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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.

 

Mae says she hasn't had much help, but didn't really want any because she didn't trust...

Mae says she hasn't had much help, but didn't really want any because she didn't trust...

Age at interview: 62
Sex: Female
Age at diagnosis: 45
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I hadn't had a lot of help' you know. this service is okay in the fact that, you know, there is some help but I don't get any other help from anywhere else, I don't, well I don't want a psychiatrist anyway and I don't want a CPN either because I just feel that sometimes they, they do things behind your back, they'll write things down about you and you don't know about it and you're merrily going along thinking well everything is okay and it's not, you know, from their reports. 

And that can do you a lot of damage when you do find out and you think, well, who can I trust? And they say well okay it's because you're mentally ill, you're just making this into a big thing. Well if it's, if they know you're mentally ill they shouldn't be putting you in that position anyway where you're thinking, you know, those paranoid thoughts. So yeah I don't trust them and I haven't, as I said I haven't had a lot of help over the years. I did, on and off I've seen different psychiatrists but to me they always feel, they, it's always felt like they're sitting on a pedestal, you know, or they're putting themselves on a pedestal and I'm just there as part of, well as part of their job really, you know, and so whatever they say goes and who am I to argue with them? And I think well okay I could do without that, you know. And part of it is getting a good doctor, if you haven't got a good doctor then you're in a lot of trouble, you really are. But I, I have good doctors and I can go, women doctors and I can go there and actually sit down and talk to them if I've got a problem or whatever and I'll feel like I'm being well look after by my practitioner. But I can say that I haven't had a lot of help from, apart from coming here to [mental health organisation] from any other mental health teams at all, you know.

 

Tariq set out his own care plan and says the mental health system is different from how it's...

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Tariq set out his own care plan and says the mental health system is different from how it's...

Age at interview: 21
Sex: Male
Age at diagnosis: 18
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I've been supported by them and the thing is that every, in, I frequently work closely with my psychiatrists, with my mental health nurse and the thing is a lot of the time staff do and having spoken to other service users the staff do try to impose their own sort of care plan, you know, this is what's going to happen, this is what you have to take. But for me it was like, you know, what do you want, what do you want us to do, how do you want to go about it? 

And they let me set out my own care plan which was amazing so on a weekly basis rather than them telling me what to do, what to take, how to take it, I'd say look I'm going to take it on this day, I'm going to take it on that day, I'm going to walk, on that day I'm going to go for this, and the thing is they accepted it so it really amazed me that the staff actually listened to what I had to say. but what I did say I sort of, I'm the sort of person that's sort of, I can be like a politician I can make concessions, I can be like, you know, if you don't do this then I'm not going to do this. If you don't let me do this then I'm not going to take the medication etcetera and the thing is that they actually engaged with me in that sort of concession sort of thing [Laughs]. 'Alright if you do the medication then we'll do this for you.' and it was like, I was able to engage with them frequently and it's, and until this very day I do, on a monthly basis I go to an outpatients' appointment to see my psychiatrist and my mental health nurse and we still do make concessions. and like I'm the sort of person that would say, you know, if you don't make concessions I'm walking out of here, and 

the thing is that I've never had staff not listen to me and they've always listened to me etcetera so I think having access to mental health services I've actually positively gained out of the support that I've received, the support mechanism, you know, they, they've been very understanding, whenever I couldn't come and wouldn't contact them they've been very, you know, 'We understand,' etcetera. they've been very, very understanding so I think that I've, the mental health services have treated me quite well and I feel that, you know, I'm very happy, I accessed the mental health services I, because I initially had this very sort of negative view having like watched TV programmes when I was young where you see people being dragged in and, but they say that it's, you know, this is not how the system is. Maybe 50 years ago this was how the system is but we're now very modernised where we treat, want to help people in the community, we want to treat them in their home, that's where they should be.

 

She felt her GP didn't try to understand what was wrong with her, whereas another doctor gave her...

She felt her GP didn't try to understand what was wrong with her, whereas another doctor gave her...

