inequalities: Obstacles to African‐Caribbean Participation in ‘Partnerships’ to Improve Mental Health

“…The key concerns of the literature on African-Caribbean mental health inequalities are the relatively high levels of schizophrenia diagnosis and of involuntary admission under the 1983 Mental Health Act (Littlewood 1986;Dunn and Fahy 1990;Boast and Chesterman 1995;Davies et al 1996;Lipsedge 1998;Singh et al 1998). The finding that African-Caribbean people tend to under-utilise support services has been proposed as an important factor contributing to the severity of mental health problems presented when African-Caribbean people eventually reach health services (Bhui et al 1995).…”

“…Cultural stereotyping of African-Caribbean users of mental health services as more likely to be irrational, threatening and dangerous than their white counterparts has also been reported as contributing to the aversive experience and subsequent avoidance of mental health services by potential clients (Callan and Littlewood 1998). Such problems are also reflected in the low satisfaction rates reported by African-Caribbean communities in relation to their local mental health service provision (Bhui et al 1995;Parkman et al 1997). Such findings suggest that the poor relationships between African-Caribbean communities and mental health services may be one of the factors generating mental health inequalities.…”