For Mental health week, theme: mental health and BME patients

In the beginning of my career as a psychologist I worked in Hackney – East London NHS mental health trust, at a schizophrenia and bi-polar multi-disciplinary team. We worked mostly with young black males who were diagnosed with schizophrenia in hugely unproportionate numbers in comparison to their percentages in the general population.

It was a big question to us as to why that is happening.

So we got together, 4 young psychologists and did a piece of research about 4 ethnicities in Hackney. Vietnamese, Orthodox Jewish, African-Caribbean’s, and Turkish. What we found through semi structured interviews was that access to talking therapy was full of barriers.

The main themes in the qualitative research identified were: 1) Confidentiality and trust was an issue, creating a sense of shared understanding with mainly white middle class therapists was problematic; The development of the therapeutic relationships required further attention and was not straight forward; and lastly – belief around mental health and help seeking were stopping these BME communities from seeking therapy.

At the discussion part of the research, we made certain recommendations:

Transparency and choice throughout the process of therapy was seen as particularly important.

Explicitness around confidentiality, and open negotiation of therapy contracts and endings.

Supportive partnership, working with community organisations was suggested as well.

This could ensure therapist’s sensitivity and respectfulness around cultural and religious differences.

This research is now 12 years old. And things still have not completely changed.

While I am no longer working for the NHS, my impression is that BMEs in the UK are still suffering from Access to talking therapy.

I am working at Harley Street area, in a co – op of therapists and psychiatrists, “The Green Door Clinic”. I am thinking particularly about one lady, Afro – Caribbean by origin who struggled so much while working for a large financial institution in the city of London. She suffered indirect, highly ‘hidden’ and ‘polite’ racism, was not mentored properly, was left out of coffee breaks and pubs after work-informal meetings. Her work was under evaluated, and eventually she got so stressed she had to sue her employers, and they settled out of court. Over that time, I supported her via therapy.  Being the highly educated lady that she was she knew to seek help, and she received it well enough. However, what she experienced was on another facet level of society, not dissimilar to the young black males of Hackney that I met 13 years earlier. We still have to go a long was as a society to break barriers of stigma around both BMEs and mental health.

Happy mental health day to all of us, clinicians and clients alike!

Morgan, Khan, Mc Farlane, Thomas and Ram du Sautoy, (2009), Access to talking therapies: The views and experiences of people from Black and minority ethnic communities in secondary care in East London, Clinical Psychology Forum, nu 196. Pages 37 – 40.