Diversity, Difference and Mental Health Flashcards

1
Q

What do we mean by valuing diversity and difference in mental health?

List 4 points

A
  1. Being sensitive to diversity
  2. Understanding diversity
  3. Personalising practice
  4. Improving services
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2
Q
  1. Being sensitive to diversity
  2. Understanding diversity
  3. Personalising practice
  4. Improving services

These are the 4 areas of…?

A

Valuing diversity and difference in mental health

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3
Q

How can we be sensitive to diversity?

A

By understanding the unique experiences, beliefs, values, and perspectives of individuals from diverse backgrounds

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4
Q

How can we understand diversity?

A

Recognising that mental health challenges and their impact can differ substantially depending on cultural context, socioeconomic status, ethnicity, gender, and sexual orientation

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5
Q

How can we personalise practice?

A

Recognising and incorporating various cultural, social, and individual preferences in mental health services

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6
Q

Recognising / respecting
diversity in mental health care leads to…?

List 3 points

A
  1. Increased help-seeking among underserved groups
  2. More accurate assessment
  3. Better engagement in intervention, therapeutic alliance, and outcomes (positive therapeutic change)
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7
Q
  1. Increased help-seeking among underserved groups
  2. More accurate assessment
  3. Better engagement in intervention, therapeutic alliance, and outcomes (positive therapeutic change)

These are the 3 advantages of…?

A

Recognising / respecting
diversity in mental health care

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8
Q

Describe the UK Equality Act 2010

A
  1. Individuals are afforded protection against discrimination, harassment and victimisation
  2. To help achieve equal opportunities across all aspects of society based on nine protected characteristics
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9
Q

What are the 9 protected characteristics included in the Equality Act 2010?

A
  1. Race
  2. Disability
  3. Religion or belief
  4. Gender
  5. Sexual orientation
  6. Sex
  7. Age
  8. Maternity and pregnancy
  9. Marriage
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10
Q

What is the aim of the UK Equality Act 2010?

A

Promote equality to groups of people who may be disadvantaged or under-represented or have particular needs

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11
Q

What are the 2 important implications of the UK Equality Act 2010?

A
  1. Discrimination based on mental health is an offence
  2. Consideration of protected characteristics and equal treatment within mental health services is a legal duty as well as good practice
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12
Q

What were the 2 main themes found in a systematic review of 14 studies by Rees et al. (2020) of lesbian, gay, bisexual and transgender communities’ MH experiences?

A
  1. Experienced stigma and discrimination when accessing MH care
  2. Professionals’ lack knowledge and understanding of LGBT people’s needs
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13
Q

List 5 ways lesbian, gay, bisexual and transgender communities experience stigma and discrimination when accessing MH care

A
  1. Being positioned as different through use of heteronormative language etc.
  2. Felt ignored / mistreated due to sexuality or gender identification
  3. Often felt pathologized for their sexuality/gender identity and under-treated for primary mental health problems
  4. Or vulnerable if sexual orientation/gender were not acknowledged
  5. Some felt questions were over-intrusive
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14
Q

List 2 ways professionals’ lack knowledge and understanding of LGBT people’s needs

A
  1. A need for MH care that promotes equity, respect for diversity, & self-acceptance
  2. A need for culturally sensitive and LGBTQ+ friendly therapists that do not pathologise sexuality or assume that MH difficulties are due to sexual identity
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15
Q

What % of gay young people (who have not been bullied) are depressed?

a. 20%
b. 35%
c. 46%
d. 18%

A

b. 35%

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16
Q

The risk of suicide among gay men is ____ times the general population

A

2-4 times

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17
Q

The risk of suicide among _____ is 2-4 times the general population

A

Gay men

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18
Q

What contributes towards worse mental health among LGBTQ+ individuals?

List 5 factors

A
  1. Discrimination
  2. Social status
  3. Concealment
  4. Stigma
  5. Internalised homophobias
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19
Q

Common MH difficulties have steadily increased for ___

a. Men
b. Women
c. Non-binary
d. Children

A

b. Women

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20
Q

Common MH difficulties have remained steady for ____

a. Men
b. Women
c. Non-binary
d. Children

A

a. Men

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21
Q

What are the 2 common MH difficulties faced by women?