Age at interview: 60
Sex: Female
Age at diagnosis: 40
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Since I brought pills from HK in 1988, I, I would still go to the hospital for regular check-ups. But again they would only ask me whether I took the medication, what time I get up, what are my daily activities, do I feel suicidal. Asking all these questions was not what I felt I needed. What I needed was to solve my marital problems; I need to know why my mind is not functioning properly. I need to solve these problems. But seems I didn't get any answers from them and was I left very disappointed. By end of '94, no matter how often I take the medicine I didn't seem to get any better. My mind might have one feeling at the park and another feeling at home and another on the street. I couldn't work out which of these was my mind's true feeling. So I thought it best to go home and sleep. Because of this, my husband accused me of being lazy and not wanting to work. All this added to my stress. After a while, I quit taking the pills and didn't see the doctor anymore. I found out later I had anemia, so I went to see the GP again, I was told a normal level should be 13 but I only reached 6. There was a volunteer who went with me, I think he was a psychology student. He translated to the doctor that my mental and physical health was not very good and I looked very pale. The doctor said I was alright and that it was nothing. Then I felt that the doctor completely failed to make an effort in understanding my situation and making a proper diagnosis. This added to my reluctance to see the GP further. Finally by 1994, I gradually took less and less medication and finally didn't take any medication in the end. I went to Healthy Living Centre and said I would like to change to a Chinese doctor and luckily they managed to find one for me. For the first few times that I saw the new doctor while not taking medication, I began to feel better, but after a few more appointments, my problems resurfaced.
 
After I left hospital, I would still have regular appointments to the outpatient's service at a psychiatric hospital all the way up until 1998. Out of all the doctors I'd met up to that point, I felt there was one doctor who really helped me. He wouldn't just ask standard questions regarding my medication and such, but really tried to get a deeper understanding of me. He asked me to partake in activities at my local community centers but I told him I couldn't because of mind's problems- the doctor seemed very understanding of this. I mentioned to him about my son's study, as he may have been affected by my marital problem. The doctor helped to write a letter to my son's school, so the school could have a better understanding of his situation and could assist him. Whether or not the school managed to help my son is another matter, but at least the doctor had done his part. I also told him about my marital problems; I wasn't happy, I couldn't apply for benefits as I was still living with my husband and my mental illness had always been a strain between us. Because of my issues, he very willingly helped me send letters to benefits and family counselling services. The letters were helpful, as those services later contacted me along with the help of a Chinese association. Even though I didn't get anything out of it as they didn't contact me further, at least the doctor did his job responsibly and didn't just repeatedly ask “Did you take your medication?” He tried to understand and help in other areas affecting my life. In all my years of seeing different doctors, that was the only doctor that did so. All the other doctors just asked me the same questions about my medication, diet, sleeping patterns, and daily activities. There was a very big difference.

 

Edward says he has a good GP who arranged for him to have an assessment when he told him his...

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Edward says he has a good GP who arranged for him to have an assessment when he told him his...

Age at interview: 59
Sex: Male
Age at diagnosis: 20
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What happened was after I'd been here for a, a year or two I thought okay alright you're well but, you know, what are you going to do if you get ill, there's a three month wait to get treatment. And I thought that's not good, three months is too long. I'll say that to the camera, it's too long. so what are you going do to about it? I thought to myself okay I'll go and see my GP who is, luckily, the coolest dude in the galaxy, he's just an ace you know he really is, wonderful man. Very bright, great sense of humour, good at his job, you know, what else can you say? And as soon as I mentioned the word schizophrenia to him he said, 'Okay well we can arrange for you to go and have an assessment.' And so I did, I went and had the assessment. Took a little while to get it organised. I had the assessment it took, lasted about an hour and I think there were two social workers that interviewed me and they sort of asked me my story, you know, the story I've told you here more or less and they took it all down long hand and then send me a copy. And what they did was they put that story on file and if I want to ring, if I feel sick and I want to ring a certain number, I just ring that number and a duty psychiatrist can call my story up onto the screen and I won't have to repeat myself and feel disbelieved, you see, because one of the key things when you're not very well is you mustn't get a sense that the person is disbelieving you, okay. And I found that a lot of people disbelieve me when I say I've had schizophrenia, they disbelieve me, they don't believe it. They don't believe it because my behaviour doesn't match their stereotype and if there's one thing that makes me upset more than anything else is when people start to question my integrity. You see, when I'm disbelieved that upsets me even more. So I was believed by these people and they wrote the thing down and I don't have to go through it again. If I don't feel well or I get depressed for more than five days in a row or whatever I ring the number, the story's on his screen, it's there. And it's not only that it's been signed by me because they sent me a copy to see if I agree with it, how about that? 

