Article Analysis Essay on The Gujarati Mental Health Article

Introduction

Mental health is a condition that is often highly misinterpreted and misunderstood with a majority not quite sure what it means or entails. According to the Centre for Disease Control and Prevention (CDC), mental health refers to a state of well-being, where an individual is aware of their own abilities and is able to cope with the normal stresses of life as well as work productively and successfully in bringing a contribution to their community. On the other hand, mental illness refers to a condition that affects an individual's thinking, feeling, mood or mannerisms. Such conditions include depression, anxiety, schizophrenia, and bipolar disorder, among others. These conditions are often long-lasting and affect how an individual relates to others as well as how they function on a day to day basis (CDC 2019).

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Article Critique

The Gujarati Mental Health Article (Dogra, et al. 2007) highlights some of the ethnicity barriers in access to proper mental health services. From the onset, the article clearly establishes that there is an ethnic divide in access to appropriate healthcare. The minority ethnic groups (mostly comprising of Black and Asian communities) are among those who suffer the most as there are forms of discrimination and ethnic that arises from seeking mental health services.

The aim of the journal article was to explore the perceptions that parents and adolescents from Gujarati have on a child and adolescent mental health services and some of the ways that these services can be improved to meet their basic needs. The people of Gujarati comprise of the greater Indo-European population, with some being located in some inner cities of the United Kingdom, where this study was conducted.

The article also highlights the considerable concern for people from minority ethnic groups getting access to appropriate mental health care. It justifies this position by referring to real or perceived barriers to these health services as a result of disadvantages related to the minority status of some of these ethnic groups. According to the Mental Health Foundation in the UK, there is limited research on the impact of mental health and access to its services has on black, Asian and minority ethnic (BAME) communities. Because of the inadequate and sufficient data on these groups of people, there has been misdiagnosed, underdiagnosed and prescribed treatment to these communities (Mental Health Foundation 2016).

Despite these findings, there have been a few contrasting views on the relationship between ethnicity and mental health service provision. Among them is that the race or ethnicity of a child is not related in any way to the admission and delivery of mental health services; rather it suggests that biases from the clinic service provider (at the primary level of healthcare) could not be a contributing factor in different service provision, including diagnosis and treatment.

Even with this point of view, there is a great amount of contrasting research which shows that many Black and Minority Ethnic (BME) groups still have varying outcomes when accessing mental health pathways such as referrals in the UK. Patients and mental health victims within BME groups still find it difficult to be referred to mental health service through their General Practitioner (GP). In addition to the barrier towards accessing mental health services beyond the primary level of healthcare, people of the BME community with mental illness are in most cases arrested by the police in the event of any crisis and this creates an avenue for the detrimental of their health as individuals (Arday 2018).

The Study Sample

The study sample included fifteen parents (3 fathers and 12 mothers) between ages 34-58 and 15 adolescents (8 male and 7 females) between ages 12-16. The study further notes that none of the parents were born in the UK. For a more accurate study, the sampling should have included a mixture of parents born in and outside the UK. It is commendable that the study involved different kind of professions in the sample that consisted of the parents. According to the study sample description, the parents who were interviewed had different education backgrounds as well as different professions ranging from shopkeepers to housewives to secretaries and skilled labourer.

Procedure and Measure

The study was based on a previous study done by the first authors of User's Perspectives and Diversity, where it structured, developed and piloted its interviews based on the previous study. Interviews were done separately with parents and young people; perhaps with the aim of encouraging the individuals being interviewed to open up on issues that they face as well as reduce the influence one party might have on the other in giving out information.

The article mentions that the study covered perspectives from both parents and adolescents on mental illness but did not include it in the final report due to its depth. However, it would have been helpful if the article gave a synopsis of some of the issues that were raised. In the discussion section, the article does give reference to some of the responses by the study sample; however, more diverse responses could have been included such as what is the major factor hindering the access to appropriate mental health services.

The study is also one-sided as it only interviews parents and adolescents but does not interview other parties such as medical providers, relevant state officials, or any other relevant organisation in the Gujarati area. This would have helped build a stronger argument as well as develop a better and sustainable justification of the actual issues affecting the access to proper mental health care by these marginalised communities. Another important factor that missed out in the study is a reference to a diverse spectrum of related studies, not only in the UK but also in other parts of the world that gives mention to mental health service delivery to marginalised groups. This could further lay emphasis of mental health service delivery as a global issue and not just confined to one geographical area or country.

