As a humanitarian, I have always wanted to focus on making a change and get talking about topics that are often ignored. This is one of the main reasons I chose a career in global health as a researcher, and another reason for co-founding a non-profit organisation, Identity International, a platform that aims to create social awareness regarding various topics that define our identities.
Like many individuals, mental health has always been a part of my life, and a big part of my identity. As someone from an Iranian background, there is no doubt that my ethnicity and culture have affected the way I recognise and talk about my mental health. As a working researcher over the past year, it has also been difficult to miss the many negative impacts of the COVID-19 pandemic on the mental health of individuals around the world.
Studies have noted that the pandemic has had a disproportionate impact on society’s most vulnerable, including those with pre-existing mental health conditions. This has also had a toll on the mental health of ethnic minorities in the UK, who were already facing significant mental health inequalities before the pandemic.
BAME (black and ethnic minority) men and women have experienced a higher average increase in mental distress than White British men during the course of the pandemic. Financial cuts and limited access to mental health facilities and care during this time has also undoubtedly had a negative effect on this group.
The Black Lives Matter movement during the summer of 2020 has also helped provide more information regarding young black people’s mental health. Recent research has shown that they appear to be at high risk, both in terms of COVID-19 and of experiencing poor mental health.
Similarly, young Black men between the ages of 16–25 have been amongst the hardest hit by job losses, a factor that has led to higher levels of mental distress.
Many of these factors inspired us to get talking about the topic at Identity International, leading us to create the “Minority Mental Health project”, as part of our #BeyondStigma campaign. The campaign involved us asking various individuals from different ethnic backgrounds about their mental health experiences in the UK.
In particular, the project found various themes on minority mental health that must be addressed:
Stigmatisation and lack of awareness
It is undeniable that globally, individuals with mental health problems experience multiple levels of stigmatisation: social exclusion, discrimination and prejudice. This can have various negative impacts on an individual, such as causing low self-esteem, and can also stop individuals from reaching out for effective treatment and care.
However, both our campaign and other research has found that this stigma towards mental illness is significantly higher among ethnic minority groups. As individuals from our campaign pointed out:
“Therapy is often seen as “weird” or “unusual” or as a sign that someone is not normal, especially in Middle Eastern cultures, where therapy is a taboo subject, and stating that one wants to seek therapy is not usually perceived as something positive, but rather as something worrying. You will be told that therapy is not needed, and that you are just exaggerating and that a 5-minute conversation with your parents will sort it out”
Another individual pointed out that:
“I think the problem when it comes to mental health in ethnic minorities would be social stigma and stereotyping. I think there’s often this notion that when people come out as depressed or even with anxiety or schizophrenia, that they’re diseased, they’re mad, they’re crazy…”
This topic of stigmatisation was highly evident across the majority of our submissions and has been a key aspect found in existing scientific research on the topic.
Research has also shown that experiencing racism and stigma regarding your race, ethnicity or religion has caused poor mental health and psychological distress for various ethnic minorities in the UK. In turn, this can influence the way you think about yourself, set difficult societal expectations, and affect how you access services. This was mentioned by mental health nurse, Judy Thomas:
“If you’re having to constantly worry about stigmas that are attached to your culture and/or race, the last thing you want is another stigma surrounding mental health on you too, so you may not take up any available services and you may not allow yourself to be seen”
- Nurse Judy Thomas
The COVID-19 pandemic has also fuelled Anti-Asian Racism and Xenophobia, causing a rise in reports of verbal harassment, insults and violent attacks in schools, workplaces and public settings.
This rise in discrimination has led to increases in anxiety, depression and sleep problems amongst those who are targeted, even though access to mental health services still remains low for this group.
Barriers to services
Accessing mental health care and resources requires the overcoming of many cultural and social stigmas for many ethnic minorities. In turn, this means many are left without treatment and care, which can cause further distress in the long run. Muslim communities in particular are disempowered in the utilisation of these services, while older South Asian women are at high risk of suicide. Black women are also more likely to experience anxiety and depression than most other groups.
Moreover, studies have shown that the relationship between ethnic minority service users and health care providers have been affected by many factors, including prolonged waiting times, language barriers, poor communication, power imbalances and cultural naivety, and insensitivity and discrimination from healthcare providers.
As one of the submissions stated:
“I think empathy is so important for patients, and being British Indian, I think I’ve experienced from different therapists, this inability to put themselves in my shoes. I think a big part of that is the lack of representation within the sector itself. I have gone to India to seek therapy, but then again there’s this issue there with them being unable to put themselves in my shoes because they don’t understand my identity from the Western perspective, whereas in the West, they can’t understand my identity from my Indian side”
During a time, such as the one we are currently living in, it is now more essential than ever to bring light to these inequalities. In order to overcome the barriers mentioned above, a wide range of actions can be taken. Personally, I believe the following steps can help ensure better mental health experiences for individuals from different ethnic backgrounds:
1) Culturally appropriate treatment and interventions:
Providing mental health services to individuals from BAME backgrounds should be culturally appropriate and should be monitored in order to help avoid any problems which usually arise, such as power imbalances, insensitivity and discrimination. Where possible, it is great to provide healthcare providers with the appropriate training and education surrounding the topic. Other suggestions include meeting faith-related and religious needs, providing gender-specific services and staff, increasing diversity within the staff and improving language barriers, such as translating, interpreting and providing literacy support.
2) Reducing cultural stigmatisation towards mental health:
It is clear that there remains a significant amount of stigma towards the topic of mental health within different cultures and ethnic groups. It is vital that community-level interventions aim to reduce these stigmas through their public messaging. The media can also play a significant role in reducing this stigma and cultural biases towards the topic.
Many ethnic minorities often feel ignored and feel as if their health problems are not being addressed by the public, the government and health providers. It is time to address this by listening to individuals from different backgrounds, including refugees, asylum seekers and individuals from indigenous backgrounds, and encouraging them to take the lead on a variety of projects and interventions.
You can access a number of resources and services which are available for the mental health care of different ethnic minority groups:
If you want more information on the mental health of BAME communities, you can read more here.
Organisations such as the Black, African and Asian Therapy Network (BAATN) can help you connect and speak to therapists from the same background as you, while The Black, African and Asian Therapy Network provides a directory of Black, Asian and ethnic minority counsellors and psychotherapists across the UK. Black Minds Matter UK also provide free mental health support for black people.
For health professionals: ACA Therapy holds monthly therapy groups for Black Mental Health practitioners in order to discuss racial issues within the society.
The Qalb Centre provides free counselling and support for Asian, African and African Caribbean people, along with a support group for women and couples.
For London-based individuals:
The Waltham Forest Black People’s Mental Health Association charity offers advocacy, wellbeing and day care services for Black Mental Health users. You can also access free services and support groups for Black and Ethnic minorities surviving mental health issues at Kindred Spirits in Southwark. They also provide frequent women-only support groups.
For anyone experiencing language barriers, the Nasfiyat Intercultural Therapy provides intercultural psychotherapy and counselling services in over 20 languages.
Enfield Saheli is a voluntary group run by women for women from Asian Descent.