A
  1. Depression
  2. Anxiety
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22
Q

Women are ___ times as likely to be diagnosed with anxiety

A

2 times

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23
Q

____ are 2x times as likely to be diagnosed with anxiety

a. Men
b. Women
c. Non-binary
d. Children

A

b. Women

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24
Q

Obsessive compulsive disorder (OCD) and phobias more common among ____

a. Men
b. Women
c. Non-binary
d. Children

A

b. Women

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25
Q

Post-traumatic stress disorder are more common among ____

a. Men
b. Women
c. Non-binary
d. Children

A

b. Women

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26
Q

Post-traumatic stress disorder are more common among women

Why?

A

Majority of cases are due to sexual assault, which causes the trauma

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27
Q

What are the 2 mental health difficulties women experience due to their reproductive cycle?

A
  1. Prenatal depression
  2. Menopause (anxiety, mood)
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28
Q

_____ as many men as women die by suicide (linked to depression & adverse life events)

A

3x

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29
Q

3x as many ____ as women die by suicide (linked to depression & adverse life events)

a. Men
b. Women
c. Non-binary
d. Children

A

a. Men

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30
Q

___ % of referrals to psychological therapies in the NHS come from men

A

36%

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31
Q

36% of referrals to psychological therapies in the NHS come from men

What does this suggest?

A

Gender stereotypes contribute to low help seeking

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32
Q

_____ ______ contribute to low help seeking

A

Gender stereotypes

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33
Q

36% of referrals to psychological therapies in the NHS come from ____

a. Men
b. Women
c. Non-binary
d. Children

A

a. Men

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34
Q

___ are underrepresented in mental health services

a. Men
b. Women
c. Non-binary
d. Children

A

a. Men

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35
Q

Men are underrepresented in mental health services

Why?

A

Gender stereotypes

Men are expected by society to not show emotions and to cope with their difficulties alone

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36
Q

3x as likely to become alcohol dependent and frequently use drugs

a. Men
b. Women
c. Non-binary
d. Children

A

a. Men

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37
Q

Men are ____ times as likely to become alcohol dependent and frequently use drugs

A

3 times

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38
Q

More likely compulsorily detained under the Mental Health Act

a. Men
b. Women
c. Non-binary
d. Children

A

a. Men

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39
Q

Describe Women’s MH difficulties

List 5

A
  1. Common MH difficulties have steadily increased for women but remain steady for men
  2. 2x as likely diagnosed with anxiety
  3. Obsessive compulsive disorder (OCD) and phobias more common
  4. Post-traumatic stress disorder (20.4% vs 8.1% for men)
  5. Reproductive cycle: Perinatal depression, menopause (anxiety, mood)
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40
Q

Describe Men’s MH difficulties

List 4

A
  1. 3x as many men as women die by suicide (linked to depression & adverse life events)
  2. 36% of referrals to psychological therapies in the NHS come from men – gender stereotypes contribute to low help-seeking
  3. 3x as likely to become alcohol dependent and frequently use drugs
  4. More likely compulsorily detained under the Mental Health Act
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41
Q

True or False?

Many minorities have worse mental health compared with White British groups

A

True

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42
Q

______ individuals, esp men, are more likely to be diagnosed with psychosis (e.g. 6-9x more risk of
schizophrenia) and compulsorily admitted to hospital

a. Black
b. White
c. Asian
d. Hispanic

A

a. Black

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43
Q

____ individuals, esp men, are 6-9x more at risk of
schizophrenia

a. Black
b. White
c. Asian
d. Hispanic

A

a. Black

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44
Q

Black individuals, esp men, are 6-9x more at risk of
_____

A

Schizophrenia

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45
Q

Black individuals, esp men, are more likely to be diagnosed with ____ and compulsorily admitted to hospital

A

Psychosis

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46
Q

Children from most ethnic minority backgrounds showed more MH difficulties from ____ years

A

3-14

47
Q

Compared to White British Individuals, which group is higher in common MH difficulties?

a. Black Men
b. Asian Men
c. Black Women
d. Asian Women

A

c. Black Women

48
Q

What 3 minority groups reported higher mental wellbeing than other minority groups?

