Barriers of Minority Communities in Accessing Mental Health Services in the UK

Abstract

The proposed research is about identifying the barriers that individuals from minority communities experience when trying to access mental health services in the UK. The purpose of the study is to show that minority communities cannot obtain the same level of quality mental health services as compared to the dominant white majority. The study aims at identifying those barriers through multiple perspectives, and that is why the Systems Theory was selected as the theoretical basis of the study. The literature review identified three major themes which are racism and discrimination, cultural views on mental health issues and communication and linguistic barriers. The population will comprise of individuals from minority groups, and stratified sampling will be used which will divide the population into strata based on culture and ethnicity. The primary data collection procedures that will be used are surveys, questionnaires, and face to face to face interviews. The study will benefit health and social care since it will identify the barriers that minority communities face when accessing mental healthcare services. Additionally, the identification of the restrictions will help to formulate policies that will combat the obstacles or mitigate their effects, providing valuable insights for healthcare dissertation help.

Introduction

There has been an increase in mental health awareness due to its documentation on social media platforms. This increase in knowledge has led people to seek mental health services to help them deal with their mental health issues. However, not all individuals have equal access to mental health services in the UK. It is easier for a white person to get access to proper mental health services in the UK than it is for an individual from minority groups to access the same level of healthcare. The government has striven to improve access to mental healthcare services for minority individuals, but it does not seem to be enough due to deep-seated barriers that continue to bar people from the minority community from accessing proper mental health services. The purpose of this inquiry will be to research the restrictions that make it challenging for individuals from minority groups to access appropriate mental health services.

There has been an increase in mental health awareness due to its documentation on social media platforms. This increase in knowledge has led people to seek mental health services to help them deal with their mental health issues. However, not all individuals have equal access to mental health services in the UK. It is easier for a white person to get access to proper mental health services in the UK than it is for an individual from minority groups to access the same level of healthcare. The government has striven to improve access to mental healthcare services for minority individuals, but it does not seem to be enough due to deep-seated barriers that continue to bar people from the minority community from accessing proper mental health services. The purpose of this inquiry will be to research the restrictions that make it challenging for individuals from minority groups to access appropriate mental health services.

In the course of the research the term “minority community” will be used. The term minority community will refer to any community that is not part of the dominant white majority. As such it will apply to African Blacks, Caribbean Black, Asians, and any other culturally or ethnically minor community that is located in the UK. A literature review will be carried out, then the methodology section shall be addressed, and the paper shall wrap up with a discussion and conclusion.

Literature Review

The NHS (2017) wrote a document titled, “Detentions under the Mental Health Act.” In the report, they showed that not only do individuals from minority communities have less access to better healthcare, but they are the ones who are more likely to be detained under the Mental Health Act. Conversely, individuals from the dominant white group were the ones who were less likely to be detained under the same act, and this showed that in accessing mental healthcare minority groups are at a gross disadvantage. The literature review section will be divided according to the major themes that were observed in the literature. The major arguments will revolve around the critical barriers that previous research has recorded.

Racism and Discrimination

In assessing the literature, the first significant barrier noted was the issue of racism and discrimination. According to Grey et al. (2013), it is more likely that an individual from minority communities is going to receive less optimal mental healthcare and at the same time they may be misdiagnosed or treated too fast. The reason for that is that General Practitioners tend to have misconceived notions about individuals from minority communities which leads them to form a conclusion long before they have evaluated the individual. The finding by Grey et al. was supported by Arday. Arday (2018) observed that individuals from minority groups tend to shun accessing mental healthcare because they are afraid of racial discrimination that they will experience. Some of the participants of the study stated that when they obtained mental healthcare services, they could tell that the doctor had already arrived at a conclusion based on the way that they looked (Arday, 2018). Vernon (2011) stated that due to racism and discrimination it was easier for doctors to interpret symptoms through the prism of race, culture, and ethnicity. As such, it is easier for individuals from minority communities to be detained if the practitioner has an inkling that they are “unhinged” (Parkin, 2018). Some studies showed that individuals from minority communities complained about receiving culturally insensitive treatment from General Practitioners (Islam, Fatemeh, & Singh 2015). According to Memon et al. (2016), some participants stated that they felt that they had to explain “their minority experiences” every time that they tried to access mental healthcare services. Some of the participants stated that they felt that they were being discriminated against due to the color of their skin and they were more likely to be regarded as aggressive (Mind 2012). Due to that, they were less likely to receive optimal mental health care and more likely to be detained under the Mental Health Care Act of 1983. Therefore, racism and discrimination are a significant barrier for minority communities when accessing mental health services.

