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ETHNIC INEQUALITIES IN HEALTHCARE

By Ashleigh Onabajo, Crown Agabi, Elliot Busari, Dotun Busari.

A Rapid Evidence Review paints devastating picture of a healthcare system failing minority ethnic patients in England. We asked 4 changemakers – a group of young people from racialised communities who are changing mental health support for the better – to share their thoughts.

A Rapid Evidence Review can be found here.

28 February 2022

Ashleigh Onabajo:

It’s shocking and unfair that it has taken a global pandemic to make it clear to health leaders that there are major disparities in the care, and subsequent health outcomes, of those in ethnic minority groups; but the NHS Race and Health Observatory’s research has shown conclusively that racial discrimination is woven throughout the way we access and receive healthcare.

This is something I’ve seen for myself, and in my friends and family’s lives for years on end – from an Asian friend of mine being told her heart palpitations are likely her being “stressed about COVID”, to my mum being told by a Doctor that she was “unclean” instead of being given necessary checks to identify a medical issue that was later identified by another doctor – the findings of this research is not surprising or new to us. For me personally, I was sent away from a GP when suffering with my own mental health, and was simply told “you’re just having a bad day”. Fortunately, at the time I was capable of finding and using a self-referral service, who’s practitioners could clearly see that I was suffering with depression and anxiety; but not all black young people are able to do this, and the results are clear as day in the report – “Black children are 10 times more likely to be referred to children and adolescent mental health services CAMHS via social services, rather than through their GP, compared with white children”. Every child and young person deserves to have access to mental health services, regardless of race.

As I said previously, these health inequalities have been clear for years to those who live through them, and we’re well aware that they don’t just stop at the NHS, but are seen in every aspect of life such as policy, living conditions, policing and education. With the help of The Diana Award, UK Youth and Centre for Mental Health, young people are being given the opportunity to take action. My team and I have chosen to look at policy related to Education, and how we can better equip teachers to look after the mental health of their minority ethnic students; and decided that we want to push for mandatory anti-racism and microaggression awareness training. If this could eventually become mandatory – it would be preventative, allowing teachers to be self-aware of their own unconscious bias and how it affects the mental health of their students, as well as making them aware of what to look for to combat racism in their own classrooms. Check out the work we’re doing and sign our petition.

Crown Agabi:

The article talks about the year-long review, which examined 13,000 papers and interviewed policy experts, NHS staff and patients based on the inequalities of ethnic minorities in access to, experiences of, and outcomes of healthcare in the NHS led by the University of Manchester.

As mentioned in the article, the review says, “Ethnic inequalities in health outcomes are evident at every stage throughout the life course, from birth to death,” and has “negatively impacted” the health of black, Asian and minority ethnic people in England for years. A health system that doesn’t treat its patients equally regardless of their ethnicity is not a fully functioning system, as it puts its patients at a disadvantage just for who they are when it’s meant to help improve their quality of life.

According to the article, the review found “strong evidence” of “clear, very large and persisting ethnic inequalities” in compulsory admission to psychiatric wards, particularly affecting black people. It uncovered evidence of harsher treatment for black patients, who were “more likely to be restrained in the prone position or put into seclusion”. Due to the inequalities Black people face in our healthcare system we’re currently working with The Centre for mental health, UK Youth and The Diana award to change public attitudes and behaviours towards black mental health. The campaign we’re running at the moment is called Change: Black Mental Health and we believe to see a change we have to be the change; our main goals are to influence the attitudes towards young Black people’s mental health and improve the communication on mental health within the Black community, whilst giving young people a voice.

The review shows that the system is currently failing people of ethnic minorities and I’d love to see a change, a significant change, we don’t need to see anymore pledges to act, we need to see those changes happening and actionable steps being taken.

Elliot Busari:

It’s devastating to hear that Black children are ten times more likely to be referred to CAMHS via social services rather than through their GP. This highlights the systemic failures that have led to a workforce that is ill-equipped to identify and support young black people by connecting them with mental health services. Often, the onus is put on the black community (or other minoritised groups) to de-stigmatise services – but this data demonstrates that the lack of cultural sensitivity, trust and systemic evaluation done by these services which has left many children, families and young people to suffer in silence. It seems the black community needs to scream before a whisper is heard by services on the other end. IAPT services won’t be able to improve access to support unless frontline practitioners such as GPs are equipped to engage underserved communities. As a part of the Young Changemakers project we are developing a digital resource to equip GPs to better identify and support children and young people in need of mental health services with cultural sensitivity.

Dotun Busari:

This article accurately highlights two key issues within the National Health Service (NHS), the treatment of minority ethnic people and the prevalence of racism within the NHS’ workforce. Unfortunately, this article represents the reality of many ethnic minorities within the UK and sadly, this experience is ongoing. With countless stories told, experiences shared, and lives lost, it is only right that serious investigations are made, and the appropriate actions taken. The reports shared in this article, express saddening similarities to the many experiences I have witnessed. ‘Racism, racial discrimination, barriers to accessing healthcare and woeful ethnicity data collection have negatively impacted the health of black, Asian and minority ethnic people in England for years…’ – My family member being one of them. My mum’s experience as both a patient and a clinical health professional in the NHS, explicitly depicts how ‘ethnic minorities are being failed’. I have seen how tirelessly my Mum has worked, to seek medical support for her health concerns – turned issues over the years. Initially, her health concerns were disregarded, their delay and misdiagnosis has contributed to its intensification. This has resulted in several procedures, uncertainty, and a reduction in her ability to continue work. A concern initially relegated as minor, almost posed a threat to life. It is disheartening to know that there have been so many people who have suffered, or otherwise lost their lives due to the inequalities that ‘permeate the practice of medicine’. I hope that this article and subsequent investigations, do not only bring awareness for a season but support changes that will last a lifetime!

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