A
  1. Indian
  2. Pakistani
  3. African-Caribbean
49
Q

What do these 3 minority groups have in common?

  1. Indian
  2. Pakistani
  3. African-Caribbean
A

They are minorities that reported higher mental wellbeing than other minority groups

50
Q

What affects MH among individuals from ethnic minorities?

List 3 factors

A
  1. Racial discrimination
  2. Social and economic disadvantage
  3. Mental health stigma
51
Q

How does Mental Health Stigma affect MH among individuals from ethnic minorities?

A

In certain cultures, people don’t believe in mental health difficulties and discourage seeking help

simply = When mental health is little recognised or shameful to discuss

52
Q

What 3 factors leads to further isolation and deterioration in MH among minority groups?

A
  1. A worse MH care experience
  2. Poorer treatment outcomes
  3. Disengagement from mainstream services
53
Q

What do these 3 factors lead to?

  1. A worse MH care experience
  2. Poorer treatment outcomes
  3. Disengagement from mainstream services
A

Further isolation and deterioration in MH among minority groups

54
Q

When mental health is little recognised or shameful to discuss, what does this impact?

A

Minority groups’ ability and willingness to care for themselves and seek MH care

55
Q

One of the goals of ____ treatment was more equitable access to therapy

A

IAPT

56
Q

One of the goals of IAPT was …?

A

More equitable access to therapy

57
Q

One of the goals of IAPT was more equitable access to therapy

What can help achieve this?

A

Allowing self-referral

(rather than being referred to by a GP)

58
Q

Allowing self-referral may improve access for ethnic minorities, if access is affected by …?

A

Organizational discrimination

59
Q

Allowing _____ may improve access for ethnic minorities, if access is affected by organizational discrimination

A

Self-referral

60
Q

According to Harwood et al (2021), compared with the White British group, Black African, Asian and Mixed groups were less likely to …?

A

Self-refer to IAPT services

61
Q

According to Harwood et al (2021), compared with the White British group, ____, ____ and ____ were less likely to self-refer to IAPT services

A

Black African, Asian and Mixed groups

62
Q

According to Harwood et al (2021), compared with the White British group, Black Caribbean, Black Other & White Other were more likely to be…?

A

Referred by community services

(e.g. employment agency, voluntary organisations, criminal justice system)

63
Q

According to Harwood et al (2021), compared with the White British group, ___, ____ and ____ were more likely to be referred by community services

(e.g. employment agency, voluntary organisations, criminal justice system)

A

Black Caribbean, Black Other & White Other

64
Q

Black Caribbean, Black Other & White Other were more likely to be referred by community services

(e.g. employment agency, voluntary organisations, criminal justice system)

What are the implications of this?

A

MH difficulties may be severe by the time they are seen

65
Q

MH difficulties may be severe by the time they are seen for Black Caribbean, Black Other & White Other

Why?

A

Because these groups are more likely to be referred by community services

(e.g. employment agency, voluntary organisations, criminal justice system)

66
Q

According to Harwood et al (2021), compared with the White British group, all or almost all minority groups were …?

A

Less likely to receive an assessment and treated

67
Q

According to Harwood et al (2021), compared with the White British group, ___ were less likely to receive an assessment and treated

A

All or almost all minority groups

68
Q

According to Harwood et al (2021), compared with the White British group, recovery rates rose by 6% among ____ and _____ groups

A

Black and Asian groups

69
Q

According to Harwood et al (2021), compared with the White British group, recovery rates rose by ____% among Black and Asian groups

A

6%

70
Q

According to Bhavsar et al. (2021), compared to non-migrants, migrants residing in UK <10 years were less likely to use _____ treatment

A

IAPT psychological treatment

71
Q

According to Bhavsar et al. (2021), compared to non-migrants, migrants residing in UK <10 years were less likely to use IAPT psychological treatment, and this was not explained by ___, ____ and ____

List 3 factors

A
  1. English proficiency
  2. Sociodemographic factors
  3. Migrating for asylum reasons
72
Q

According to Bhavsar et al. (2021), compared to non-migrants, migrants residing in UK <10 years were less likely to use IAPT psychological treatment

What 3 factors can help explain these findings?

