Culturally appropriate services
Many carers said it is hard to ‘find your way around’ the health and social services. This could be because they were new to the UK, because they didn’t speak much English or because they had difficulties with reading and writing. Others said the system is simply too complicated.
Some carers said that there is much more help available in different languages today than when they started caring, and these carers were generally happy with what was available. Many others, however, said it needs to become easier to get interpreters and support workers who can explain to carers how the system works, as well as their rights and options.
More help is available now, but when her husband first became unwell it was hard to get…
People from different cultures need different things from services. Sometimes professionals don’t distinguish between different ethnic communities. One South Asian woman who had a Carers’ Assessment (see ‘Carers’ assessments‘) had been recommended to go to an African-Caribbean support centre, but they could not meet her needs for services in her own language.
Carers said it is important that services meet the cultural and religious needs of their loved ones. For instance, people in hospital or residential care need to be able to follow their religion by having appropriate food (such as Halal or vegetarian food). Many carers spend a lot of time every single day making sure their relative in hospital gets appropriate food. For some, personal care (such as skin and hair care) is an issue too.
Tina says the meals in hospitals don’t suit a Hindu diet (played by an actor).
White British professional carers don’t look after her sister’s hair and skin properly.
Others said interpreters should be skilled enough to help the person with a mental health problem to understand better what is happening to them. Many thought that health and social services should learn more about what people in different communities need. Some felt that having a GP or worker from their own community helped because they would better know what kind of support to give. Others thought the cultural background of workers didn’t matter as long as they listened and were willing to learn and to be flexible.
Many carers said that voluntary and community organisations are often good at providing culturally appropriate services. Since many of these have short-term funding they may not offer a long-term solution.
Nita says voluntary services are best at meeting individual needs, but funding is an issue.
Communicating across cultures
Many carers reported no problem talking to workers in health and social services (see ‘Support from carers’ services’). However, some felt workers need to learn to listen and communicate better.
Some said those working in services lack openness and respect for people from a different culture and are not always willing to listen. Sometimes ‘shutters come down’ when there’s a challenge. One woman felt that when you belong to a minority culture ‘no one really wants to know you’. Another said she didn’t expect services in the UK to know much about her culture, but she had hoped that they would be willing to listen and take her needs into account.
Aiko thinks services should be more open minded and listen to people from different cultures.
One man said it was difficult for people from minority communities to speak their mind about services. He had often been told to ‘go home’ to his country of origin if he was not satisfied. Others talked about how service personnel are often unaware of the importance of cultural differences and ‘don’t have a clue about how we live and express ourselves and how we do things differently”
Elaine talks about how she felt when the social services wanted to section her father (played by…
Experiences of racism in services
Some carers said they had never felt discriminated against by services because of their race (i.e. racism). Others did not want to discuss this issue. A few felt there was racism towards themselves or the person they cared for. People talked about being looked at or talked to in disrespectful ways. One carer had been told that his son’s problem was that ‘Asian parents are over protective’. The son was later diagnosed with schizophrenia.
Nick lost confidence when he was told that his son’s symptoms were the result of his parenting.
She says professional home carers make remarks because she is Asian and Muslim.
Some said that it can be difficult to point to specific examples of racism but they felt that racism is ‘always there’.
Ramila says ‘you just know racism is there, even if it is difficult to explain.
Carers talked about how others ‘assume the worst’ of people from minority ethnic communities or think that ‘black people are just more aggressive’ than white people. Such stereotypes are thought to make workers not listen properly, or even make wrong decisions. People said although this needs to change, it is ‘not something that can be changed overnight’.
Sophie says we all notice race, but the problem comes when workers make decisions based on…
Being on the receiving end of racism leads to anger, frustration, loss of confidence and a lack of trust in services. People with such experiences may even stop using services. Some carers said they try to ignore racism, rise above it, or even play along with it to diffuse tense situations. Some of those who had lived in the UK for many decades thought there is less racism now than there used to be.
Gou has been called racist names and told to ‘go home’ many times, but he avoids confrontation.
Inequality and mental health
Several carers had noticed that in some psychiatric wards most people were from minority ethnic communities. Some believed that people from such backgrounds are more likely to be diagnosed with a mental illness, to be given strong medication and to be in and out of hospital a lot (the ‘revolving door’ syndrome).
Raye thinks there is racism in mental health services and in society generally.
Some called this a form of ‘institutional racism’, which means that organisations (and not individual workers) have failed to give proper services to people because of their race.
Some said that people from minority ethnic communities are more likely than others to live in poverty, which can also affect mental health (see ‘Carers’ views: mental health problems & causes‘).