Community conversation: addressing mental health stigma with ethnic minority communities
- 3.3k Downloads
Stigma associated with mental health problems is a significant public health issue. Patterns of stigma and discrimination vary between and within communities and are related to conceptualisations of, and beliefs about, mental health. Population approaches to addressing stigma rarely consider diverse cultural understandings of mental health.
257 members of the major black and minority ethnic communities in Scotland participated in 26 mental health awareness workshops that were designed and delivered by community organisations. Questionnaires measuring knowledge, attitudes and behavioural intent were completed before and after the intervention.
Community led approaches that acknowledge cultural constructs of mental health were received positively by community groups. The study found significant reported stigma in relation to public protection, marriage, shame and contribution, but also high levels of recovery optimism. The workshops resulted in significant positive change in relation to knowledge, attitudes and behavioural intent amongst participants, with most aspects of stigma showing significant improvement, with the exception of dangerousness.
The paper argues community approaches to tackling stigma are more valuable than top-down public education and could form the basis of national initiatives. Refinements to the evaluation framework are considered.
KeywordsMental Stigma Discrimination Ethnicminority
The authors would like to acknowledge a broad community of practice involved in this programme, including Chinese Healthy Living Centre, Chinese Community Development Partnership, STEPS Primary Care Team, Glasgow Association for Mental Health, Mental Health Foundation, Shante Bhavan, Mel Milap, Pollockshields Development Agency, Youth Counselling Services Agency, NHS Greater Glasgow And Clyde. Particular acknowledgements are due to Pratima Pershad for community development support, and the staff and volunteers of CHLC for time spent developing the workshop template.
- 2.Blackwell MJ (1997) Psychiatrists and Chinese mental health in Chinese mental health issues in Britain. Chinese Mental Health Association/Mental Health Foundation. http://www.cmha.org.uk
- 3.Braunholtz S, Davidson S, Myant K, O’Connor R (2006) Well? What do you think? The third national Scottish survey of public attitudes to mental health, mental wellbeing and mental health problems. Scottish Government, EdinburghGoogle Scholar
- 4.Brown J, Hanlon P, Webster D, Turok I, Arnott J, MacDonald E (2007) Turning the Tap Off! incapacity benefit in Glasgow and Scotland—trends over the past five Years. Paper 6 in the Glasgow Centre for Population Health Briefing Papers—Findings series. http://www.gcph.co.uk
- 8.Glasgow Anti-Stigma Partnership (2006) Mosaics of meaning: exploring stigma and discrimination towards mental health problems with black and minority ethnic communities in Glasgow. http://www.healthscotland.com
- 9.Hatfield B, Mohammad H, Ahim Z, Tanweer H (1996) Mental health and the Asian communities: a local survey. Br J Soc Work 26(3):315–336Google Scholar
- 10.Hussain A (2006) Islamic beliefs and mental health. http://www.mentalhealth.org.uk/conferences/shift/Islam_mental_health.pdf
- 13.Lee S, Lee M, Chiu M, Kleinman A (2005) Experience of social stigma by people with schizophrenia in Hong Kong. Br J Psychiatry 186(15):3–157Google Scholar
- 15.Miles MB, Huberman AM (1994) Qualitative data analysis: an expanded source book, 2nd edn. Sage, Beverly HillsGoogle Scholar
- 16.Patel K (2005) The complex mosaic. Inaugural Professorial Lecture. 12 May 2005. The Centre for Ethnicity and Health, UCLANGoogle Scholar
- 20.Quinn N, Knifton L (2005) Promoting recovery and addressing stigma: mental health awareness through community development in a low-income area. Int J Ment Health Promot 7(4):37–44Google Scholar
- 21.Rethink (2004) Reducing stigma and discrimination. What works. Conference Report. http://www.rethink.org
- 22.Rooney R (2005) Explanatory models of mental health and reducing stigma among people from CALD backgrounds: towards a model of culturally sensitive mental health care. http://www.mmha.org.au/MMHAPublications/Synergy
- 25.Taha A, Cherti M (2005) Caught between stigma and inequality: Black & Minority Ethnic Communities and mental well-being in Kensington & Chelsea and Westminster: BME Heath Forum and the Migrant & Refugee Communities’ Forum. http://www.westminsterpct.nhs.uk/pdfs/caught_between_stigma_and_inequality.pdf
- 26.Tilbury F, Slee R, Clark S, O’ Ferrall I, Rapley M (2004) Listening to Diverse Voices: understandings and experiences of and interventions for depression among East African migrants. http://www.mmha.org.au/MMHA/Publications/Synergy
- 28.Wong L, Richman J (2004) Chinese Understanding of Diankuang in a Metropolitan City in the United Kingdom. Int J Ment Health 32(3):5–30Google Scholar
- 29.World Health Organisation (2002) Nation for mental health final report. World Health Organisation Department of Mental Health and Substance Dependence http://www.who.int/mental_health/media/en/400.pdf
- 31.Yeung E (2004) Endurance: Improving accessibility to mental health services for Chinese people. Training manual/resource pack, 2nd edn. Merseyside Health Action Zone, LiverpoolGoogle Scholar