Cultural View on Mental Health

Minority communities have different cultural views on mental health, and that affects the decision of whether they will choose to access mental health services. According to Mehraby (2009), some minority communities root their understanding of mental health issues on religion and other superstitious views. Some communities believe that psychological problems are caused by demons, curses, and other spiritual causes. As such, some of the communities think that white doctors are not qualified to treat them because they do not understand the underlying cause of the issues that individuals are facing (Osman and Carare 2015). Due to that view, some members of minority communities would instead seek help from spiritual leaders rather than seek professional mental health services (Rabiee and Smith 2014). Moreover, in some minority community’s mental health issues is associated with stigma and that causes some individuals to choose not to access mental health services. According to Memon et al. (2016) if one has mental issues one is expected to deal with it since seeking mental health services is announcing to the community that you have a problem. The stigma associated with mental health affects not just the individual but their family too (Bhattacharyya and Benbow 2013). The repercussions of such shame are that it lowers the family’s standing in the community, employment opportunities reduce, and in some instances, marriage prospects diminish (Islam, Fatemeh, & Singh 2015). At the core of the cultural views that some individuals from minority communities have lies ignorance that is fueled by lack of information (Radford et al. 2015. Some individuals in minority communities believed that mental health issues were contagious because they simply did not know better. Due to such negative cultural views on mental health issues many individuals from minority groups choose not to access mental health services.

Communication and Linguistic Barriers.

For the majority of individuals from minority communities, English is not their first language or their grasp of the English language is tenuous at best. Fountain and Hicks (2010) observed that many people from minority groups do not have enough grasp of the English language for them to express themselves. As such, they cannot articulate their symptoms and their experiences to the General Practitioner. Communication issues are a key barrier in a profession where talking is part of the treatment process. Grey et al. (2013) state that high satisfaction levels are derived when both the doctor and the patient both speak the same language. In a situation where the doctor and the patient do not speak the same language, satisfaction levels are low even in the presence of an interpreter (Grey et al. 2013). Some participants in the study stated that they preferred to wait and when they went to access mental health services it was usually too late (Grey et al. 2013). Memon et al. (2016) also note that communication barriers arise not only because of people from minority groups not speaking English but also from the healthcare providers lack of listening. According to Salway et al. (2016), individuals from minority communities do not like going to the doctor’s office because they feel that doctor rarely listens to what they say and they treat them in a general sense. As such they would rather not seek mental health services because the doctor will not listen to them even if they do. According to Fernando (2010), part of the reason why General Practitioners treat individuals from minority groups in a general sense is that mental health in the UK is Eurocentric. As such, healthcare providers treat individuals from minority communities based on a system that was designed for European people, and that may explain why minority communities do not feel like doctors listen to them. Therefore, communication and linguistic issues are key barriers for minority communities in accessing mental health services.

Methods

Theoretical Direction

The research problem that will be tackled is the barriers that minority communities experience when trying to access mental health services in the UK. The research shall be a qualitative primary research study. The theoretical basis of the study will be the Systems Theory. The Systems Theory advances the claim that human behavior cannot be defined from one perspective but from multiple perspectives (Simmons University 2018). This theoretical perspective was selected as a basis since as seen from the literature review section the barriers must be evaluated from multiple angles for a holistic understanding of the issue.

Data Collection Methods

The primary data collection methods that will be utilized are face to face interviews, questionnaires, and surveys. The survey will be carried out first, and the results of the study will be used to select the individuals that will be called in for face to face interviews. Ponto (2015) notes that survey research is an essential primary research tool since it gives room for the collection of information from many individuals. Therefore, surveys will be used to understand and overall overview of the issue. The questionnaires will also be used during the study since they will involve preconceived questions. Primarily it would be better if each individual could be interviewed, but that will be unfeasible for a long-term study. Interviews will be of significant advantage since they give the researcher to obtain information that they would not have been able to attain through surveys and questionnaires (Alshenqeeti 2014). During the interview, the researcher will take note of non-verbal cues such as body language, the tone of voice and facial expressions. The non-verbal cues will put the information in its proper context.