Responses

The study highlights responses from the study sample (which comprised of 400,000 people from an inner city in the UK with 40 percent being from the non-white population) where some of the responders prefer services for ethnic minorities to be run by ethnic minorities. It should, however, be noted that there are both advantages and disadvantages to this suggestion. An advantage is that speaking the same language as the clinic practitioner or doctor could help in describing symptoms and diagnosis. They could also give appropriate health services to patients and reduce delay in cases that require a referral. The disadvantage, on the other hand, is that it may further increase the ethnicity divide in mental health services.

This aspect was further highlighted in the journal article is that a majority of responders wanted to be treated with respect and dignity - a value they held dearer than the factor of ethnicity (Santiago and Miranda, 2014). This then changes the perspective that ethnicity could be an overriding factor in community members seeking mental health services. However, although it is an important factor, it does not dismiss the immense contribution of ethnicity in getting appropriate mental healthcare services (Padget, et al. 1994).

Another issue that was highlighted in the journal article was the lack of awareness of mental health, mental illness as well as the mental health specialists and clinics in the areas they lived in. The study revealed that neither adolescents nor parents had a clear understanding of or the difference between mental health and mental illness. A majority considered mental illness to be the same concept as a learning disability.

It is essential that BAME communities get the necessary information on mental health, what it is, methods of diagnosis and forms of treatment. There is a considerable amount of illiteracy on mental health awareness in these minority groups and some of this could be attributed to factors such as language barriers; communication constrictions; inadequate recognition for a need of mental health services; cultural naivety; imbalance of socio-economic power between service users and providers; insensitivity; and discrimination (Memon, et al. 2016).

The adolescent responders also pointed out that by educating teachers on mental health as well as other issues affecting young people, there would be increased awareness of mental health. This is not just limited to teachers alone, healthcare providers operating in these communities also need to be sensitized and given relevant training that would help improve effective communication and relationships with service users and ensure there is culturally sensitive care (Bowl 2007).

Way Forward

As a result of global awareness and a push for the understanding of mental health issue, there are now frameworks that have been put in place to facilitate the training of psychiatrists and other healthcare professionals by expanding their knowledge and diversity in mental health issues. A majority of these advances are difficult to discuss on as there is very little information on how these changes have been made. However, with the little information, these advances and frameworks are in the form of policies such as the Race Relations Amendment Act, the National Service Framework for Mental Health and a publication entitled Inside Outside meant to help reduce ethnic inequalities (Keating, Robertson and Kotecha 2003).

The aim of these policies is to help end the unlawful discrimination of persons (especially those in the BME community); promote equality and promote good relations between people of different ethnic and racial groups within the mental healthcare system. The National Service Framework for Mental Health was established to specifically introduce and establish a set of standards for mental health service provision in England and Wales. This framework would help to emphasize the importance of the needs of adults from BME communities and other minority groups that have been at a point of disadvantage.

Conclusion

Mental health is a global issue and is not confined to one community, thus, it should be treated as a universal need. Every person in the world has the right to have access to mental health services despite their ethnicity, race or place of origin. It is clear that ethnicity is a huge barrier in acquiring appropriate mental health services and governments as well as institutions should make the necessary steps in ensuring that this hindering factor is eliminated from society. It is also clear the sufferings that some individuals and communities go through because they lack the necessary knowledge and information on mental health and how to approach it. It is, therefore, essential to creating awareness of mental health and how it can be treated or managed. It is also important that elements such as biases, discrimination, misuse of power and arrogance to be eliminated so as to reduce the ever-growing rate of mental health issues and disorders.

References

Arday, Jason, 2018, "Understanding Mental Health: What Are the Issues for Black and Ethnic Minority Students at University?" Social Sciences vol. 7, no. 196, pp.1-25.

Bowl, Ric, 2007 "Responding to ethnic diversity: black service users' views of mental health services in the UK." Diversity in Health and Social Care Vol.4 pp.201-210.CDC, 2019. Mental Health, CDC, Viewed April 1, 2019, <http://www.cdc.gov/mentalhealth/learn/index.htm>

Dogra, Nisha, Panos Vostanis, hall Abuateya, and Nick Jewson, 2007 "Children's Mental Health Services and Ethnic Diversity: Gujarati Families' Perspectives of service prov...