Now that is value, that is, that is state of the art mental health care in my view because my rights were always considered the whole time, no secrets were kept from me about what I diagnosed or what was said about me or anything. I was able to look at it, change it, just the same as I am here now. And that was a big change from Australia where everything is kept in a file secret, you know, you've got to ask for the doctor to go to the hospital, get it out with the hospital's permission, sign to say you've asked for it, sign to say you've seen it, as well as him seeing it, he's got to be allowed to see it too, not that I understand it anyway.

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.

 

Sara says her mental health team were patronising and didn't listen; she didn't feel like a "free...

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Sara says her mental health team were patronising and didn't listen; she didn't feel like a "free...

Age at interview: 31
Sex: Female
Age at diagnosis: 17
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I came out of hospital after nine months and I was sent back to where I was living and I was told I could only live there if I carried on taking the antipsychotic depo injection. And I found out later that that isn't legal either because there weren't any community treatment orders then. But I didn't know that at the time and I was very kind of scared of being forced into some kind of mental health hostel that, you know, I agreed and I took it. I don't know, they didn't really do anything, they would have meetings every now and then and they would just speak to me like, like I was a child. And, you know, just really, really patronising, like speaking to me like I was stupid. And I mean that is one thing, I think throughout my years of having mental health problems, that, you know, no matter how badly I thought of myself and how crazy and how fat and how ugly and whatever, you know, I'm not stupid, you know, I may not be as intelligent as them because they're doctors, but I'm not stupid and I don't like being treated like I am'

And even when I was out in the community it was like I was very much aware that I wasn't a free citizen and I couldn't just do what I wanted. That they were going to be, you know, kind of watching over me and, and asking me intrusive questions and I didn't really communicate with them and I think that made them think that I was more sick. And it was actually just that well, you know, I can't talk to them about anything that's going on, because they don't understand and they don't listen. You know, I would try with my CPN I would try over and over again to try and get her to understand that I had an eating disorder and I would ask her, 'But why am I schizophrenic? And I don't have these symptoms. And why are you saying this?' And it would just be, that, you know, 'Stealing food is irrational and psychotic,' and also things like, like cutting myself.

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. 

 

Her white, male psychiatrist is supportive, but she says it's important that the rest of her...

Her white, male psychiatrist is supportive, but she says it's important that the rest of her...

Age at interview: 36
Sex: Female
Age at diagnosis: 21
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And do you see a psychiatrist or…?

I see one every two months… Yes, he's quite good actually. He is I didn't like him at first because I thought he looked like a banker [Laughs]. But he proved to be really kind of good, you know, supportive. I mean he's really helpful, with, you know, me preparing to go to university. He's making sure I get all the support I need from the university. So, you know, he has been good. Yes. 

Are they white, your Mental Health Team?

My psychiatrist is white. My nurse, she's a Black woman… It's the Mental Health Team is reflective of the kind of ethnic, the ethnicity of the area I am in, which is really good actually. So there is a mix of white, Black and Asian professionals, you know.

Do you think it matters?

It does matter. Hugely it matters, you know.

In what way?

…It's just you just feel more at home really, if I mean, for example, when I was growing up, we lived on a kind of really hugely racist street. So… and that made me at times too scared to go to school, and, you know, and I'd be surrounded by teachers asking me why was I scared. They were all white, they had no, any kind of understanding of where we were coming from saying, you know, we were too scared to go to school, because there were certain people in the street who would swear at us, or spit at us. They just, they hadn't been through the experience. They would try to argue… You know, their argument that it's not so bad. You know, people aren't that bad and stuff like that, yes. It's just… I think every Black person in this country has experienced some racism unfortunately… 

It's a very huge, sort of tricky subject actually. But to me it just feels nice that there is a nice of, not only ethnic backgrounds, but ages and kind of sexualities and it, all, you know, all that really is helpful, you know. Because I mean, how could I relate my life to what, for example, a white middle class, professional male, when my, my, my experience has been the total opposite, you know. That he's in a very empowered position, not really understanding what it is to be disempowered. You know. So it, it just closes the gap between service user and professionals if there is, you know, you know, other kind of other ethnicities and kind of other ways of life, you know, in. So it just closes a gap and the gap needs closing you know?

 

Tariq says the ethnicity of his mental health team doesn't matter, because they've all given him...

