The major ethnic minority group living in the UK are the South Asians the Afro-Caribbean, blacks and the Chinese. The ethnic minority group encounters multidimensional hurdles to access proper healthcare. Such barriers make them vulnerable to developing chronic and acute mental conditions. Consequently, a lot of affliction is placed on the healthcare organization. According to an article by Freeman, Muth, and Kerner, (1994, p.19-21), the community navigator programs are meant to offer sensitive cultural management to the population at risk so as to overawed the obstacles of accessing healthcare. Navigators play have cultural significance in taking the responsibility of supporting patient in obtaining the required healthcare. This review thoroughly explores and summarizes the literature on the role of the Mental Health Patient community navigators towards the ethnic minority groups in the UK, in promoting health outcomes with the view of improving healthcare environment.
The significance of mental health care navigation emerges from the disintegration of the mental health industry that can leave patient with a lot of questions. Patient navigators work together with the patients as well as their families through collaboration and discussion to offer information on finest option and referrals to the health care, professions, organizations and facilities specialized with the needs of the patient (Wells et.al., 1999). The aspect that differentiated the patient navigator from the mental health professionals is that the patient navigator gives information and also directs the patient to the appropriate assistance instead of providing treatment. Another factor that distinguishes traditional condition services from navigation services is that the navigator frequently interacts and outreach with patients. However, patient navigators can offer diagnostic and treatment plan (Paskett, Harrop, and Wells, 2011, pg. 237).
In the previous decades, patient navigation has been utilized in increasing the receipt of effective care and services for people with mental disorders. However, the navigation services are viewed among underserved people; also, they are used among the general public. As patient navigation program and services have flourished, just like its definition, role and program description and the job title related to the services (ELK, R., & LANDRINE, H. (2012, p. 213).
Nowadays, patient navigation reflects quite different program strategies and is provided with professional and lay workers such as the nurses, certified health managers, social workers, outreach workers or community health and trained mental health peers. The blend of the of the navigators' services is significantly propelled by the individuals' needs (Darnell et.al, 2014, p. 2758). At the center of navigation is the emphasis on building a solid relationship with the person and between the person, her community as well as the health care team, that may comprise of specialty care providers and primary care physician for example pharmacy, psychiatrists together with the community-based service providers DOHERTY, 2016, p. 201).
On top of facilitating improved healthcare access, and care coordination, patient navigators also address deep-rooted matters correlated to distrust in the healthcare system and providers that frequently lead to prevention of the health problems as well as the non-compliance with the treatment recommendations. However, Schwaderer, and Itano, 2007 (p. 633), emphasizes that, communities that register with the highest ratio of ethnic minorities are regarded to be among the vulnerable in reducing quality and healthcare access. Furthermore, according to literature article by Freund et al., (2014, p 115) these communities appear to be troubled with more social economic barriers to attending, such as the high rates of the non-insured and medically needy populace.
Besides, Hoffman et al., (2012, p.119). Chronic health diseases are a substantial burden to both the healthcare system as well as the patients. They entail both the mental and physical disorder and at least more than a third of all people in the UK are affected. Individuals with chronic disorders have augmented morbidity and consume substantively additional health care resources compared to those without. Devotion to guidance and the accomplishment of the treatment objectives is connected to better results and utilization of minimal resources among patients that offer from chronic illnesses. For instance, tight control of schizophrenia among patient steers to a substantial increase in time to growth if complications, without a drastically increasing the overall cost of care. Similarly, BENNETT-LEVY (2010, p.189), maintains that, in spite of the guidelines. Several people with chronic illness fail to receive recommended care. People with chronic disorders have difficulty in attaining care goals because of the combination of provider, patient, plus system-level barriers.
Ethnic Minority Groups
According to National Black Nurses Association (U.S.). (1986, p187), various ethnic groups display a distinctive experience besides rates of mental illness, replicating their diverse socio-economic and cultural contexts as well as the culturally appropriate treatments. The black minority ethnic people staying in the UK can be:
Possibly diagnosed with mental health illness
Possibly diagnosed then admitted to hospital
Possibly undergo a deprived consequence from the treatment
Possibly extricate from normal mental health services, prompting to social elimination and social decline in their mental wellbeing.
These variances may perhaps be clarified by various elements, such as racism as well as poverty. Also, they can be due to common mental health amenities regularly fail to comprehend or offer services which are accepted and reachable to nonwhite British group together with meeting their specific culture as well as other needs (Karlsen, and Nazroo, 2002, p.625).
Possibly, mental health illness goes unnoticed and untreated since individuals in a certain ethnic minority communities are hesitant in engaging with general health services. There is also the likelihood that mental health difficulties are overdiagnosed in individual who are second English speakers (Karlsen, et.al., 2005, 1780).