Ethics

Since the study involves people the first ethical issues that must be addressed is one of consent. Individuals will be informed that they will only participate in the study out of their own volition and that they can leave whenever they feel uncomfortable in any way. The second ethical issue is one of confidentiality. Participants will be informed that any information that they provide for the study will be kept confidential and will not be revealed. If and when data needs to be revealed their names will be changed to ensure that they remain anonymous. If an individual who is under 18-years-old will be needed to be part of the study, then their parent’s permission will be required, and parents will have the option of withdrawing authorization if and when they choose. The third ethical issue will be one of language. Since the study narrows in on minority communities, language barriers will exist. Different language interpreters will be needed more so if participants come from more than one community. Therefore, those are the ethical issues that will arise and the manner in which they will be addressed.

Sample and Participants

The study concentrates on the minority community; thus the prerequisite for one being part of the study is that they have to come from a minority community. The ideal age will be between 18-50, and it will be better if they have experienced mental health issues or if they know anyone, whether a family member or a friend from a minority community, who have experienced mental problems. Individuals from minority communities have been selected since the research will aim to detail their experiences and the barriers that they have encountered when trying to access mental health services. Stratified sampling will be utilized as the primary sampling method. Lyn (2016) notes that stratified sampling splits the population into manageable groups that are defined by a unique and similar characteristic. The population will be stratified into groups defined by their culture and ethnicity. The term “minority” community is all-encompassing, but it includes Asians, Indians, Black Caribbean, Black African and many other communities. The number of strata will be defined by the number of minority communities that will be represented in the study.

Work Plan

The ideal timeline for the research and completion of the project is 4-6 months. In 4-6 months, surveys will be carried out, questionnaires handed out and interviews performed. Furthermore, it will be enough time for one individual to synthesize the information and complete a research paper. The timeline was chosen under the assumption that it is one individual who will carry out the study. However, with research assistants, the schedule may be cut in half. The key activity necessary for completion of the project is identifying individuals from minority communities. Once the individuals from minority communities have been identified it will be easier for the rest of the activities to take place. As said, the process will include surveys, questionnaires, interviews, synthesizing the information, and finally writing the report.

Discussion

The research proposal presented has merits as well as limitations. The overall value is that it presents information on the barriers that minority communities face when they are trying to access mental healthcare services. That does not mean that the study is particularly novel since the literature review revealed that there are a number of studies that have explored the issue. However, the study will further reinforce the information that has been provided by other literature. The second merit of the research is that by identifying the barriers policies and laws can be created that will help combat the barriers or mitigate their effects. In the end identification of the barriers will not help if no changes are carried out to ensure mental health services are made equally accessible for all individuals in the UK. This study will act as a framework directing where efforts should be applied when making changes. The third merit of the research is that it carries implications for social work practice. The social worker is the one that tends to deal directly with disenfranchised populations. This study will call the social worker to examine themselves to see if they have conscious or unconscious preconceived notions of minority communities and whether that is affecting the manner through which they are providing care. Additionally, it will show the importance of multicultural competence training that will help social workers offer better care to individuals from minority communities. Therefore, those are the merits afforded by the study.

The study has a number of limitations. First, there is the limitation of time. A better review would be one that would take a relatively longer time than the amount of time spent in this study. More time would allow for the use of a larger population and sample. Moreover, it would allow for a more in-depth analysis of the retrieved information. Second, only one researcher will be involved due to financial constraints. Since only one researcher will be included in the study, the probability of the researcher’s bias affecting the survey is very high. Lee et al. (2013) note that the researcher’s bias occurs when the researcher consciously or unconsciously interprets information to confirm their inherent biases. The potential for the researcher’s bias is exceptionally high since it is only one researcher who will be involved in the study. With more finances, other researchers or research assistants could be hired, and they would help in the synthesis of information which would help reduce the possibility of researcher’s bias. Third, the conclusion of the study will not end with recommendations on how the perceived barriers can be solved. The purpose of the research is to identify the barriers. Future research can concentrate on methods of combatting the identified barriers.