A
  1. Lack of information and effective communication about services
  2. Stigma within the community and wider society
  3. Mistrust trust of professionals
73
Q

Among the lowest fifth of household income compared to the highest fifth, the risk of ____ is 9x higher

A

Psychotic disorders

74
Q

Among the lowest fifth of household income compared to the highest fifth, the risk of psychotic disorders is ___ times higher

A

9 times

75
Q

Among the lowest fifth of household income compared to the highest fifth, _____ is doubled

A

Common mental health problems

76
Q

Among the lowest fifth of household income compared to the highest fifth, common mental health problems is ____

A

Doubled

77
Q

True or False?

There is a complex relationship between Socioeconomic disadvantage and MH

A

True

78
Q

List 2 reasons why there is a complex relationship between Socioeconomic disadvantage and MH

A
  1. MH can lead to difficulties gaining employment, substance abuse, poor handling of personal finances etc.
  2. Socioeconomic deprivation creates conditions of MH risk due to lack of resources, but also low social trust in area / high perceived crime
79
Q

Socioeconomic deprivation creates conditions of MH risk due to …?

List 3 factors

A
  1. Lack of resources
  2. Low social trust in area
  3. High perceived crime in area
80
Q

In IAPT, more socioeconomically disadvantaged individuals are less likely to…?

List 2 points

A
  1. Be referred for treatment
  2. Receive or complete treatment
81
Q

Therapy may also be less effective for those from low socioeconomic backgrounds

Why?

A

Because of the multiple factors that might be affecting engagement in the process and/or one’s MH

e.g. someone who works 2 jobs have multiple stressors in their life, not enough time to get adequate MH care

82
Q

Multiple factors that might be affecting engagement in the process and/or one’s MH

e.g. someone who works 2 jobs have multiple stressors in their life, not enough time to get adequate MH care

What is the result of this?

A

Therapy is likely to be less effective for those from low socioeconomic backgrounds

83
Q

According to Alvarez-Galvez & Rojas-Garcia (2019), those belonging to more minoritised ‘categories’ have more depressive symptoms

This effect is stronger in which countries?

A

Eastern and Southern European countries

84
Q

Those belonging to more minoritised ‘categories’ have more _____ symptoms, an effect that is stronger in Eastern and Southern European countries

A

Depressive

85
Q

In the UK, men are less likely to seek / complete treatment for …?

A

Common MH difficulties

86
Q

In the UK, ____ are less likely to seek / complete treatment for common MH difficulties

a. Men
b. Women
c. Non-binary
d. Children

A

a. Men

87
Q

In the UK, men are less likely to seek / complete treatment for common MH difficulties

This is especially true if they are from …?

List 4 groups

A
  1. From minoritised ethnic background
  2. Of Muslim faith
  3. Unemployed
  4. Living in deprived neighbourhood
88
Q

Various biological, social and cultural categories that are linked with social disadvantage/oppression often intersect or overlap

What does this suggest?

A

Disadvantage (or oppression) often comes from multiple
sources, not just one

89
Q

Define cultural competence

A

The ability to understand the beliefs, backgrounds, and values of the client that may differ from our own

90
Q

The ability to understand the beliefs, backgrounds, and values of the client that may differ from our own

This is known as…?

A

Cultural competence

91
Q

Define Cultural Humility

A

An ongoing process of self- exploration and self-critique combined with a willingness to learn from others

92
Q

An ongoing process of self- exploration and self-critique combined with a willingness to learn from others

This is known as…?

