Ethnicity and inequalities in health and social care最新文献

{"title":"Responding to the Delivering Race Equality (DRE) agenda in mental health services: national recommendations informed by local experience","authors":"D. Truswell, R. Bryant-Jefferies","doi":"10.5042/EIHSC.2010.0146","DOIUrl":"https://doi.org/10.5042/EIHSC.2010.0146","url":null,"abstract":"This article summarises what the Department of Health's (2005) Delivering Race Equality (DRE) agenda in mental health services set out to achieve and the background to this. The article then provides commentary on the Central and North West London NHS Foundation Trust's experiences while acting as one of the 18 focused implementation sites (FIS) created as part of the Department of Health's five‐year Delivering Race Equality Action Plan and highlights the recommendations that developed out of this work and have national application.","PeriodicalId":90494,"journal":{"name":"Ethnicity and inequalities in health and social care","volume":"3 1","pages":"36-46"},"PeriodicalIF":0.0,"publicationDate":"2010-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5042/EIHSC.2010.0146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70549576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mother tongue or non‐native language? Learning from conversations with bilingual/multilingual therapists about working with clients who do not share their native language","authors":"Beverley Costa","doi":"10.5042/EIHSC.2010.0144","DOIUrl":"https://doi.org/10.5042/EIHSC.2010.0144","url":null,"abstract":"Many people accessing services, including counselling services, do not speak the official language of the country in which they find themselves. This paper first considers, in general terms, the way that language is used to negotiate relationships and to structure and provide meaning for our experiences, needs, feelings and ideas. This is then related to the use of native language in therapeutic work and the practical issues that this can present for services.The paper then reports on a small‐scale informal piece of research that was conducted in 2009 by Mothertongue multi‐ethnic counselling and listening service with six bilingual and multilingual counsellors, none of whom were native English speakers. The aim was to explore what might be learned from their experience of living with more than one language and then to apply this to the task of communicating in English with non‐English speakers in the therapeutic relationship.Some practical observations and suggestions are included in this paper. These incorporate the themes that emerged from the research such as: attending to clients' linguistic history; the way in which emotions are expressed in different languages; how speaking more than one language impacts on identity formation and the ability to understand across languages and culture; how we convey and construe significance and meaning; how we relate to people's experiences of learning a language. The author of this paper hopes that these findings and observations will stimulate further conversations on this topic.","PeriodicalId":90494,"journal":{"name":"Ethnicity and inequalities in health and social care","volume":"6 1","pages":"15-24"},"PeriodicalIF":0.0,"publicationDate":"2010-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5042/EIHSC.2010.0144","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70549351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consultation, referral and ethnicity: the role of primary care in accessing mental health services","authors":"Marion Johnson, S. Weich","doi":"10.5042/EIHSC.2010.0143","DOIUrl":"https://doi.org/10.5042/EIHSC.2010.0143","url":null,"abstract":"Young men of African‐Caribbean origin are over‐represented in mental health services (MHSs), often entering these services by coercive routes, such as under the Mental Health Act or via the criminal justice system. This pilot study focused on patients' narratives of their journey from first contact with primary care services. Our principal aim was to describe and compare early experiences of help‐seeking for serious mental health problems among young men of white and black ethnicity.In‐depth interviews were conducted (using a topic guide) with black and white men aged 18‐30 years old and who were accessing secondary care mental health services for the first time for a psychotic illness. Participants were recruited from the early intervention services serving inner‐city Birmingham. Seven participants were interviewed, and 12 themes were identified from transcripts. Six of these individuals had consulted their GP prior to accessing the early intervention service. Only one attendee received medication at initial consultation, and none were referred to specialist mental health services. Participants described the manner in which family or friends interceded on their behalf to advocate for and secure specialist help ‐ either by accompanying them to see their GP, contacting mental health services directly or taking them to the local accident and emergency department. The latter route was accessed by black but not white participants. Three out of four black participants and one out of three white participants were subsequently admitted to hospital. None of the participants were particularly satisfied with their experience of primary care. Communication was less than ideal, and participants were able to reflect on their own failure to disclose critical information to their doctor. By contrast, all participants confided in family or in their trusted friends that they were becoming aware that they were experiencing mental distress.Our findings confirm the difficulties faced by GPs and those who consult them in the early stages of first onset psychotic episodes, and the importance of having family or friends who are able to advocate on other people's behalf at times of crisis. Despite the advent of universal early intervention services across the UK, those most in need may still not be receiving the help that they need in the timeliest manner.","PeriodicalId":90494,"journal":{"name":"Ethnicity and inequalities in health and social care","volume":"3 