Access to mental health services for African-Caribbean migrants
From United Kingdom Wiki
Several studies have pointed out the poor mental health experiences by African-Caribbean migrants and minorities, the high prevalence of schizophrenia and psychosis among this group and the overrepresentation of African-Caribbeans in compulsory mental health services.
"Breaking the Circles of Fear" (2002) is a comprehensive report on the problems experienced in mental health service provision to the African and Caribbean communities by both mental health users and staff. Mclean et al (2003) used a qualitative study of a community to illustrate inequalities experienced in accessing mental health.
SCMH (2002). Breaking the Circles of Fear. A review of the relationship between mental health services and African and Caribbean communities. London: Sainsbury Centre for Mental Health. Download
Mclean C; Campbell C and Cornish F (2003). African-Caribbean interactions with mental health services in the UK: experiences and expectations of exclusion as (re)productive of health inequalities. Social Science and Medicine. 56. 657-669 Abstract
Summary of Mclean et al. (2003)
Institutions are ill-equipped to cope with the unique characteristics presented by minorities. Standardised procedures and services may not fit the requirements of a unique local community, whose ethnic, religious or socio-economic composition presents specific needs. The mainstream frameworks and assumptions that are at work in the design of services may result in services unsuitable or inaccessible to minority ethnic potential users. At the level of inter-cultural communication between clients and service providers, it has been suggested that African-Caribbean service users are vulnerable to mis-interpretation by mainstream services, due to divergent usage of language and gestures. In the absence of language support, usage of patois or Creole dialects may result in misunderstandings, and low levels of referral of African-Caribbean clients to psychotherapy may be due to a perceived lack of linguistic ability. Perceptions of aggressivity may result from misinterpretation of normal modes of behaviour common in African-Caribbean communities, which often seem overly ‘loud’ or extrovert to outsiders.
Misinterpretation of the symptoms with which African-Caribbean people present may result in inaccurate diagnosis and feed into the high rates of schizophrenia diagnosis. African-Caribbean people may resist the experience of ethnocentric stereotyping and culturally inappropriate communication by refusing to access health services. From their study it was found that negative comments far outnumbered and outweighed positive ones, in regard to the mainstream services, while the ethnically specific service was highly praised. Exclusion and mistreatment due to cultural difference were frequently reported. Interviewees emphasised that African-Caribbean people must be understood to belong to a cultural community with different characteristics to the mainstream and that issues of cultural identity should be central to mental health services. A lack of understanding of African-Caribbean culture on the part of health service staff was perceived by interviewees to lead to misinterpretation of ‘normal’ behaviour as ‘deviant’. Stereotypes were perceived to influence diagnosis, type of treatment offered, quantity of drugs prescribed and quality and quantity of after care and support offered.
