NSUN Values-based Commissioning - Culture, Race and Ethnicity in Commissioning for Mental Health • To reflect on the origins of racism, prejudice and stigma. • To understand the social determinants that make people from BME communities more vulnerable to poor mental health - racism, stigma, discrimination, interpersonal violence, conflict • To understand the inequalities experienced due to structural discrimination and how it translates into coercion, control and restraint in practice • To introduce the principles of ‘values based practice’ and ‘values based commissioning’ and devise the cultural competencies and actions commissioners can take to eradicate structural discrimination of BME people. • To explore baseline involvement standards and how they can be put into practice • (National Involvement Partnership’s 4pi standards – Principles, Purpose, Presence, Process, Impact and DTOOT’s). 08/10/2015 Racism, mental health and services 1
Transcript
NSUN Values-based Commissioning - Culture, Race and Ethnicity in Commissioning for Mental Health
• To reflect on the origins of racism, prejudice and stigma.
• To understand the social determinants that make people from BME communities more vulnerable to poor mental health - racism, stigma, discrimination, interpersonal violence, conflict
• To understand the inequalities experienced due to structural discrimination and how it translates into coercion, control and restraint in practice
• To introduce the principles of ‘values based practice’ and ‘values based commissioning’ and devise the cultural competencies and actions commissioners can take to eradicate structural discrimination of BME people.
• To explore baseline involvement standards and how they can be put into practice
• Participants will: • be confident in their ability to describe and identify ethnic
inequalities in the mental health system• • have a thorough working knowledge of ethnic
inequalities with a thorough understanding of systemic and structural discrimination
• • be able to prescribe commissioning action to address
inequality and racism• 08/10/2015 Racism, mental health and
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The historical eye and race as a perception
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Reflections on the origins
Euro-centric
• Kant• Wittgenstein• Darwin• Eugenics• IQ• Mental health Body
reader• Exploitation• Legacy of Slavery
AFRO-CENTRIC
• Fanon Mask• Dubois Veil• Welsing Symbol
• Rodney• Europe underdeveloped
Africa• Self-determination• Person centred
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The Social determinants
• "If any one or more of them, at any time, are inclined to raise their heads to level with their master or overseer, humanity and their own good requires that they should be punished until they fall into that submissive state which was intended for them to occupy. They have only to be kept in that state, and treated like children to prevent and cure them from running away." Cartwright (1851p:)
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Historical valuesCultural schizophrenia
Bowlby International Detachment
Slavery
FreudBlack penis envy
The madness of theEuropean
Whiteness as a Psychotic illness
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THE EXPERIENCES
Experiencedabuse
AssessedEducationalsubnormal
Failed 11+
GeminiV
Schizophrenic
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Structural discrimination
• Six times more likely to be excluded from school.
• Three times more likely to be given a custodian sentence.
• Ten times more likely to have a mental illness
• More likely to be diagnosed with schizophrenia
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Structural discrimination.
• Failure of the legislation• 1983/2007 Mental Health Act• 1990 Community Care Act• 2014 Care Act• 1998 Human Rights
The missed (diagnosis)Meeting the white specification of madness
• Reading their words
• Writing their words
• Madness specification• DMS
• Treatment specification
• Educationally subnormal
• Dyslexic
• Manic Depression• Schizophrenic
• ECT. Medication. Locked up
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Survival V Selling outPersonal and Professional
• From maudsley to College, from O levels to A levels and qualifying as a Approved social worker.
• Trading the black body for European accolade, working along side the enemy of your own misdiagnosis.
• Managing the new slave trade of mental illness in your own community.
• Moving over to other side, decoding whiteness as mental disorder, GP/Consultants/
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Values. They diagnosed me a schizophrenic when I was really a Gemini
• The night shift of mental disorder.
• The day care and the voluntary sector.
• The plantation field of higher education, from MA – PHD – NOTHING.
• Writing and reflections, breaking down and breaking down.
• Teaching re-emergence of radical community based social work.
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Researching the other sideBody dysmorphic disorder
• Re-conceiving the Europe centric.
• The role of black theorist.• Challenging research as
social process of whiteness, Goffman.
• Changing the models.
• Challenging needs and service approach to race and racism.
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Well-beingWORLD HEALTH ORGANISATION
Definition. BAME – No reference• State of well-being in
which every individual realises his or her own potential. Can cope with normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.
03/07/2014 PFA Mental Health Slides 1404/21/23 PFA Mental Health Slides 1404/21/23 PFA Mental Health Slides. BACA Copyright 2014 1408/10/2015 Racism, mental health and
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Baseline Practice
• Goffman (1961) • Littlewood and Lipsedge (1981) • Small (1994) Racialised barriers – Housing –Education –
Social Welfare - Politics• Richie Report (1994) Christopher Clunis• Fernado (2010) Criminal Justice and Mental health.• Fernando (2010) Survey in schizophrenia• Lambeth, (2014) Black report• Mental Health Foundation (2001)• Mental Health Foundation (2008)
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Implications
• Dancing to Our Tunes: Reassessing BME Mental Health Service User Involvement - by NSUN consultant Jayasree Kalathil published in 2012 and reprinted in 2013
• Ethnic Inequalities in Mental Health: Promoting Lasting Positive Change - a consultation with Black and Minority Ethnic Mental Health Service Users - by NSUN for the Lankelly Chase Foundation - published in 2014
• JCP guidance: Commissioning Mental Health Services for BME Communities - published in 2014
• 4PI: Mental Health Involvement Standards - 4PI: Principles, Purpose, Presence, Process, Impact: the standards defined by NSUN and the National Involvement Partnership (NIP) – 2012 - 2015
• Evidence and Ethnicity in Commissioning 201408/10/2015 Racism, mental health and services 16
