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1 – 10 of 274The purpose of this study was to explore providers' and commissioners' perceptions of the extent to which services currently meet the perinatal mental health needs of black and…
Abstract
The purpose of this study was to explore providers' and commissioners' perceptions of the extent to which services currently meet the perinatal mental health needs of black and minority ethnic (BME) women. A mixed method study involving a national survey and in‐depth interviews was undertaken in response to reports of patchy service provision and particular concerns about potentially unmet needs among BME women. Findings indicate that the surprising number of professional groups (n=27) involved in delivering perinatal mental health care were predominantly located in secondary care. Perceptions of the validity of ‘BME‐specific’ services were equivocal. Service delivery for minority women tended to focus on language and translation; which might facilitate assessment and physical (though not psychological) care but would do little to address women's cultural needs.
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Perinatal mental health is a major concern among women of childbearing age. Women from a black and minority ethnic background are widely believed to have particular needs that are…
Abstract
Perinatal mental health is a major concern among women of childbearing age. Women from a black and minority ethnic background are widely believed to have particular needs that are often not given the attention they deserve. NHS Croydon launched a perinatal mental health project to develop a closer and better partnership between the Primary Care Trust (PCT), Croydon Council and black and minority ethnic (BME) voluntary organisations through an action learning approach. Experience was shared to improve engagement and use of health services by mothers from BME communities in Croydon who had encountered mental health problems during pregnancy or following childbirth. By exploring and identifying such issues and problems, the action learning set endeavoured to find solutions for a joined‐up approach to achieve identifiable benefits. Some problems were encountered, such as a lack of communication between health professionals and BME community groups. The learning outcomes were to raise awareness and to recognise the cultural differences with mothers of BME background experiencing perinatal mental health problems. The learning from the project will be disseminated to a wider audience to promote best practice.
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Zarrina Kurtz and Cathy Street
Research has highlighted problems in accessing mental health services for people from minority ethnic groups. Much of this literature is focused on adults. The Minority Voices…
Abstract
Research has highlighted problems in accessing mental health services for people from minority ethnic groups. Much of this literature is focused on adults. The Minority Voices study aimed to identify and describe the perceptions and use of mental health services from the viewpoint of black and minority ethnic (BME) young people aged between 12 and 25 in England and Wales, and to examine initiatives designed to improve the access to, and acceptability of, services for these young people. It used a mixed methods approach, including a literature review, national service mapping, in‐depth interviews and focus groups in four sample areas and action research in preparing materials designed by BME young people. A number of issues that impede access to services, and that are specific to them, were identified and explored with young people from BME groups. These include concerns related to discrimination and racism, confidentiality, family and community pressures, uncertainty about any help they may receive, and marked fears of the stigma that surrounds mental health difficulties. Within services, a lack of capacity of targeted services and of cultural competence were highlighted. The research concluded that there is a need to improve awareness of mental health and information about services among BME communities, and for child and adolescent mental health services (CAMHS) to work with these communities to explore ways in which acceptable and appropriate mental health expertise can be made more readily available through both informal and mainstream provision.
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Perinatal mental illness is an important public health issue. Conditions such as postnatal depression increase mothers' risk of suicide and can herald onset of recurrent and…
Abstract
Purpose
Perinatal mental illness is an important public health issue. Conditions such as postnatal depression increase mothers' risk of suicide and can herald onset of recurrent and chronic mental health problems. Maternal mental illness can also adversely impact the cognitive, physical, and psychological health and development of children. In light of known psychosocial risks, there is concern that fewer than expected women from black and minority ethnic (BME) backgrounds access care and treatment. This paper aims to address this issue.
Design/methodology/approach
Responding to persistent reports of patchy service provision across the UK more generally and particular concerns about potentially unmet needs among BME women, mixed‐method research was undertaken between September 2009 and March 2010. Using survey questionnaires and telephone interviews, the study sought to explore professional stakeholders' perspectives on current perinatal mental health provision and the extent to which it meets the needs of BME women. Findings from the study were intended to inform policy and plans to improve provision by establishing managed care networks (MCNs) for perinatal mental healthcare.
Findings
In total, 45 questionnaires were returned from the national survey. One‐third of respondents (n=14) consented to follow‐up telephone interviews. There was evidence of multi‐agency working among the 27 professional groups which respondents reported as being directly involved in delivering perinatal mental healthcare across the country. However, there was also evidence of disjuncture and poor communication – particularly between statutory and voluntary sectors and NHS primary and secondary care. Some respondents had difficulty defining “BME” or identifying the women to whom the acronym might be applied. They also questioned the validity of providing “BME‐specific” services. Instead, they endorsed more ethnically “inclusive models” of provision and “signposting” women to appropriate “community” services.
