Mental health: ethnic minority experiences

Outpatient & community services for mental health problems

Experiences of outpatient and community services
The majority of mental health care is provided by services in the community. People described using day centres, day hospitals, rehabilitation centres and being a hospital outpatient. Various professionals were involved in their care including support workers, GPs, CPNs (community psychiatric nurses), psychiatrists and social workers. Some people referred to the combination of different professionals as their 'mental health team'.

As with hospital inpatient services, various activities were available through these community services, including leisure activities, therapies, and work training. A few people found going to day centres helpful, but one woman said the day centre was only a “reason to get out of bed” and the only thing she got out of it was the opportunity to write poetry in their creative writing class. A few people mentioned that day centres were no longer available in their area.

Many people talked about professionals who had been helpful. This was usually because they had felt able to talk to them, and they had listened and seemed to understand.

People also mentioned receiving practical help and support from mental health services in the community, including noticing when they are becoming unwell, and from their GP - “without her, I don't know what I'd do”. One man felt that community mental health should also have responsibility for people's physical, as well as mental health problems. Many people went to day centres or saw a mental health professional for their medication (see 'Prescribed medication & side effects').

Professionals who didn't listen or give support were seen as unhelpful and even intrusive. One woman mentioned that although her GP was good, she didn't have the opportunity to discuss at length the things she felt were making her unwell. Another woman felt neglected because she'd been waiting for months for a referral to a psychiatrist. Some people valued the choices they had over their community based care and felt they had been really involved. Others, however, described feeling under pressure from mental health professionals.

Class, gender and ethnicity of professionals
Many felt it was important that the professional in question was able to understand their experiences and listened carefully to them, whatever their background. Some people felt it could be especially helpful if the professional had similar experiences, for example, of racism or mental health issues.

For some, it was essential that professionals shared the same background (whether gender, class or ethnicity), while for others it didn't matter at all. For one man, the professional didn't have to be the same ethnicity, but from any ethnic minority background. Another felt it would be helpful to have more Black psychiatrists in the system, but that sharing the same belief system as the patient was more important. 

One Asian woman found it difficult to talk to her White, middle class therapist (see Sara's story), although another Asian man felt that ethnicity didn't affect his care because he was middle class. Several people felt that professionals “don't seem to understand Black culture”, including one woman of mixed heritage who felt that her white CPN couldn't identify with her. 

Another woman noticed that she had expectations for professionals based on their ethnicity and gender which were not met: for example, she was initially disappointed when she couldn't talk openly with a Black female GP, and pleasantly surprised when a White male GP was very helpful. The same GPs, however, acted quite differently in later appointments. 

Not wanting to use services
Some people mentioned being reluctant to get help from services because they didn't trust professionals [see Mae above]. One woman didn't want to see an Educational Psychologist because she felt angry that she was perceived to be “the problem” and in need of treatment, not her family. She was also concerned about having a psychiatric diagnosis and whether that would make it difficult to get a job in the future.

A few people felt that the services they received didn't take their culture into account. They felt that more should be done to make services more attractive to people from Black and minority ethnic backgrounds, “I really do think that a lot has to be done to draw the Black people in who really do need help and aren't getting any”. 

It is hoped that new government programmes for mental health will improve access to services for minority ethnic communities, but the approach is questioned by many BME mental health campaigners and it is too early to tell whether it will be effective.

Last reviewed September 2018.
Last updated September 2015.


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