The African-Caribbean groups in the United Kingdom display a minor rate of ordinary mental disorders as compared to the rest of the ethnic communities, but there is the likelihood of them being diagnosed with an acute mental illness. The chances of African Caribbean people to get diagnosed, then hospitalized for schizophrenia is three to five times more than any other group.
Although, several scholars in this field are centered on service utilization of the statistics. Other researchers have suggested that the definite number of African-Caribbean individuals with schizophrenia is significantly lower in contrast to the initial thought, individuals are assisted by Mental Health Patient Navigators assist African Caribbean people in accessing the mental health facilities in particular through the police or the court instead of primary care (Karlsen, et.al., 2005, p.1799). There are higher chances of them receiving medication under the unit of Mental Health Act, and there are possibilities of them receiving medications, instead of being offered to talk treatments like psychotherapy.
According to the statistical facts regarding the mental ill Asian individual living in the UK vary, although it is recommended that the mental health difficulties are always neither diagnosed nor recognized in this ethnic community. The Asian group have higher rate of recovery from schizophrenia, that can be connected to level of Patient Navigators support (Karlsen and Nazroo, 2002, 625).
Patient Navigators have played a unique role in reducing the incidences of suicides among the Asian men as well as the older people, though it is high among the young Asian women as compared to the rest of the ethnic of ethnic groups. The intervention of Patient Navigators is necessary since it is discovered that Western approach towards issues with mental health treatment is always inappropriate and culturally unsuitable to the expectations of the Asian groups. Asian individuals lean towards viewing the person in a complete manner, as a mental, emotional, spiritual and physical being (Bhugra et.al., 795).
However, there is limited information regarding the degree of mental health problem among people of the Chinese community. According to Crisp, et.al., (2000, p.4-7), the Patient Navigators together offer substantial physical, psychological support directing them to the treatment of their mental health problem.
BENNETT-LEVY, J. (2010). Oxford guide to low-intensity CBT interventions. Oxford, Oxford University Press.
Bhugra, D., Leff, J., Mallett, R., Der, G., Corridan, B. and Rudge, S., 1997. Incidence and outcome of schizophrenia in whites, African-Caribbeans and Asians in London. Psychological medicine, 27(04), pp.791-798.
Cantor-Graae, E. (2007). Ethnic minority groups, particularly African-Caribbean and Black African groups, are at increased risk of psychosis in the UK. Evidence-Based Mental Health, 10(3), pp.95-95.
CHRIST, G. H., MESSNER, C., & BEHAR, L. C. (2015). Handbook of oncology social work: psychosocial care for people with cancer, p.98.
Crisp, A.H., Gelder, M.G., Rix, S., Meltzer, H.I. and Rowlands, O.J., 2000. Stigmatization of people with mental illnesses. The British Journal of Psychiatry, 177(1), pp.4-7.
Darnell, J.S., Ko, N.Y., Calhoun, E., Freund, K.M., Wells, K.J., Shapiro, C.L., Dudley, D.J., Patierno, S.R., Fiscella, K., Raich, P. and Battaglia, T.A., 2014. Can patient navigation improve receipt of recommended breast cancer care? Evidence from the National Patient Navigation Research Program. Journal of Clinical Oncology, 32(25), pp.2758-2764
DOHERTY, M., BIJLSMA, J. W. J., ARDEN, N., HUNTER, D., & DALBETH, N. (2016). Oxford textbook of osteoarthritis and crystal arthropathy, p. 201.
ELK, R., & LANDRINE, H. (2012). Cancer disparities: causes and evidence-based solutions. New York, Springer Pub. Co., p. 213.
Freund, K.M., Battaglia, T.A., Calhoun, E., Darnell, J.S., Dudley, D.J., Fiscella, K., Hare, M.L., LaVerda, N., Lee, J.H., Levine, P. and Murray, D.M., 2014. Impact of patient navigation on timely cancer care: The Patient Navigation Research Program. Journal of the National Cancer Institute, 106(6), pp.115.
Hoffman, H.J., LaVerda, N.L., Young, H.A., Levine, P.H., Alexander, L.M., Brem, R., Caicedo, L., Eng-Wong, J., Frederick, W., Funderburk, W. and Huerta, E., 2012. Patient navigation significantly reduces delays in breast cancer diagnosis in the District of Columbia, p. 119.
Karlsen, S. and Nazroo, J.Y., 2002. Relation between racial discrimination, social class, and health among ethnic minority groups. American journal of public health, 92(4), pp.624-631.
Karlsen, S., Nazroo, J.Y., McKenzie, K., Bhui, K. and Weich, S., 2005. Racism, psychosis and common mental disorder among ethnic minority groups in England. Psychological medicine, 35(12), pp.1795-1803.
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