Why More Blacks Are in Psychiatric Settings - Essay Example

0 Introduction Several factors have been put forward as the possible reasons why there are more blacks and ethnic minorities like Hispanics detained in psychiatric settings than the whites. Psychiatric disorders are disturbances in one’s mental faculties which affect their inter-personal relationships. 1.1 Rationale This research has come at the right time when there is a heightened concern on how to address this problem and ensure that the racial minorities enjoy their rights to health just like any other race in UK. 1.2 Limitations of the study Major limitations would be the hesitations to bring forth honest answers to the questionnaire. This may bring challenges in that, health officials may be unwilling to open up as that may be in contravention to their code of conduct and professional regulations. 1.3 Research questions The overall goal of the research is to better understand how the black people in the community have been isolated trhough poor access system and to develop strategies to reduce this isolation. To move in that direction, the following research questions will be pursued: - i. What changes if implemented can reduce the number of black people and ethnic minorities detained in secure psychiatric settings? ii. How have the current government policies caused an increase in the number of black people and ethnic minorities in secure psychiatric settings? iii. In which ways are the blacks and ethnic minorities isolated by the Psychiatric department of health in the U.K? iv. What are the main issues facing the black people and ethnic minorities detained in secure psychiatric settings? v. What is the government doing to improve the above worrying trends? By answering the above questions, the researcher hopes that solutions, measures and strategies would be developed to curb the problem and provide long lasting solutions to the problems highlighted. These strategies and measures will hopefully lead to decreased cases of black people and ethnic minorities detained in secure psychiatric settings. 1.4 Research Benefits This will be beneficial to the community in that, the general problem associated with black people and ethnic minorities detained in secure psychiatric settings will be resolved. The study shall seek to identify causes of increased incidences of psychiatric disorders amongst blacks and ethnic minorities. This is beneficial in that, the findings shall be used to offer suggestions to the government and other stakeholders on how the government can intervene to solve the problem which is clearly threatening to get out of control. Secondly, the research is beneficial in that, it will inform the stakeholders and the general public on the status of the black people and ethnic minorities detained in secure psychiatric settings with an aim of making the community to appreciate the need for a reliable, organized, secure and dependable mental health system. By studying on how the blacks are affected by the psychiatric setting, the researcher shall help the community see the impact of an oppressive and imbalanced social services system and therefore appreciate the need for a more rational health system which would take care of the special needs of the blacks especially in regard to mortality and morbidity. Thirdly the research will bring in new and fresh insights as to how the blacks are affected by the current health crisis as well try to quantify the loss suffered as a result of the problem. Such insights are very necessary as they guide policy makers in devising ideal policies as well changing any rules or policies which serve as impediments to the solution of the health sector problems. 2.0 Literature review Although there are no many research studies which have been carried out on this field, the research managed to draw from a few literature sources mainly journals, textbooks, as well as internet sites which provided in-depth information regarding the problem. The literature is presented in this section of the research with an aim of understanding the problem better through dissecting what others have found out and therefore using the information to generate knowledge which in turn shall form the necessary guidelines for the researcher. 2.1 Prevalence. Blacks and Ethnic Minorities (BEM) seem to experience higher stress levels than whites. Some BEM are averse to psychiatric treatment or help (Bhugra, & Bahl, 1999. 1 – 9). They are thus likely to experience the stress for a longer time period since they do not seek treatment. They fail to seek treatment both due to ignorance on the best available options for psychiatric treatment and also due to a cultural belief that such a measure is an admission of helplessness. When the sources of the stress are not removed or the stress levels are not lowered, the conditions become psychiatric or clinical. 2.2 Socio-economic stratification. Socio-economic stratification is another reason for this phenomenon with the majority of the BEM community members being found in the lower socio-economic levels. In effect they live in much disorganized areas of the city. These places experience over-crowding, noise pollution and high crime rates. Abas (1996. 