Conclusion

The purpose of the suggested proposal is to identify the barriers that minority communities experience when accessing mental health services. Reviewed literature showed that the topic had been explored before so the purpose of the study will be to reinforce existing information. The theoretical framework that will be used for the study is the systems theory which will act as a guide in evaluating the issue from multiple perspectives. The key population group that will be part of the study is individuals from minority groups. Stratified sampling will be used, and it will divide the population into strata based on culture and ethnicity. Additionally, the primary data collection methods will be surveys, questionnaires, and face to face interviews. It is expected that the study will take 4-6 months to complete; that includes the research process and the writing of the report. The key strengths of the study are that it will offer more information on the issue, it will act as a framework for policy changes, and it will delve into the impacts on social work practice. Conversely, the key limitations of the study are that there is little time, no finances to hire other researchers, and it will not offer recommendations on how to deal with the barriers. All in all, the study will aim to look at the issue of barriers to accessing mental health services as experienced by individuals from minority communities.

References

• Alshenqeeti, H., 2014. Interviewing as a data collection method: A critical review. Sciedu Press, vol. 3(1), pp. 39-45.
• Arday, J., 2018. Understanding mental health: What are the issues for Black and Ethnic Minority students at university. Social Sciences, vol. 7, pp. 1-25.
• Bhattacharyya, S. & Benbow M, S., 2013. Mental health services for Black and Minority Ethnic elders in the United Kingdom: A systematic review of innovative practice with service provision and policy implications. International Psychogeriatric Association, vol. 25(3), pp.359-373.
• Fernando, S., 2003. Mental health, race, and culture. London, England: Palgrave Macmillan.
• Fountain, J. & Hicks, J., 2010. Delivering race equality in mental health acre: Report on the findings and outcomes of the community engagement programme 2005-2008. Lancashire, England: ISCRI. Accessed 20th March 2019.
• Grey, T., Sewell, H., Shapiro, G. & Ashraf, F., 2013. Mental health inequalities are facing U.K. minority ethnic populations. Journal of Psychological Issues in Organization Culture, vol.3(1), pp.146-157
• Islam, Z., Fatemeh, R. & Singh P, S., 2015. Black and minority ethnic groups’ perceptions and experience of early intervention in psychosis services in the United Kingdom. Journal of Cross-Cultural Psychology, pp.1-17
• Lee C, J., Cassidy R, S., Zhang, G. & Cronin, B., 2013. Bias in peer review. Journal of the American Society for Information Science and Technology, vol. 64, pp.2-17
• Lyn, P., 2016. The advantage and disadvantage of implicitly stratified sampling. Accessed 20th March 2019.
• Mehraby, N., 2009. Possessed or crazy? Mental illness across cultures. Accessed 12th March 2019.
• Memon, A., Taylor, K., Mohebati, L., Sundin, J., Cooper, M., Scanlon, T. & de Visser, R., 2016. Perceived barriers to accessing health services among black and minority ethnic communities: a qualitative study in Southeast England. BMJ Open, vol. 6.
• Mind. (2012). Statistics 3: Race, culture and mental health. Accessed 20th March 2019.
• NHS., 2017. Detentions under the Mental Health Act. Accessed 20th March 2019.
• Osman, S. & Carare O, R., 2015. Barriers faced by the people with dementia in the black and minority ethnic groups in accessing health care and social services. Journal of Gerontology & Geriatric Research, vol. 4. doi:10.4172/2167-7182.1000198
• Ponto, J., 2015. Understanding and evaluating survey research. Journal of Advanced Practical Oncology, vol. 6(2), pp.168-171.
• Rabiee, F. & Smith, P., 2014. Understanding mental health and experience of accessing services among African and African Caribbean Service users and carers in Birmingham, UK. Diversity and Equality in Health and Care, vol.11, pp.125-134.
• Radford, K., Sturgeon, B., Cuoma, I. & Lucas, O. (2015). “Walking this thin line” Black and Minority Ethnic (BME) experiences of mental health and wellbeing in N. Ireland. Institute for Conflict Research. Accessed 20th March 2019.
• Salway, S., Mir, G., Turner, D., Ellison H, G., Carter, L. & Gerrish, K., 2016. Obstacles to “race equality” in the English National Health Service: Insights from the healthcare commissioning arena. Social Science and Medicine, vol. 152, pp. 102-110.
• Simmons University., 2018. Theories used in social work practice and practice models. Accessed 20th March 2019.
• Vernon, P., 2011. Put race equality in mental health back on the agenda. The Guardian, Accessed 20th March 2019