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Tariq says the ethnicity of his mental health team doesn't matter, because they've all given him...

Age at interview: 21
Sex: Male
Age at diagnosis: 18
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To be honest, you know, my psychiatrist he's white, my mental health, she's white, every single professional I've worked with the majority of them are white and every single one of them have helped me, every single one of them have wanted me to recover. If, if it was a racist white person what would they have done, sectioned me, 'Oh he's, he's an Asian guy let's section him, that's what we need, we need coloured people in the system that's what we need.' But they didn't section me, why didn't they section me? I'm, I'm from an ethnic minority background, why wasn't I sectioned? Huh? Surely we are a disappropriate number in the service, surely we should be sectioned so why wasn't I sectioned, I'm a coloured person. then, you know, what they'll say, they'll say basically the reason why you, they'll try and make up a number of sort of defence arguments and it wouldn't add up because they know that there's no argument against it. I'm like one of them, I'm an ethnic minority, I'm from a coloured background, so why didn't they section me? They had grounds to do it but you see it's, they want to live in a, a world that they see everything as racist, everything has to be racist and unless everything doesn't go as they want to see it it's racist and that's what I don't like'

The thing is people always say you need to have an Asian man support you, you need to have an Asian man be next to you to be your advocate, why do I need that? I don't. What will, I don't understand what the difference is between a white person supporting and an Asian person supporting. It's like they're, you one is sub-human and one is human and [laughs] and it's true, and, and they're two different kinds of people and they can't do the same thing. It's like because of their race they have to be different somehow. I think it's not true, I think that the support I received from white members of staff has been the same I have received from Asian members of staff and I've had Asian people that have supported me in terms of the mental health system.

I've had a, you know, my psychiatrist I've had three psychiatrists because one had, they've all had to move on to different areas of psychiatry and etcetera but one, my first one was an Asian guy, my second one was a, I think he was , yeah I think he was a Jewish guy and the third guy the now, now, actually I've ahead four, the third guy was a Chinese guy and the fourth one is an Englishman and I've had a broad range of people and all of them seem to have the same belief that they want to see me recover and do well.
 

 

Lorenz believes it's important for a doctor to be open minded and to have the same belief system...

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Lorenz believes it's important for a doctor to be open minded and to have the same belief system...

Age at interview: 50
Sex: Male
Age at diagnosis: 20
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I think the system is partly wrong because there's not enough Black doctors and things like that you see. Although saying that in the early stage I wouldn't have liked a Black doctor to treat me. A Black psychiatrist, not the, not the medical physical doctor but Black psychiatrists I find very difficult to come to terms with, to know if he has, his belief system, it may be geared different from mine and be, his belief system maybe in the, what I used to, what is a voodoo type thing that used to practice in the West Indies or in Africa. I don't know what his belief system is so I was wary to take on a Black psychiatrist to talk to me about my mental health because I'm not for the voodoo business, I'm not superstitious and these sort of things he may portray in some way and categorise me wrong. 

I want somebody with a broader view of life and see, I still want somebody with a belief, they believe I mean in God but whatever their God is but whatever, but the belief system but knowing that Black people's belief system would be geared to some sort of practices which is black magic so I assume I didn't want a Black psychiatrist. Today my view has changed in the sense that education has bought them further on. And saying that education don't seem to have any morals in it so I sort of have a moral standing as well. So having a broad education or being highly education, educated you may lose some of your morals. And I'm all for Black being in the system but having an open mind and not treat you to say, 'Oh or you're from the West Indies so you may have some sort of, some sort of belief which may cause you to have mental illness.' Now I'm saying this is what the Black might be saying as a Black psychiatrist. Where I'm talking about a white society psychiatrist he hasn't got the depth of knowing, he may have hearsay of how the belief system work in a Black society but he's not fully aware of the mechanics of it. So because I'm thinking that Black psychiatrists may be aware of the mechanics of a belief system which is voodoo or black magic they may not treat me in the, with the right medication. Although they have the education with the scientific pills made up with the scientific they would know which one to give you I feel that their system, their belief may overact what they think and say, 'We'll give him this because this will calm him down because of his hysteria for what he did from this belief.' Now where I come to the white society take on, the white doctor look at me and he has no conception of anything of the belief system that I may carry. I want to explain to him the system I carry, each individual should explain to them, to those doctors, psychiatrists I particularly mean, what belief system they carry so they can be more understanding of the, how it builds up the whole person because you need to know how, what belief system the person is carrying to know how to treat him, the whole self because if you just, because he is behaving weird it might be part of his belief system what makes him to roll on the floor or whatever, you know, to get out whatever. But then you can come to say something can be treated or give him education, educate them to say this is not, this is just a form of controlling yourself from your behaviour you've got but teach them or let them understand or try to help them to understand that the brain is, is, is what shall I say organic, organic really, it's like any part of the body and it can go wrong'