A

Cultural humility

93
Q

List 3 ways we can practice cultural competence in MH

A
  1. Consider client’s lived experiences and their social and cultural contexts: culture, race, ethnicity, SES, and sexuality
  2. ‘Seeing’ all aspects of the client and taking into account the things that they value
  3. Being sensitive to the role of culture without stereotyping
94
Q

List 3 ways we can practice cultural humility in MH

A
  1. Entering a relationship with the intention of honouring their beliefs, customs, and values
  2. Understand own beliefs, background and values as reflecting a specific cultural lens
  3. Understanding that culture influences help-seeking or care pathways; may bias the process of assessment and choice of management of MH care
95
Q

Entering a relationship with the intention of honouring their beliefs, customs, and values

What does this statement apply to?

a. Cultural humility
b. Cultural competence
c. Neither
d. Both

A

a. Cultural humility

96
Q

Considers client’s lived experiences and their social and cultural contexts: culture, race, ethnicity, SES, and sexuality

What does this statement apply to?

a. Cultural humility
b. Cultural competence
c. Neither
d. Both

A

b. Cultural competence

97
Q

‘Seeing’ all aspects of the client and taking into account the things that they value

What does this statement apply to?

a. Cultural humility
b. Cultural competence
c. Neither
d. Both

A

b. Cultural competence

98
Q

Understand own beliefs, background and values as reflecting a specific cultural lens

What does this statement apply to?

a. Cultural humility
b. Cultural competence
c. Neither
d. Both

A

a. Cultural humility

99
Q

Understanding that culture influences help-seeking or care pathways; may bias the process of assessment and choice of management of MH care

What does this statement apply to?

a. Cultural humility
b. Cultural competence
c. Neither
d. Both

A

a. Cultural humility

100
Q

Being sensitive to the role of culture without stereotyping

What does this statement apply to?

a. Cultural humility
b. Cultural competence
c. Neither
d. Both

A

b. Cultural competence

101
Q

Define culturally-adapted interventions

A

The systematic modification of a mental health programme or treatment that considers language, culture etc. in ways that are compatible with the client’s values, cognitions etc.

102
Q

The systematic modification of a mental health programme or treatment that considers language, culture etc. in ways that are compatible with the client’s values, cognitions etc.

This is known as…?

A

Culturally-adapted interventions

103
Q

People experiencing poverty, homelessness, intersecting oppressions (based e.g. on ethnicity, gender, sexuality, disability or class), and other forms of marginalisation remain highly under-represented in..?

List 2 types of research

A
  1. Mental health research
  2. Qualitative research on lived experiences, such as
    experiences of recovery
104
Q

Which 3 minority groups are highly under-represented in mental health research and qualitative research on lived experiences, such as
experiences of recovery?

A
  1. Poverty
  2. Homelessness
  3. Intersecting oppressions (based e.g. on ethnicity, gender, sexuality, disability or class)
105
Q

What research informs policy and practice?

List 2

A
  1. Mental health research
  2. Qualitative research on lived experiences, such as
    experiences of recovery
106
Q
  1. Mental health research
  2. Qualitative research on lived experiences, such as
    experiences of recovery

These researches inform ___ and ____

A
  1. Policy
  2. Practice
107
Q

True or False?

An individual’s identity and their mental health are intrinsically tied

A

True

108
Q

An individual’s identity and their mental health are intrinsically tied

What 3 points support this claim?

A
  1. Higher rates of mental health difficulties in particular groups
  2. Different life experiences, including discrimination and internalisation of stigma
  3. Mental health tends to affect different groups in different ways
109
Q

True or False?

Healthcare systems are part of a system that is designed for the minority

A

False

Healthcare systems are part of a system that is designed for the majority

110
Q

Healthcare systems are part of a system that is designed for the majority

What 3 points support this?

A
  1. Systemic factors lead to unfair access and treatment
  2. Actual experiences and perceptions of MH care professionals (part of the system)
  3. Despite attempts to improve access, IAPT has not really succeeded in doing so for under-represented ethnic groups
111
Q

True or False?

Considering diversity is not a priority to meet individual’s mental health care needs

A

False

Considering diversity is critical to meeting individual’s mental health care needs

112
Q

Considering diversity is critical to meeting individual’s mental health care needs

How can we achieve this? List 2 ways

A
  1. Train workforce
  2. Tailored services
113
Q

Considering diversity is critical to meeting individual’s mental health care needs

List 3 ways we can train workforces

A

Train them in:

  1. Intersectionality
  2. Cultural competence
  3. Cultural humility
114
Q

Considering diversity is critical to meeting individual’s mental health care needs

List 3 types of tailored services that would be useful

A
  1. Culturally adapted interventions
  2. Gendered services
  3. LGBTQ+ services