1. Introduction

Over the past years, health care standards in the UK has been heavily criticized by media practitioners and stake holders in terms of quality and availability of its services In regards to the growth in population and the influx of migrants workers and asylum seekers. Despite the fact, there has been enormous effort in providing efficient and “State of the Art” Health Care Services. Recent development in the 21st century has raised so many concerns that needed immediate attention; pin pointing the awareness of the determinants of Health Care for minority ethnic communities.

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2. Background Research – Health Care In BME Communities across the UK

Mental Health Care Policies has been partially welcomed by users in the BME Communities, due to the bottlenecks that has stifled the progress and development of improving the wellbeing of patient suffering mental illness of various kinds. This led to setting up independent commission to investigate the root causes of poor delivery of mental health services. foster

As a matter of fact, black people came to this country in the early fourteenth century, whether as slaves or migrant workers and the NHS has been in existence since 1948; long enough to have identified and address the disproportionateness of mental health care services in BME Communities. Therefore, the controversy surrounding the fairness in delivering mental health care services across diverse cultures had long over-due and timely action needed to be taken to combat racial inequality in the health sector.

In 1986, the Ottawa Charter for Health Promotion identified nine pre-requisites for health care.

See Appendix 1.4

According to the Acheson’s Report which is based on the glaring inequalities in the provision of Health care, particularly to women, old people, the working class and Black Ethnic Minority group. It states that,

” … Persistence and entrenched inequality exist in the mental health provision for women, working class and old people. He further indicated that women have a higher rate or mortality from poor mental health and this strongly influence by socio-economic status. ; And working class black men are three times more likely to commit suicide and old people are less likely to receive some health care services…”. Acheson, D, 1998, Independent Inquiry into Inequalities in Health Report, London: The Stationery Office.

Otherwise, very little attention is presumed to have been put forward, regarding social division and its negative impact on BME Communities. This major constraint cut across all aspects of Health and social care. in which, the principal causes of disproportionate delivery of health care services can still affect other health issues such as Cancer, Diabetic, Infant Maternal Mortality, Post Natal Care, Organ donation and Transplant , Ageing and a wide range of specialist treatments.

3. Sketch – (Government Policies on Mental Health Care Bill – UK)

Historical facts revealed that, there has been a lack of reliable ethnicity data relating to mental health care services. Inspite of this, there is significant and local anecdotal evidence of the disproportionate impact of services upon ethnic minority communities. These evidences were generated by independent Commissions including , Health Care Commission and Mental Health Act Commission.

A comprehensive quantitative and as well as qualitative research method was initiated in obtaining live data models whereby, the results are currently used and been perceived as the factual representation of service used to date cited in Parliamentary Briefing for Mental Health Bill.(16th April,2007).

Also, in recent years key findings in the “Count Me In Census” exposed what many people had long suspected, especially people from a number of Black Minority Ethnic Communities had very different experience in mental health services. Key findings of the “Count Me in Census ” in 2005 – 2007

See Appendix 1.1

4. Determinants of Health for Minority Ethnic Communities

It is evidently clear that that BME’s Community are directly affected by the above health factors which quite worrying for parents and relatives of affected victims of Poor Mental Health Care services. Therefore, raising awareness on key factors such as Poverty, Unemployment, Bad-housing, Social-isolation, Pollution, Ethnic-minority status and gender – have for too long been regarded as peripheral to health policy.

In regards to Mental Health, there are other contributory factors that are quite related to the above mentioned determinants in the BME Communities such as Alcohol and Drugs, Immigration regulatory policies, Lack of Adult Education Programs, Cultural differences, Socio-economic issues and Inequality. One of the main determinants is the draconian migration control policies which has created a vacuum in the BME communities. See Appendix 1.5

As a result of these inconsistencies with migrant worker’s and asylum seeker’s regulatory policies, it h has influenced the degradation of Socio-economic status and access to quality health care in the UK. This has vacuum has left BME communities with limited options, rather that been productive i.e improve their living standards through community projects and self- help initiatives

Therefore, most black ethnic minority youth, young adults, women and men subsequently ended up depressed and became much more vulnerable to the abuse of street drugs and crime.

5. Critical Evaluation – Mental Health Care Services in BME Communities.

Contemporary issues involved in providing quality health care in Black Minority Health Care, varies across all sort of ill health issues, which we can now say its been perceived as a mockery to the victims and relatives who are directly affected. These policies cannot be ignored, due to the biased delivery and disproportionateness of mental health services to Black Minority Communities.

Research analysis and fact finding initiatives conducted by various independent and non-governmental practitioners’ reveals that, there are still more Health concerns, especially the delivery methodologies of Mental Health Services to the Black Minority Ethnic Communities. Whereby raising the awareness of cultural and ethnic practices in those communities that are contrary to an effective mental health care and the good practices in the UK.

Also, the legal arrangements in addressing mental health and crime has been defect, which raises the question regarding the implementation of the race equality duty and the degree to which the individuals concerned would be covered by the duty and the approval of mental health professional whom should be subject to race equality duties. Other secondary finding reveals that inpatients at admitted at mental health center are been misdiagnosed and also victims of stereotype. Cited in Parliamentary Briefing for Mental Health Bill.

Therefore, the Commission for Race Equality(CRE) has recommended and also pinpointed their views on the proposed Mental Health Bill that should put firm legal provision in place to prevent ongoing disproportional of ethnic minorities in mental health services. See Appendix 1.2

6. Conclusion

The government has recognized the importance of the mental wellbeing of Black Minority Ethnics in the UK and these concerns needed participation in raising the awareness of the need to improve Mental Health Services for individuals with mental health issues. Recent development indicated that, there have been numerous strategic amendments to the mental health bill in an effort to address the ongoing problems that have arisen within the mental health system. However, Implementation of these strategies has begun, but there has been little evidence to determine how effective they are or how it will be in time to come.

Therefore, the underlying factors that affect fairness in the delivery of mental health services will still remain in the UK health system, if health policy makers failed to acknowledge the problems of mental health care as it is experienced by black and minority ethnic groups.