So the white doctor is, it's really to do with open mindedness. You, you don't know your options, you look at a open mind and say well he's got this or he's got that but he may not have according to how you can interpret, without bringing your own system, belief system into play. But we all, I'm sure we all have a belief system ourselves'

I'm, wh

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. 

 

Sara believes that white middle class people can't always understand Asian culture. (Played by an...

Sara believes that white middle class people can't always understand Asian culture. (Played by an...

Age at interview: 31
Sex: Female
Age at diagnosis: 17
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But yes, I just, I don't always think that middle class people can understand like, oh and, you know, white middle class people can understand. I mean for instance, like they would not understand Asian culture. And things like, you know, like in Asian culture it's kind of like you don't talk to people outside the family. You know, you don't let them know things, it stays in the family, and… I don't know, I think they, they are looking at things from what is normal from a white middle class person's perspective. And what might be normal for them will not necessarily be normal for me. You know, I mean for instance in this culture it's very much kind of individualistic, sort of go-getting thing, whereas in other cultures it might be more sort of collective community that's more important. I mean for instance like just giving an example, I don't really have very much ambition and in this culture that matters, because we are kind of brought up to achieve and succeed and have a career and be successful, whereas if I was growing-up in, I don't know, an African village or something, it would be fine for me to just, I don't know, you know, gut fish or something for a living and I'd still be part of the community and valued. I don't know, I just…

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. 

 

Imani saw GPs from different backgrounds and reflects on her expectations and experiences of the...

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Imani saw GPs from different backgrounds and reflects on her expectations and experiences of the...

Age at interview: 48
Sex: Female
Age at diagnosis: 47
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[long inhalation of breath] I walked in and I saw a black female GP and I was so relieved. I was so relieved. And I just thought, well I knew she would be female, but I didn't know if she would be black, or if she'd be white, or if she'd be South East Asian or if she would be, I didn't know. And I really just, I really wanted to get vulnerable with her and just, you know, tell her this is what has been going on for me and stuff, but she was so strong, you know, she was so strong that I kind of, you know, I let the jelly off the plate for a bit, but when I looked into her eyes, I realised that I don't think it's acceptable. So I put the mould back on and kind of spoke to her like that, and like this, and like that I am fine and dah dah and she just said, 'Okay fine. All right then. And what can we do for you?' And I just thought well I don't know what you can do for me [laughs]. I am here to talk to you so you can tell me what you can do for me. I'm not here to tell you. And then eventually she just said, 'Well all right then, I'll tell you what, I'll give you a month off. Because it is clear that you are depressed, and yes, come back and see us again in a month.' And that was it. 

Is that what you were expecting?

No way. I really thought that. I walked in there and I saw a black woman and I thought this black woman if I talk to her and let her know, she will just, you know, slip into my shoes and she'll know exactly what I am talking about. She'll know the language. You know, she'll know the sisterhood language and, but it wasn't like that at all. It wasn't like that. And I don't know if my vulnerability made her feel vulnerable and made her feel soft, and made her feel less then strong. And it was something that she didn't want to identify with at that time. I mean I see her as a black female GP, but I don't know how many, you know, trials she has been through. How many times she's had to stand up for her race and her gender. I don't know how many times she could have written a letter of complaint about someone's treatment of her, but chose not to. I don't know what her history was. The only thing was I just wanted this woman who was going to understand [laughs] and I didn't get her. I didn't get that on that day.

