Discussion in 'Professionally Qualified, RAMC and QARANC' started by dui-lai, Mar 31, 2007.
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Any Psych nurse comments before I get on my soap box?
So providing them with mental health care is racist now?
It's all down to Post Traumatic Slave Disorder. LINK
Anything and everything any non black does or says is racist if a non white says it is.
I have found the NHS mental health services to be equally lacking in their resources, no matter what your colour or creed.
Im a student psych nurse and NHS mental health services are pretty poor at present whatever the colour of your skin, we try hard but like soldiers the government try shaft us anyway they can.
The stats are actually correct (for once) but no-one seems to be clear as to WHY you are much more likely to end up with a diagnosis of schizophrenia or end up in Secure services if you are Afro-Carribean (particularly).
Part of it (I think) is that we are too scared of PC-ness to look properly at whether this group is more likely to be susceptible to illnesses like schizophrenia (it wouldn't be the first time that one ethnic group has been shown to be prone to an illness more than others, sickle cell anaemia being the best known). I'm not saying that it is or it isn't but it may be useful to exclude it as a possibility.
There may also be cultural reasons in how people from different ethnic groups express different things that are happening to them. The problem is that the research community is very lairy of anything that proves that ethnic groups are different physiologically/psychologically and that it's possible that certain ethnic groups are more pre-disposed to some conditions than others.
I don't personally have a view either way, but I'm not quite convinced by the institutionally racist argument as I think it's over simplistic. There may be other factors as well (equally there may not!). I also noted that Lord Patel has said that he doesn't think individual nurses & consultants are racist, more than the institutions. Problem with this is that it's RMN/Drs/Soc. Workers (and psych. commissioning managers like myself) who make all the decisions, so if it's not us then who is it?
In essence I suppose I'm saying the same as Louis Appleby about this, in that other factors MAY be present. It's also worth remembering that the statistics are very urban area weighted. As far as I can recall my NHS trust has only had one Afro-Carribean patient as an inpatient in the last two years (very rural indeed!). More work is needed in this area, and whilst Lord Patel makes a good point about the stats, which are very obvious and he wouldn't have been doing his job if he hadn't highlighted it, I'm not sure that the old 'institutional racism card is particularly helpful withoput some evidence to back it up.
It was inevitable that the Rocky Bennett case would be mentioned, but deaths of white patients have also happened in very similar circumstances, they just aren't newsworthy.
I totally agree bout the Rocky Bennet thing, white people having accidents in an institution just isnt headline grabbing! unless its an ethnic person causing the accident, its just not PC enough, I also agree about there being other factors in the incidence of mental illness in ethnic communities particularly afro-carribbean, but its all too easy in Britain to play the racism card, I dont know what the answer is, Im only a second year student I dont have the answers I dont think anyone has the definitive answer and its debateable whether we ever will. Ive never seen an afro-carribbean patient on any of my placements as yet and very few staff Ive spoken too have either, so where do all these mentally ill people go?
To claim an instituition/organisation is "Instituitionally racist" implies all who work within demonstrate or show overt/covert or tacit support for racisim, is in my humble opinion, the easy option in this PC ridden world, instead of doing scientific research. There are too many people scared of being tagged a racist by people who can't put forward a reasonable debate because they are blinded by their own left-wing, marxist views.
What is needed is not this degrading denounciation of the NHS mental services but something more positive. However this government likes anything which shows the majority population to be demonstrating racisim, just to appease the minority.
I thought the term "Instituitionally racist" did not infact claim all the staff were racist but that the intended, or more likely unintended, consequences of a system causes groups to be treated differently from each other. An example might be money for a disorder being disproportiately spent in an area with a high level of one ethnicity whilst less money spent in another area, with similar rates of the disorder but a different ethnic make up. No one here would be making a decision to actively discriminate against one race or another but the effect is the same. I don't know how true this is in NHS mental health provision as I haven't enough experience but I don't discount the possibility ( and if it does exist then I bet the existance of the postcode lottery for treatment makes it's incidence much worse)
As for being PC hampering effective research, you're probably right as people often tie themselves up in (no doubt well intentioned) knots in order to stay away from any possibility of appearing to be, or worse, giving ammunition to racists. And I say this as a fully signed up wooly thinking liberal. As a result any research can be hamstrung such as any effective investigation into why African immigrants have higher rates of mental illness here than the communities they have left in Africa suggesting a cultural element to the rise in prevalence in black communities in Britain. Or else it could simply be underreported in African countries. Who Knows and who can tell without effective research into it.
This is really my 'area' ,as I've looked into it in depth. I think that it is not really speaking of therapuetic parts of the service, rather diagnostic levels and the fact that statistically young black men (and not women to the same extent) do seem to be labelled with a mental illness diagnosis more often than might be predicted.
I recently produced an epidemiology paper for my school entitled 'Is the idea of mental illness as deviancy supported by the epidemiological data?' I sourced the stats from datasets provided by official government sources, and there do seem to be anomalies around young black men and diagnosis, certainly not proveable without serious interview work on both patients and psychiatrists, but certainly signifcant enough to raise eyebrows.
I don't have my books with me as I'm up North doing research (on mental health as it happens) but in the UK a black male has an eightfold chance to be diagnosed schizophrenic over his white counterpart, whereas in the Carribean the instance of schizophrenia amongst the general population is at the same level as for whites in the UK, which certainly means there is something 'social' going on, either in the reality of living as a black guy in the UK, or in the diagnostic process.
This is covered in lots of the literature and is usually called 'Labelling theory'...sure wiki will have a link...it does...
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