Communication breakdown and cultural factors create barriers to BME groups accessing mental health services
A new study has found that members of black and minority ethnic (BME) groups are facing barriers to mental health services because of a communication breakdown between healthcare users and providers. Cultural factors, such as an inability to accept mental health problems and stigma, were also found to affect access to services.
Professor Anjum Memon, Chair in Epidemiology and Public Health Medicine at BSMS, who led the study, said: “We already knew that mental health services are not meeting the needs of BME communities. Our study has identified a number of barriers that these groups are facing – both from within their community and through the service provision process. Until barriers such as stigma, communications problems and discrimination are counteracted, BME communities will continue to miss out on mental health support.”
Professor Memon also said that the prevalence of common mental disorders varies markedly in different BME communities. For example, more than twice as many south Asian women are diagnosed with anxiety and depression as white women (63.5% vs 28.5%), and psychotic disorders are more than ten times more prevalent among Afro-Caribbean men than white men (3.1% vs 0.2%). Use of mental health services also varies widely, with people from ethnic minorities less likely than their white British counterparts to contact their GP about mental health issues, be prescribed antidepressants or referred to specialist mental health services.
Two broad themes were identified as contributing to reduced access to mental health services.
First, personal and environmental factors included a negative perception of, and social stigma against, mental health, an inability to recognise and accept mental health problems, the positive impact of social networks, a reluctance to discuss psychological distress and seek help among men, and cultural identity, along with financial factors.
Second, factors affecting the relationship between service user and health-care provider included the impact of long waiting times for initial assessment, language barriers, poor communication between service users and providers, inadequate recognition or response to mental health needs, imbalance of power and authority between service users and providers, cultural naivety, insensitivity and discrimination towards the needs of BME service users, and lack of awareness of different services among service users and providers.
Professor Memon added: “We need to engage people from BME backgrounds in the development and delivery of culturally appropriate mental health services, in order to facilitate better understanding of mental health conditions and improve access. Alongside this, healthcare providers need training and support in developing effective communication strategies to deliver individually tailored and culturally sensitive care. In order to improve mental health literacy, raise awareness of mental health conditions and combat stigma among BME communities, we need to improve information about services and access pathways for these groups.”
The full study is published in the journal BMJ Open.
The study was also presented at the Lancet Public Health Science Conference held on 25 November 2016 at Cardiff.