Services in the community
Many people with mental health problems and their carers are helped by services in the community instead of - or in addition to - doctors...
Culture is about the practices, knowledge, and beliefs that are more or less shared among a group of people. Most carers we spoke to believed that we can all learn a lot from cultures that are different to our own. People said that learning from each other can teach us how best to help families affected by mental health problems.
Many carers felt that in White British culture people focus mostly on themselves as individuals: they are ‘preoccupied with their own life’. Several carers commented on the differences between life in Britain and life in their country of origin.
In contrast, in many other cultures, people tend to think of themselves as part of a family or community. One man said that in his native Sri Lanka, ‘when someone is sick, the whole family suffers.’ Others remarked that close knit families and communities meant those who are sick would not be left ‘to fend for themselves’ and that ‘family involvement would be the norm’.
In particular, some carers believed the way people with mental health problems in the UK are ‘locked away’ and separated from the community is unhelpful, making them feel rejected and lonely.
Some African-Caribbean carers emphasised how in the West Indies, many people with mental health problems continue to be an important part of the community. People just don’t make such ‘a big deal’ out of it when people are unwell. One woman said that the move towards ‘care in the community’ in the UK means things are improving. Living in a close knit community can help carers because more people could ‘muck in’, stop by during the course of the day, and help out with shopping, transport or keeping them company.
Some said that the downside of putting the family first, even before yourself, was that it could also lead to carers not being able to help themselves. The same thing was said about living in extended or polygamous families. Carers from different ethnic backgrounds also said that the ‘next generation’ in their community didn’t always share more ‘traditional’ family values.
Some people were critical of the reliance on medication in the British mental health care system and said in other cultures the focus was more on caring, comforting and encouragement.
Others felt that the UK system can be needlessly complicated. For instance, in a crisis it can take 6-7 professionals, from police officers to psychiatrists, to get someone admitted to hospital. Elsewhere things could be quite different.
Another carer thought we could learn from cultures where family participation in the hospital care of loved ones is more welcome and where professionals are more willing to discuss their care.
A couple of people questioned whether a patient’s individual rights (e.g. to refuse medication) should be more important than the efforts of others to improve their health. An example was given of Indian institutions where psychiatric medication is made without taste so it can be added to food without the knowledge of the person taking it. Other carers disagreed with the approach of treating people without their knowledge.
Several carers from African and South Asian backgrounds said in their culture there were more negative attitudes to mental health problems than in other cultures. They felt that their community needed to learn more about mental health problems from the British or West Indian perspectives so it would be easier for people to ask for help (see ‘Negative attitudes to mental health problems‘).
The UK social security system, which provides financial support from the government, was also seen as a good model for other countries as it could put carers’ minds at ease and make them less dependent on family support. People were also grateful for a National Health Service (NHS) which, despite its weaknesses, is free of charge.
Many people with mental health problems and their carers are helped by services in the community instead of - or in addition to - doctors...
The work carers do is part of the UK government's plans for caring for people with mental health problems in the community. Most carers agreed...