Race Discrimination in mental health part 2

This is a continuation of my last post so for context please read that first.

So on to point two which was that people within the ethnic minorities actually suffer with more mental illness and that they have more severe symptoms.

Well I don’t have any direct research on this however lots of research has been done on risk factors for particular mental illnesses and there are many sites that could give you big lists on what they were. Sadly many of these are very general or what I call generic and could make you think that anything could or would cause mental illness and obviously this isn’t the case. So what is it that is causing this spike amongst the ethnic minorities?

I feel that part of the stumbling block here is that worldwide the incidence of mental illnesses in the different ethnic populations are about the same and so when an increase is seen it is often assumed and sometimes rightly that this is a race prejudice however I feel that several factors that are related to race but are not racial discrimination within the health service but are factors that affect these individuals because of their personal circumstances.

If you look at my post on risk factors for Schizophrenia you see that I have listed several factors and I would like to draw your attention to one of the things that lie in the possibly making a difference list to the risk of illness

Living in an urbanised area, living in non ethnic environment (migrants) or with few individuals of the same ethnicity

It might not seem a big thing however there are many other things about being a migrant or an immigrant that may also make it more likely that you will suffer mental illness

·         Poverty

·         Social deprivation

·         Social isolation/ spiritual isolation

·         Childhood traumas, including natural disasters and parental separation

All of which could play a part in the onset and also the severity of a mental illness.

The complexity of the problem can be seen I feel quite clearly in this scientific paper by,SCOTT WEICH, LIZ TWIGG, GLYN LEWIS and KELVYN JONES found here BJP 2005, 187:29-34 (http://bjp.rcpsych.org/content/187/1/29.full.pdf+html) where the authors are looking at whether there are any regional variations in mental illness. This article defines several different levels to the geographical areas but also levels within the populations.

For instance they looked at an individual, a household and a ward (so for instance a few streets of a city or town would be a ward). They found that for the different factors they were looking at the significance of each was not the same for an individual versus individuals of a household versus a ward for the same factors even when they were essentially the same area.

The fact is that different factors such as poverty can affect individuals differently if all the individuals are poor versus some of them being poor, whether they are all of the same age or marital status or ethnic minority, or living abroad as opposed to their home country. In fact the paper reported the significant findings but in many cases without any suggestions as to why it would make a difference particularly for the differences between individual, household and ward where the same factors were risks on one level but not all.

In fact it seems that so little is known about the onset of mental illness and why it occurs that research is often seeing patterns without being able to suggest any reasons why. In many ways I feel that we really have no idea what impact rapid change in social circumstances can have on an individual or what could alleviate the impact on their mental health either. So when there are only simple counts of the number of people getting ill and the length of stay in hospital people have, alongside their ethnicity it is extremely difficult to come to any conclusions as to why it is happening.

I for one feel that at least part of the reason we see so much of a problem is because of the isolated nature of immigrants –

·         New country

·         often new language

·         new community

·         loss of contact with close relatives and friends

·         change in culture

·         change in jobs and working conditions

plus many more and actually all of these things have an impact on an individual and their family.It should be also be considered that the affects of one or all of these changes will affect children differently to adults. To simply put it down to racial prejudice is far too simplified and the simple count of how many are becoming sick, how frequently and how severely, may not actually be giving us very much information about whether the problems are getting worse or not, nor how to combat them.

The situation of immigrants seems to me to highlight exactly what can happen when people become disconnected from each other physically and emotionally and therefore is an extremely important thing to look into. It does not take moving to a foreign country to become disconnected from people/family nor to be in poverty or social deprived.

It does raise the question of where a persons spirituality would fit in, since spirituality could be seen as a connectedness to something and actually it may well be that the feeling of being connected to something is what is important.

 I would like to stress that I doubt that your beliefs could sustain you without human contact, and most certainly not for children but it may well alleviate the problems of isolation that may be less good for a person’s mental health.

So to my mind it is far more likely that people who are less connected to people and who have gone through great change, particularly if it was unanticipated, are in poverty or are social deprived are more likely to suffer from mental illness. I see all of these contributory factors within the ethnic minorities that have such big problems with mental health; so prejudice aside there may be far bigger problems that need to be addressed.