1","pages":"6-14"},"PeriodicalIF":0.0,"publicationDate":"2010-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5042/EIHSC.2010.0143","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70549288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Raising silenced voices: South Asian women immigrating after marriage","authors":"G. Hague, G. Gangoli, H. Joseph, M. Alphonse","doi":"10.5042/EIHSC.2010.0145","DOIUrl":"https://doi.org/10.5042/EIHSC.2010.0145","url":null,"abstract":"This paper looks at the experiences of first‐generation South Asian women who entered the UK to marry and then suffered domestic violence. It is based on an innovative and collaborative trans‐national project, carried out in two stages. In the first stage, a range of immigrant South Asian women, who had experienced domestic violence, were consulted. This consultation aimed to ascertain what they believed would have been useful information, if available prior to immigration, about the UK and the life they might expect there, including what might happen in cases of marital discord and difficulties. The second stage of the project consisted of feeding that information back through meetings and consultations to relevant women's and state agencies in India, including the police, the media and women's organisations. While there is no evidence to suggest that immigrant black, minority ethnic and refugee women experience more domestic violence than majority white women, their experiences of abuse are different due to cultural factors, language, immigration status and lack of contact with natal families. The paper makes key recommendations on policy developments that would assist women in this situation, raising the voices of South Asian immigrant women in the UK, and highlighting their views and advice for policy‐makers and for other women considering such marriages.","PeriodicalId":90494,"journal":{"name":"Ethnicity and inequalities in health and social care","volume":"3 1","pages":"25-35"},"PeriodicalIF":0.0,"publicationDate":"2010-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5042/EIHSC.2010.0145","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70549537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Crisis management: a case study on racism","authors":"M. Shekhar, M. Saxena","doi":"10.5042/EIHSC.2010.0147","DOIUrl":"https://doi.org/10.5042/EIHSC.2010.0147","url":null,"abstract":"This article documents instances of racism that have previously acted as barriers to Indian students' academic success in Australia. It is felt that such incidents would not have happened to students from, for example, China or Japan, as their governments would have taken more serious steps against the Australian government. There is a feeling in India that the Indian government can be seen as weak. Against this background, the article looks at potential reasons for racially motivated attacks against Indians in Australia, and at what can be done to reduce these, as well as both the Australian and Indian government responses to the particular instances reported.","PeriodicalId":90494,"journal":{"name":"Ethnicity and inequalities in health and social care","volume":"20 4 1","pages":"47-52"},"PeriodicalIF":0.0,"publicationDate":"2010-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5042/EIHSC.2010.0147","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70549588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delivering quality care: the power of the patient narrative","authors":"D. Sallah","doi":"10.5042/EIHSC.2010.0142","DOIUrl":"https://doi.org/10.5042/EIHSC.2010.0142","url":null,"abstract":"","PeriodicalId":90494,"journal":{"name":"Ethnicity and inequalities in health and social care","volume":"3 1","pages":"2-4"},"PeriodicalIF":0.0,"publicationDate":"2010-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5042/EIHSC.2010.0142","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70549244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The ‘Twice a Child’ projects: learning about dementia and related disorders within the black and minority ethnic population of an English city and improving relevant services","authors":"D. Jolley, N. Moreland, Kate W. Read, H. Kaur, K. Jutlla, Michael Clark","doi":"10.1108/17570980200900024","DOIUrl":"https://doi.org/10.1108/17570980200900024","url":null,"abstract":"Dementia is found in all races. Within the UK, elders in black and minority ethnic (BME) communities are often unable or unwilling to access services that might help them when they develop dementia. A series of research‐based studies in Wolverhampton have demonstrated that working with community leaders and family carers can identify strengths as well as areas for development in service arrangements. Some areas for development are those shared by all individuals and families with dementia, while others are specific to the cultural group. Areas for action include: the lack of understanding of the normal and pathological features of ageing; fear and stigma associated with mental disorders within BME communities; lack of knowledge of dementia; and insensitivity and inflexibility within some components of services. Knowledge gained from a collaborative review of the situation can be used to plan and deliver iterative improvements. The most effective single initiative is the appointment of a link nurse competent in language, culture and clinical skills. Despite progress over a 10 year period, difficulties remain and there is more to be learned.The research reported here has been conducted over a period of nine years within the city of Wolverhampton. The research has been co‐ordinated from for dementia plus (previously Dementia Plus), which has functioned as the Dementia Development Centre for the West Midlands since 2000.","PeriodicalId":90494,"journal":{"name":"Ethnicity and inequalities in health and social care","volume":"2 1","pages":"4-9"},"PeriodicalIF":0.0,"publicationDate":"2009-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/17570980200900024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62175533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The personalisation of dementia services and existential realities: understanding Sikh carers caring for an older person with