Lecture 11 - Diversity/Difference in Mental Health Flashcards
What is valuing diversity/difference in mental health?
Being sensitive to diversity: understand unique experiences/beliefs/values/perspectives from individuals from diverse backgrounds
Understanding: recognising mental health challenges + impact can differ depending on cultural context/socioeconomic status/ethnicity/gender/sexual orientation
Personalising practice: recognising/incorporating various cultural/social/individual preferences in mental health services
Improving services: recognising/respecting diversity –> increased help seeking in underserved groups, better engagement, more accurate assessment
What is Equality Act (2010) - UK Legislation?
Individuals afforded protection against discrimination/harassment/victimisation to achieve equal opportunities across all aspects of society
Promote equality to groups that may be disadvantaged/under-represented
What are implications of Equality Act?
Discrimination based on mental health = offence, consideration of protected characteristics + equal treatment within mental health services is legal duty + good practice
What are statistics about sexuality/gender identity + mental health?
35% gay young people (not bullied) depressed
Risk of suicide among gay men 2-4x general population, Discrimination/social stress/concealment/stigma/internalised homophobia contribute to worse mental health
What did Rees et al. find?
Review of 14 studies of lesbian/gay/bisexual + transgender communities, found 2 main themes
Experienced stigma + discrimination when accessing MH care
Positioned as diff through use of heteronormative language, felt ignored/mistreated due to gender/sexuality identification, felt pathologized for identity + undertreated, vulnerable if sexual orientation/gender not acknowledged, intrusive questions
Professionals lack knowledge + understanding of LGBT people’s needs
Need for MH care promoting equity/respect for diversity/self-acceptance, need for culturally sensitive/LGBTQ+ friendly therapists that don’t pathologize sexuality/assume MH difficulties are due to that
What are some statistics about men’s mental health in UK?
3x as many men than women die by suicide (linked to depression/adverse life events)
36% referrals to therapies in NHS come from men (gender stereotypes contribute to low help-seeking)
3x as likely to become alcohol dependent + frequently use drugs, more likely to be compulsorily detained under Mental Health Act
What are some statistics about women’s mental health in the UK?
Common MH diffs steadily increased for women but steady for men
2x as likely to be diagnosed with anxiety, OCD/phobias more common
PTSD (20.4% vs 8.1% for men)
Reproductive cycle (perinatal depression, menopause – anxiety/mood)
What do statistics about men’s/women’s mental health tell us?
Need for gendered services (peer support/trauma programmes)
What is diff between White British groups + minorities in mental health?
Many minorities have worse mental health in comparison to White British groups
Black individuals (esp men) more likely diagnosed w/ psychosis (6-9x more risk of schizophrenia) + compulsorily admitted to hospital
Children from most ethnic minority backgrounds showed more MH diffs from 3-14 years
Within/Between group diffs
Common MH diffs: 29% black women vs 20.9% white British (13.5% black men)
Indian/Pakistani/African-Caribbean origin –> higher mental wellbeing
What affects MH in ethnic minorities?
Racial discrimination (overt/subtle/institutional level), social/economic disadvantage, mental health stigma (not recognised/shameful to discuss)
Worse MH care experience, poorer treatment outcomes, disengagement from mainstream services –> further isolation + deterioration in MH
What is goal of IAPT for minorities?
Equitable access to therapy –> self-referral may improve
Harwood et al. (2021): compared w/ White British group
Black African/Asian/Mixed less likely to self refer, Black Caribbean/Black Other/White Other more likely referred by community services –> MH diffs severe
Almost all groups less likely to receive assessment/treated
What are some statistics for migrants usage of IAPT?
Migrants residing in UK <10yrs less likely to use IAPT, not due to English proficiency/sociodemographic/asylum factors
Lack of info + effective communication about services, stigma in community, mistrust of professionals may contribute
What are the effects of socioeconomic disadvantage on MH problems?
In lowest fifth of household income compared to highest: risk of psychotic disorders 9x higher, common MH problems doubled
Complex relationships between SE disadvantage + MH
Diffs gaining employment, substance abuse, poor handling of personal finances, creates conditions of MH, low social trust in area/high perceived crime
More disadvantage individuals less likely to be referred for treatment, complete treatment
What are intersectionalities?
Various biological/social/cultural categories linked w/ social disadvantage/oppression often intersect/overlap –> part of personal/social identity, comes form multiple sources
What did Alvarez-Galvez/Rojas-Garcia find in relation to intersectionalities?
In Europe those belonging to minoritised categories have more depressive symptoms, stronger effect in Eastern/Southern European countries
In UK, men less likely to seek/complete treatment esp if: minoritised ethnic background, Muslim, unemployed, living in deprived neighbourhood