Practical implications
Taken together, these findings suggests that whilst there might be a theoretical argument for perinatal mental health MCNs, considerable effort is required if policy‐makers' aspirations for more “joined‐up” services capable of meeting the needs of all women are to be fully realised. Furthermore, current proposals for public sector reform coupled with reduction in voluntary sector provision is likely to disproportionately affect women from BME and other marginalised communities as they provide significant amounts of “below the radar” care and support.
Originality/value
This paper is of particular relevance to policy makers and practitioners. Findings suggest that women from BME backgrounds might be particularly vulnerable to perinatal mental illness. Contraction of voluntary sector provision increases the likelihood that the needs of BME women will remain unmet with deleterious consequences for their health and wellbeing of their families. This has potentially serious public health implications. MCNs/clinical networks have the potential to reduce inequalities by providing more “joined up” care for all women. However, the evidence base for levels of need and appropriate service response to perinatal mental illness among BME women is weak. Further research is required to bridge the evidence gap and to evaluate the impact of health and social care reform on vulnerable groups.
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The black and ethnic minority (BME) elderly population in England and Wales is increasing. As dementia is an age‐related disorder and the prevalence of depression in old age is…
Abstract
The black and ethnic minority (BME) elderly population in England and Wales is increasing. As dementia is an age‐related disorder and the prevalence of depression in old age is high, the absolute number of cases of dementia and depression will increase among BME elders. This has implications for the development and delivery of old age psychiatry services (OAPSs) for BME elders. Demographic data pertaining to the elderly from BME groups in the 2001 population census were analysed in detail to evaluate the implications for development and delivery of OAPSs for BME elders. The demographic changes identified have important future implications for the development and delivery of OAPSs for BME elders. Unless they are addressed systematically, BME elders will continue to harbour untreated, hidden psychiatric morbidity. Strategies to ensure that this vulnerable group of elderly are identified and provided with accessible, acceptable and culturally sensitive OAPSs should be developed.
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V.S. Kalra, P. Abel and A. Esmail
The National Health Service (NHS) is the largest employer in the UK but, despite decades of equal opportunities legislation, its senior management workforce does not reflect the…
Abstract
Purpose
The National Health Service (NHS) is the largest employer in the UK but, despite decades of equal opportunities legislation, its senior management workforce does not reflect the diversity of either the wider NHS workforce or the UK population. The aim of the paper is to consider the range of management interventions available to organisations like the NHS to deliver change in the area of promotion of Black and minority ethnic staff.
Design/methodology/approach
Intervention programmes in a range of public and private organisations are reviewed and the nature of barriers to promotion and the range of interventions to overcome these are explored. The paper uses the paradigm of institutional racism to examine the ways in which the NHS discriminates against certain sections of its workforce. The methods used include a literature review combined with key stakeholder interviews. A comparative dimension which involved a review of research on leadership initiatives in the USA was also undertaken.
Findings
The literature review found that there were a range of initiatives which could be implemented by public organisations such as the NHS to increase the presence of Black and Minority Ethnic (BME) staff in senior management positions. Most of these interventions were largely focused on the individual. Much more progress on institutional or organisational change needed to be made before the NHS could be perceived as a model employer in this area. The literature review also indicated that there is little published research on such initiatives within other European Union countries.
Originality/value
The paper is targeted at both policy makers and human resource officers responsible for equality and diversity issues within large organisations, who have a remit to improve the career pathways of staff. The analysis provided offers a set of critical tools and interventions that have not hitherto been well examined in the UK context.
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The proportion of those over the age of 65 years in black and minority ethnic (BME) groups in England and Wales is increasing. The prevalence of dementia and depression among BME…
Abstract
The proportion of those over the age of 65 years in black and minority ethnic (BME) groups in England and Wales is increasing. The prevalence of dementia and depression among BME elders from different groups in the United Kingdom is generally similar to or higher than in indigenous white British elders. Two methods were used to provide a conservative estimate of the absolute number of cases of dementia and depression among BME elders. Data on prevalence from published studies of different BME elderly groups and the number of those over the age of 65 years from different BME groups in the general population in the 2001 population census were used for analysis. The most conservative estimates of the absolute number of cases of dementia among BME elders were 7270 and 10,786 for the two methods of analysis; the corresponding figures for depression were 33,559 and 52,980. There is a significant amount of psychiatric morbidity among the elderly from BME groups. A multi‐faceted approach is needed to ensure that commissioning, design, development and delivery of culturally capable, appropriate and sensitive old age psychiatry actually occurs and improves the equity of service access by BME elders.