355-391) observe that the highest rates of schizophrenia are observed in the most disorganized areas of the city. Approximately 10 percent of all BEM youth have experienced violence. This also means that BEM members have limited access to good psychiatric facilities in the country. Even when they can afford the high cost psychiatric centers the prejudice and racism experienced in such areas is repulsive at the least. According to Department of Health (2001.1-43) BEM members have unique socio-demographic, psychosocial and socio-cultural characteristics. It is therefore, crucial that for effective addressing of their psychiatric disorders needs they need psychiatrists who can provide culturally competent services. In the absence of this as is the case currently, their needs might not be fully met. This has been reflected in that despite treatment most patients’ needs are not fully met and thus 100% recovery is not seen. Though it’s suggested that BEMs metabolize medication more slowly, they receive higher dosages especially in public psychiatric health centres (Kleinman, 1977. 2-13). They end up experiencing more severe side effects. Eventually they quit taking the medication. Healing thus becomes a long process. This is something that doesn’t happen to the whites. 2.3 Social and environmental factors. BEM community also experiences higher levels of social stressors in childhood and adolescence. They are stigmatized by their white peers. At times they also come to experience the pressure of the general society, which is basically racist. The racial violence and discrimination experienced by their parents’ affects them psychologically. The fact that they have to work extra hard, way harder than the white kids are likely to lead to depression levels higher than normal. They have to work harder to prove themselves. The adolescence stage becomes critical because about this time the kids are seeking their own identity. The result is incapacitation of these institutions. In the absence of this institution based support, stress and depression set in leading to serious mental health disorders. The only solution thus becomes detention in psychiatric facilities to rehabilitate them (Lett, 1999. 31-52). As well there is the American society and the policy-making institutions have failed to integrate BEM members in social relationships in the community. These same networks are crucial for advancement up the socio-economic ladder in the society. Once these positions of power are held by BEMs the already existing mutual aid networks will be facilitated to be effective. But until this has happened BEMs continue to be more in secure psychiatric settings because of psychiatric illnesses. Another major cause for this prevalence is the exiting family structure within BEM people. Most of these people do not have their larger extended families living with them. They have since died or still live in the native countries or have traveled to different states to try making ends meet. Their kind of family structure is majority nuclear and sometimes even they just have themselves and close friends living with them. In the absence of family support, their mental health becomes hard to maintain. Psychiatric disorders set in easily probably due to the number of social stressors experienced by BEM it is recorded that they have a higher rates of panic disorder, phobic disorder, somatization schizophrenia & Agoraphobia. Discrimination in public and private establishments, socio-economic disparities, poor living conditions, lack of mobility and high crime rates all combine to cause stress to the BEM peoples (Silveira, & Ebrahim, 1995. 370-478). As a result of this stress their immune levels decrease remarkably. Incase of infection their bodies are not able to fight the disease effectively. This goes to further cause physical stress to the people. 2.4 Homelessness and Drug misuse. Homelessness is another major cause of mental health problems. Those left especially the youth end up abusing drugs and alcohol. It becomes so severe that they end up becoming physically dependent on those substances to function normally. They are not able to work independent of these substances (Silveira, & Ebrahim, 1995. 370-478). Unproductivity eventually leads to mental incapacitation. When the detention involves unfair judgment the family of the victim feels the blunt of judicial injustice. This causes feelings of hatred, suicidal feelings and they end up in clinical depression. 2.5 Availability of mental health services. There are a very small percentage of mental health services providers of psychiatrists and psychologists from the BEM community (Royal College of Psychiatrist, 1990.35-79). That means that these areas critical to prevention and remediation of mental health illness remain unfamiliar to the BEM community. The effect is continued ignorance. Though it’s suggested that BEMs metabolize medication more slowly, they receive higher dosages especially in public psychiatric health centres. They end up experiencing more severe side effects. Eventually they quit taking the medication. Healing thus becomes a long process. This is something that doesn’t happen to the whites. As well medical insurance is another factor in the question of BEM mental health. Nearly 25% of BEM population is uninsured compared to slightly over 15% of all US population. The percentage of employees who are covered by their employers among the BEM people is about ½ compared to about ¾ of the white population (Watkins, & Callicutt, 1997.200-217). That means they get poorer medical services compared to the whites. Further, they worry more about their health issues, as they know in the event of an illness they have to dig into their meager earnings to foot the hospital bill. It also means that they have limited access to current medical information relevant for well-being (McCallum, 1990.54-90). A bigger portion of BEM people is unemployed causing mental instability. Those who are employed working in the industrial sector, execute heavy manual jobs with physical and mental strain. Even those working within formal offices experience such racism that their mental health suffers. BEM keep migrating these migratory experiences affect the mental well being of the people. In some of these areas, they experience such hostility and inhumane conditions that they end up suffering Post Traumatic Stress Disorder (Manthorpe, 1993. 