dementia in Wolverhampton","authors":"K. Jutlla, N. Moreland","doi":"10.1108/17570980200900025","DOIUrl":"https://doi.org/10.1108/17570980200900025","url":null,"abstract":"While personalisation and service choice remains a central plank of the Labour Government's policies in health and social care, there is a growing evidence base confirming that ethnic minority groups, are disadvantaged as service users in the UK. Building on some baseline data collected in 2000 and 2003/04, our recent research (Jutlla & Moreland, 2007) has reaffirmed the difficulties that Asian carers have in accessing services when caring for a relative with dementia.While such access data is important, we wish to move beyond the demographic aspects to consider the existential realities (the ontology) of the lives and cultures of those in minority ethnic groups. This paper consequently discusses the diversity and complexity of migration patterns among the Sikh community living in Wolverhampton. The paper conceptualises some of the ways in which different migration experiences and the realities of daily life influence the perceptions, experiences and patterns of care among migrant Sikh carers in Wolverhampton caring for an older person with dementia. The paper thus explores the thesis that the Sikh community is not a homogeneous group; and that the diversity and differences within the Sikh community can have important implications for care. Taking a biographical narrative approach to fieldwork, the relevant factors to be considered include: the carer's country of origin; their migration route and reasons for migration; their age at migration and the cultural experiences of the carers and their communities both in the UK and India.","PeriodicalId":90494,"journal":{"name":"Ethnicity and inequalities in health and social care","volume":"2 1","pages":"10-21"},"PeriodicalIF":0.0,"publicationDate":"2009-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/17570980200900025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62175547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cultural competence: definition, delivery and evaluation","authors":"D. Cowan","doi":"10.1108/17570980200900027","DOIUrl":"https://doi.org/10.1108/17570980200900027","url":null,"abstract":"It is again suggested that people from black and minority ethnic (BME) communities comprise a disproportionately high percentage of mental health inpatients. Furthermore, the Commission for Racial Equality (CRE) concluded the Department of Health (DH) did not have ‘due regard’ to the Race Equality Duty, retaining major concerns regarding the ability of the DH to ensure future compliance (CRE, 2007). In light of these ongoing problems the DH published a five‐year action plan, Delivering Race Equality (DRE) in Mental Health Care to develop race equality and cultural competence training for mental health practitioners (DH, 2005).A focused review of literature was undertaken, structured around three questions.1. How is cultural competence in mental health care defined?2. How is cultural competence in mental health care delivered?3. How is the delivery of cultural competence in mental health care evaluated?Consensus is lacking on definition of cultural competence and on the sequence of when the components should be acquired, some terms being used interchangeably. It is unclear how cultural competence in mental health care can be delivered. No attempts have been adequately evaluated, particularly by service users (Bhui et al, 2007). More innovative research is needed to develop a consensual definition of cultural competence and to facilitate the delivery and evaluation of such, in ways acceptable to service users and service providers.","PeriodicalId":90494,"journal":{"name":"Ethnicity and inequalities in health and social care","volume":"2 1","pages":"27-38"},"PeriodicalIF":0.0,"publicationDate":"2009-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/17570980200900027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62175622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethnic disparities in child health in Nigeria: a multilevel analysis of individual and contextual factors","authors":"D. Antai, S. Wedrén, R. Bellocco, T. Moradi","doi":"10.1108/17570980200900028","DOIUrl":"https://doi.org/10.1108/17570980200900028","url":null,"abstract":"Each ethnic group has its own peculiar cultural practices that may widen inequalities in child health and survival among ethnic groups. This study estimated ethnic disparities in mortality of under‐five‐year‐olds, controlling for individual and community level characteristics. Using multilevel multivariable regression analysis on a nationally representative sample drawn from 7,864 households in the 2003 Nigeria Demographic and Health Survey, we estimated the risks of deaths under‐five‐year‐olds for 6,029 children nested within 2,735 mothers aged 15‐49 years old, who were in turn nested within 365 communities. Results were expressed as odds ratios with 95% confidence intervals. The observed risk of under‐five death was highest among children of Hausa/Fulani/Kanuri mothers and lowest among children of Yoruba mothers. The mother's affiliation to the Yoruba ethnic group, compared to Hausa/Fulani/Kanuri, was still significantly associated with decreased under‐five mortality (OR = 0.66, 95% CI = 0.45 ‐ 0.96) after adjustment for individual and community level factors. Under‐five mortality was significantly related to socio‐economic and demographic factors (birth order/birth interval, mother's age, and mother's education), which explained much but not all of the ethnic disparities. Findings underscore the need for measures aimed at improving female education and the socio‐economic standard of women, changing short birth spacing norms and reducing inequitable distribution of maternal and child health services.","PeriodicalId":90494,"journal":{"name":"Ethnicity and inequalities in health and social care","volume":"2 1","pages":"39-49"},"PeriodicalIF":0.0,"publicationDate":"2009-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/17570980200900028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62175928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}