Minority voices: Research into the access and acceptability of ... - MMC

Black and minority ethnic groups generally have a younger age structure than the ‘White’population in England and Wales, though the extent of this differs between ethnic groupsaccording to history and immigration patterns. In England, there are approximately 3 millionchildren aged under 5 years, 6.4 million aged 5-14 years and 3.1 million aged between 15 and19 years. 27 Children and young people from Black and minority ethnic backgrounds make upabout 20% of the total population aged under 20.The number of ethnic groups in the UK is diverse and some studies have made a distinctionbetween ‘visible’ ethnic minorities including Black Caribbean, Pakistani, Indian, Bangladeshi,Chinese and Travellers, and other groups commonly referred to as ‘other’. The largest ‘other’groups are estimated to be Iraqis, Somalis and Yemenis, followed by Iranians, Kurds,Bosnians, Algerians, Tamils and Vietnamese. 28! Understanding ethnicity, cultural competence and socially inclusivepracticeIn recent years, there has been increasing recognition of the complexities of defining ethnicity,that “the way ethnicity is perceived and defined is, among other things, influenced by social,political, historical and economic circumstances,” 29 of the importance of understandingethnicity as “a process by which people create and maintain a sense of identity,” 30 that“ethnicity is something that we all have. In its widest sense it involves our culture, lifestyle,language and religion as well as our roots and origins.” 31This literature highlights the limitations of current census categories - that these do notprovide information about identity; that “profiles of broad groups also obscure enormousdifferences between their members” 32 - and that this needs to be borne in mind in theplanning, provision and monitoring of services. Furthermore census data is lacking for somegroups, there may be important differences between generations and the information that isneeded about ethnicity “for administrative purposes is likely to be different to that needed forproviding effective clinical interventions.” 33Also evident in the literature concerning the delivery of health and welfare services morebroadly, has been a growing interest in services being ‘culturally competent’ and ‘sociallyinclusive’ and what this might mean. Recognition of the increasingly diverse backgrounds ofchildren, young people and families presenting to services - and the limitations of someservices, including mental health, to work effectively in cross-cultural situations - lies behind34 35this interest. In addition, some of the literature discusses the important distinctionbetween cultural awareness (which refers to knowledge about various cultures) and culturalsensitivity (which refers to experiences that challenge individuals to explore their personalcultural issues). 36! The mental health needs of young people from Black and minority ethnicgroupsUnderstanding the prevalence of mental illness among different ethnic groups is acknowledgedto be both a “controversial and complex field of inquiry” 37 and considerable caution is neededin interpreting results, not least because many studies are based on very small sample sizes,lack consistency in how ethnicity is defined and have often used measures developed fromWhite populations. 38 However, “existing research suggests that, as with physical health, thereare important and possibly large differences in mental health across ethnic groups….” and it ispossible that there are “important cultural differences in the way in which people experienceand express mental illness…” 39The following gives a ‘snapshot’ of some of the findings in this area:• The Office for National Statistics Survey of the mental health of children andadolescents in Great Britain (1999) revealed that nearly 10% of White children and12% of Black children were assessed as having a mental health problem. Theprevalence rates among Asian children were 8% of the Pakistani and Bangladeshi and4% of the Indian samples. 40Minority Voices Research Report11