Inequalities in Mental Health Service Provision Flashcards
how many to black caribbean make up of the population in Tower Hamlets but how many mental health service registrations do they make up
- make up 10-15% of the population.
- but make up 52% of the registrations in mental health services
What factors lead to mental health inequalities
Material inequality - poverty, poor housing, lack of employment opportunities.
Social inequality and injury - stigma and discrimination or experiences related to:
- living in care
- immigration status
- ethnicity
- sexual orientation
- disability
- experience of violence or abuse.
Health inequality - including having long-term physical health conditions
what are the types of inequalities are there in tower hamlets
Lack of access to high quality medical care
Food deserts in poor neighbourhoods
Exposure to environmental toxins
High rates of incarceration
Experiencing the stress of racial discrimination
what does racism and racial discrimination in the NHS lead to
- disparity in access to and experiences of various areas of psychiatric care including crisis care, admissions, detentions, pathways into care
- although black british adults had the highest mean score for severity of mental health symptoms they were the least likely to receive treatment for mental illness
What is structural racism
The macro-level systems that create, sustain, and reinforce inequities among racial and ethnic groups
What are the forms of structural racism
- social segregation
- disproportionate criminalization
- unequal resources
- inequalities in access to high quality personalised HIV care which are overlapping and mutually reinforcing
how many children from BAME backgrounds are in youth justice systems
over 40% in youth justice system are from BAME backgrounds & more than 1/3 have a diagnosed mental health problem
who is more likely to be picked up in terms of mental health when arrested
- BAME groups are more likely to be diagnosed with a mental health condition when they are arrested
- Diagnosis and arrest go together
What are ethnic minority people more likely to report in comparison to white British people
- adverse, harsh, or distressing mental health experiences and poorer outcomes
- issues are persistant and driven by societal disadvantage and institutional and interpersonal racism
How long have ethnic inequalities in mental health care systems been documented for
at least 3 decades
these include
- compulsory admission and treatment (sectioning)
- being subjected to forcible treatment, seclusion and restraint
What is an explanation for the adverse experiences felt in mental health
One set of explanations is based on the notion of structural racism and institutional racism.
This means the way that institutions, such as health agencies, organise practices, policies and priorities, reflect and replicate power dynamics in broader society.
This then has an adverse effect on ethnic minority groups compared to White majority groups
what are the consequences for the lack of recognition and awareness of the role of racism in mental health care
- lack of ability to access appropriate therappy at a time they need
- stigmatising
- ## experience of not being heard, mistrusted or being treated with hostility are commonly expressed
What is the life expectancy of a homeless person
Life expectancy for a homeless person is currently 47 years for men and 44 years for women.
What do homeless people find difficult to access
Homeless persons often find it hard to access primary health care which results in homeless people being 60 times more likely to visit Accident and Emergency departments compared to the rest of the population.
what factors lead to homelessness (Bramley and fitzpatrick)
- Individualistic - explanations focus on personal vulnerabilities and behaviours of homeless people such as mental health and addictions
- structural explanations - housing, market conditions, poverty and unemployment
Conflate individualistic explanations with personal agency - person has no control over there situation
what is the interrelationship between poverty and domestic violence a key trigger for
Interrelationship between poverty and domestic violence which in turn is a key trigger for homelessness amongst women and children.
in terms of well developed countries what is homelessness like
Countries with benign social and economic conditions – well functioning housing and labour markets and generous social security policies – will have a low overall prevalence of homelessness, but that a high proportion of their (relatively) small homeless populations will have complex personal problems
how do welfare regimes impact on homelessness
impact on the scale, causes and nature of homelessness
According to the scottish household survey
Demographics – accounts for <2% of variance; females greater risk, ‘other’ ethnicity
Childhood Poverty – single largest contributor – 52% variance
Geographical factors – rural, housing pressures, 6% of variance
Teenage experiences – not living with both parents, excluded from school, serious drug use, ever in care, mother’s mental state; moderate level of explanation of 15%
Adult Economic Situation – unemployment, rented housing 16% variance
Adult family & life events – lack of relationships, long term illness/disability, can trigger or reinforce poverty, accounts for 11% of variance
What is the biggest predictor of homelessness
Poverty
- homelessness can also reinforce adult vulnerability to poverty
What is co-production
Co-production means delivering public services in an equal and reciprocal relationship between professionals, people using services, their families and neighbours; recognising people as assets
What is synergi collaborative
an independent centre of excellence on ethnic inequalities, severe mental illness and multiple disadvantage.
What does synergi do
Invest in infrastructure
Invest in relational roots
Devolving decisions
Access through clear roads, bolt on/off bridges, and tunnels
Who’s got power?
Enable safe spaces for dialogue & negotiation, or creative spaces for relational & network actions on health systems
What is the offer we make to this community?
What does syndemic suffering apply to
Syndemic suffering applies to the clustering of poverty, homelessness, discrimination, mental health issues and (lack of) family support.