So the next day, the next time I went a month later I went back and I, I, oh I hate going to the doctors, I hate it. I hate the thing of not being well. And not being well in a way that you can't look at me and see. And so I go to the GP and I wait in the surgery and I see people around me and it makes me anxious and I can feel my heart racing and I can feel it pounding in my ears and I can feel fight or flight and there have been occasions when they have given me the wrong times for my appointments. I have had to go there and wait. Like, you know, I have arrived at 10 o'clock think that my appointment is at 10. And they say oh no, no, there was a mistake, sorry. Your appointment is actually at 10.40. So I have had to sit and wait and of course they don't call you at 10.40. So it's 10.50 something that I will be in and I am sitting there and I'm getting more and more anxious. Anyway so I made another appointment a month later and thought, let me see someone else. So I saw another GP and this was a GP that I'd seen at another practice before. And her style is, 'Let's get you in and get you out as soon as possible, is that okay, lovey? Good. What have you got, okay fine, medical certificate, right jolly good. Trying to find, how does this computer work?' And I was giving her IT classes in my, in the doctor's surgery. And I just thought well, you know what, this is obviously not the space for this and then she just said, 'Well thanks for the IT lesson' [Laughs]. And that was it. She gave me my certificate and I was gone. 

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”. 

 

Jay says there was nothing for Black people at the day centre she attended.

Jay says there was nothing for Black people at the day centre she attended.

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And there was this woman there and she was loud and she often called me, 'Darkie' and things like that. She was a lot older, you know, the old school type mentality. And because I never spoke a lot, there wasn't the defence from the staff that I would expect, until a nurse heard it and [sniffs] she addressed the person's behaviour. But up until then it was just a given, 'Well, Jay don't speak anyway, so it doesn't matter if you call her whatever you want to call her.' Or maybe that person was doing it to see if they could get me to talk. I don't know. But that was, that was particularly horrible. 

 I think the, the experience of being part of the day service care in [the area] was discriminatory against women, against black people. There was nothing. I, I, I just, I went to the day centre and I just thought, 'Why am I here? There's nothing that interests me. There's nobody here who I can identify with. There's no activities that I'm vaguely interested in. There's nothing. So why am I here?' But, you know, I kept getting calls and, 'You've got to come, and you've got to come, and you've got to come.' And so I just kept going because I was told to go. And, you know, I was, I was in that mindset where I'd just do what people told me to do. Because I thought, 'Well, perhaps they know better.'

 

Devon reflects on why Black people don't want to use services and says the system needs to be...

Devon reflects on why Black people don't want to use services and says the system needs to be...

Age at interview: 49
Sex: Male
Age at diagnosis: 22
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To experience bereavement is different from actually saying it. I never thought I go through bereavement until happened to me. Yes. It just gets hold of you, you can't shove it off, it's a hard thing. Causes a lots of mental health problems, bereavement, loneliness, social inclusion. Being in your flat on your own. Not having no work. Unemployed. No money to buy a proper meal. There are loads of people out there in the community. Loads in the community like that. But they don't know where to go to no one. They don't go to a doctor or no GP. They want to deal with it themselves. It's called Breaking the Circle of Fear. Which is something by the Sainsbury Centre in mental health has brought out a paper. You know, some Black folk they don't want to go to the GP, they don't want to go, then them's not treated, because the stories they hear about the system, so we've got to find a way to make it more attractive to help them to go and get treatment before it gets worse. All these things because of the way how the system is. And the GP, oh they have no clue about mental illness. If you go to them about any major problem, they look into the book, any tablets they can give you. Oh.

 

Ali says he didn't want to seek help because mental health is a taboo and because he was worried...

Ali says he didn't want to seek help because mental health is a taboo and because he was worried...

Age at interview: 27
Sex: Male
Age at diagnosis: 26
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I never believed in psychiatric, that's the thing. I always, I think this is probably the culture that I'm brought up in, that is basically first of all mental health is a taboo issue, secondly it's, it's always when you hear about patients who are mentally ill, they always seem to go to doctors like ten years, for ten years, or five years, or you know, they have been a mental patient for life. They have chronic depression for the past twenty years, so, like they never tend to get fixed like other diseases. If you have a problem with your appendix you go to the surgeon and he takes it out. But if you have a mental problem it's like you take the medicine for the next twenty years, you know? That's, that's absurd. So I think that sort of made me stay away from psychiatrists. 

But anyways, since I've been here in my college, I came here to do my MSc at University of [name removed], and over there, there was quite a bit of awareness about mental issues. So I used to read all these pamphlets and this and that, depression, everyone suffers from depression, one in three persons feel anxiety blah blah blah. So, you know, that sort of made me a bit more confident about, 'Okay, so I'm not alone and, you know, it might not be such a taboo issue' and you know. But I didn't seek help back then.

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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