The understanding and awareness around mental health problems in the UK has improved immensely over the last 10 years. However, this change has only benefited the white population of the UK. People from a Black, Asian, Minority Ethnic (BAME) background constitute 13% of the UK’s population. Yet they are far more likely than white people to experience mental ill-health. They also have poorer outcomes from therapy. So, if we really want to progress towards an equal and healthy population, we need to actively work towards solving this problem.
People from a BAME background face unique challenges when it comes to mental health. A recent YouGov poll reported that 84% of BAME individuals believe that the UK is very or somewhat racist. Research has shown that regular exposure to racism significantly increases an individual’s likelihood of developing psychosis and depression. Additionally, people from a BAME community are more likely to struggle socio-economically. Other issues are higher unemployment, lower educational outcomes, and higher poverty rates. All these factors increase the chances of developing a serious mental health problem and accessing suitable care.
A survey of BAME individuals by the charity Mind finds that one third of respondents believe that current therapy in the UK is not fit for people in a BAME community, and only 10% believe that their talking therapy has adequately considered their cultural background. I read one appalling account of an Indian woman attending a talking therapy session for depression in which her white, male therapist insisted her family were to blame for forcing her into an arranged marriage, which had not happened. Sadly, this specific example and similar cultural biases are commonplace, and only result in vulnerable people feeling more alienated and confused than when they began seeking help.
This is a systemic problem within mental health services. BAME trainee therapists are more likely to drop out of their course, with many citing poor understanding of cultural differences from a majority white training institute. In addition, qualifying takes longer and some course leaders dismiss concerns about racial issues. This has led to a national shortage of therapists equipped to deal with a large proportion of patients . In 2015, 17% of therapists in the IAPT programme (the NHS service providing treatment for depression and anxiety) were from a BAME background. Salim Kassam, a Muslim activist for mental health hit the nail on the head:
“Mental health and the psychiatry from which it emerged has been an elitist, white and male discipline. This is much more dangerous in mental health than it is in treating physical pain because unless a therapist understands, appreciates and respects the cultural baggage of a client, they will get sicker, not better.” – Salim Kassam (2019)
So, what is the solution?
It is not as simple as registering more people from a BAME background into existing therapy programmes if it’s going to worsen their condition. We need to completely dismantle the current structures in place. Then allow access to therapy designed to incorporate everyone’s cultural background. Several organisations are leading the way, such as Black Minds Matter, Sakoon, and HealHub. However, why should 13% of the population have to seek therapy outside of the National Health Service? The NHS needs to implement a more diverse training programme, which prioritises conversations about race. In addition, clinical textbooks must be re-written, to ensure future therapists understand the implications of their backgrounds on their clients.
Let us know your thoughts in the comments.
Written by Alison Fulop
For Aspire4U CIC,
The Mindset Lead Organisation
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