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Aisha K. Gill and Samantha Walker
Although this chapter situates all violence against women as a human rights issue, it emphasises ‘culturalised’ forms of this violence, such as honour-based violence/abuse, forced…
Abstract
Although this chapter situates all violence against women as a human rights issue, it emphasises ‘culturalised’ forms of this violence, such as honour-based violence/abuse, forced marriage and female genital mutilation. The authors draw upon their respective research to highlight how these forms of gendered violence have been subjected to a process of culturalisation. The chapter shows that while this process has raised awareness of previously under-researched forms of abuse and highlighted some of the contextual differences between women’s experiences of violence more broadly, its overemphasis on culture and cultural pathology has resulted in policy and legislative responses that do not always benefit victims. Ultimately, this chapter aims to problematise ‘culturalised’ understandings of violence in diverse communities and to show how current policy, legislative and support responses fail to adequately address the intersectional needs of black and minority ethnic victims/survivors.1
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Until May 2003, there was no coherent national strategic approach to the development of women's enterprise in the UK although for decades researchers and support groups have been…
Abstract
Purpose
Until May 2003, there was no coherent national strategic approach to the development of women's enterprise in the UK although for decades researchers and support groups have been calling for a distinctive approach to supporting women business owners due to their different business ownership profiles such as different motivations for entering business ownership, reduced access to resources, particularly finance and longer incubation periods. Historically, a piecemeal approach has dominated the policy landscape with regard to small business development as well as female entrepreneurship. As part of the effort to provide a more coherent national strategic approach to women's enterprise policy, the government launched the Strategic Framework for Women's Enterprise (SFWE) in 2003, an umbrella document from which all initiatives to support female entrepreneurship acquire their momentum. The paper seeks to explore the SFWE.
Design/methodology/approach
Taking an intersectional approach, this paper explores the SFWE seeking to examine its provisions and how these relate to black and minority ethnic (BME) women in the light of the multiplicity of their experiences in terms of gender, ethnicity and class.
Findings
The paper concludes that the SFWE approaches the issue of BME women's entrepreneurship as a sub‐set of female entrepreneurship and therefore assumes that they will benefit from all gender‐based policies. The document treats women as a homogenous group and the acknowledgement of the diversity of female entrepreneurs, particularly BME women's experiences, is not reflected in the action priorities relating to business support provision, access to finance, childcare and caring responsibilities and transition from benefits to self‐employment.
Research limitations/implications
The paper shows that there is a need for further research into the experiences of BME women in business in order to address their peculiar needs brought about by the intersectionality of ethnicity, “race”, gender and class in their lived experiences and to support this with policy provisions that are relevant to their needs. The recurrent problem is whether to concentrate on making mainstream business support provision and initiatives responsive to the needs of BME women or to define issues and develop independent initiatives that cater for these needs.
Originality/value
The main contribution of this paper is its focus on a significant but under researched group of women business owners in the context of an evidence‐based policy approach to entrepreneurship support and highlights the need for a more focused approach to their specific needs if the entrepreneurial potential of all women is to be harnessed.
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Lauri Johnson and Rosemary Campbell‐Stephens
The aim of this paper is to discuss the views of black and ethnic minority school leaders about the Investing in Diversity program, a black‐led program developed in 2004 to…
Abstract
Purpose
The aim of this paper is to discuss the views of black and ethnic minority school leaders about the Investing in Diversity program, a black‐led program developed in 2004 to address the underrepresentation of black leaders in the London schools. Major themes are identified from interviews with black and South Asian women graduates of the program and recommendations made for leadership development strategies to help aspiring and current black and global majority headteachers “bring who they are” to their leadership.
Design/methodology/approach
Qualitative case study data about the Investing in Diversity program include document analysis of curriculum modules and participant observation of the weekend residential, survey satisfaction data from several cohorts, and face‐to‐face interviews with a purposive sample of seven headteachers from African Caribbean, African, and South Asian backgrounds who completed the Investing in Diversity program six‐seven years ago. These semi‐structured individual interviews were conducted in the spring of 2012 during an all‐day visit to their schools and focused on barriers and supports in their career path, approach to leadership, and their views on their leadership preparation.
Findings
Participants identified black and ethnic minority headteachers as role models, the importance of mentoring and informal networks, and opportunities to lead as supports to their career path to headship. Many of their long‐term informal networks were established with other BME colleagues who attended Investing in Diversity. Barriers included subtle (and not so subtle) discrimination from parents, teachers, and administrators for some of the participants.
Research limitations/implications
Observational studies and interview studies, which included a bigger sample of black and ethnic minority headteachers, would extend this research.
Practical implications
This study provides suggestions for schools and local authorities about leadership preparation strategies that make a difference for aspiring BME leaders.
Originality/value
There is a paucity of research on the views of British BME headteachers. This study adds to the research base on BME leadership development in Britain and contributes to international research on self‐defined black leadership perspectives.
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