240-273). 3.0 Methodology 3.1 Research design This research will be based on both quantitative and qualitative approach where by data will be collected and analysed using appropriate data collection instruments including questionnaires, verbal interviews both structured and semi structured as well as telephone conversations. Questionnaires and interviews will be the main data collection instruments for this study. Since the research findings should be generalisable to the whole population of America area, the sample for the study was arrived at using a random sampling method in which 124 respondents were selected to fill the questionnaires as well as to respond to the interviews. 3.2 Analysis. Significance tests will be performed on all relationships and only those with statistical significance will be presented here. Data analysis for both the qualitative and quantitative data garnered in the data collection will be analyzed using statistical software called SPSS in order to arrive at findings. The findings shall be represented through graphs, charts and tables which are easy to understand and interpret. 3.3 Ethical issues Those who are not wishing to volunteer in participation and have been selected will be replaced with others who will be willing to offer voluntary participation. This research will not discriminate against any group in the society as long as that group meets the basic criterion for the interview and has given consent of participation. This research will also not expose the participants’ risks such as those resulting from negligence on the part of the part of the researcher. Confidentiality will be highly practiced in this research whereby no personal information will be released or used for purposes other than for academic purposes stipulated in this research. Conclusion The longstanding public debate on the causes of more black people and ethnic minorities detained in secure psychiatric settings will be brought to an end by the findings of this research. It is hoped that, suggestions and recommendations presented in the research will inform the government and the relevant departments as well as the other stakeholders and therefore serve as the benchmark to new policies or amendments to the existing ones. APPENDIX 1 REFERENCES Abas, M. Depression and anxiety among older Caribbean people in the UK: Screening unmet need and the provision of appropriate services. International Journal of Geriatric Psychiatry, 11. 1996. 355-391. Bhugra, D. & Bahl, V. Ethnicity – issues of definition. In ethnicity: An Agenda for mental health. London. Gaskell. 1999. 1 - 9. Department of Health. National service Framework for older people. London: Department of Health. 2001.1-43. Kleinman, A. Depression, somatization and the new cross-cultural psychiatry. Social Science and Medicine, 11. 1977. 2-13. Lett, J. Epidemiological factors in research with ethnic minorities. In Ethnicity: An Agenda for Mental Health. London. Gaskell. 1999. 31-52 Manthorpe, J. and Hettiaratchy, P. Ethnic minority elders in Britain. International Review of Psychiatry. 4. 1993. 240-273. McCallum, J. The forgotten people: Careers in three minority communities in Southwark. London. King’s Fund Centre. 1990.54-90. Royal College of Psychiatrists. Psychiatric Practice and Training in a British multi-ethnic society. (Council Report CR10). London. Royal College of Psychiatrists. 1990.35-79. Silveira, E. & Ebrahim, S. Mental Health Status of elderly Bengalis and Somalis in London. Age & Ageing. 24. 1995. 370-478. Wattikns, J. & Martin, C. The organization of services and the law in relation to treatment. In practical psychiatric of old Age. London: Chapman & Hall. 1994. 211-261 APPENDIX 2: GANTT CHART/SCHEDULE OF ACTIVITIES Timing Activity Resource person Expected output Week 1 Preparations. Social workers, those working with psychiatric settings Obtain first hand information/ true situation on the ground. Administering Questionnaires/Data collection. Research Assistants Fill questionnaires capturing data for the research. Week 2 Final touches on questionnaires /sorting for valid questionnaires Research assistants Consolidate primary data for the study. Week 3 Data analysis and documentation Interpreting and compiling the research findings. Week Dissemination of research finding to the supervisor APPENDIX 3 PROJECT BUDGET The project has a Budget which will be shouldered by the researcher. Activity Item Units Cost/unit $AUSTR. Total cost $AUSTR. 1. Familiarization tour Field travel Local assistance N/A N/A Sub- Total 2. Data collection Field travel And materials N/A N/A N/A Sub total 3. primary data collection Field travel Allowances Days Days 7 03 Sub total Data analysis and documentation A4 papers plain graph papers Typing services Duplicating Binding services 1 Rim Booklet 36 Pages 36 Pages 3 copies Sub total Consultancies Data Analysis 160 Questionnaires @ Sub total TOTAL Read More