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The mental health of Chinese people in Britain: An update on current literature
Journal of Mental Health
Abstract
Research evidence concerning the mental health (including learning disability) of the Chinese population in Britain is much more limited than for other British ethnic groups. Chinese people do not have higher rates of psychiatric disorder but are underrepresented in service uptake on account of poor access. This is due to inadequate linguistic support in dealings with mainstream professionals, a lack of culturally competent practitioners and poor community awareness of mental illness issues. Information for service users and their carers in accessible Chinese is very limited. Younger Chinese people show partial identification with mainstream British society and experience of racism is pervasive. It is suggested that services for Chinese people are best developed through community organisations involving culturally and linguistically competent mental health practicioners linked to mainstream services and trained community workers.
... In the same study, although 70 per cent of the sample experienced some form of racial discrimination, only 4 per cent reported facing extreme distress from such discrimination. The low uptake of mental health services by British Chinese was found by Cowan (2001) to be because of inadequate linguistic support, the cultural incompetence of practitioners, inaccessible outreach and poor community awareness of mental illness issues. This is why the MCTC was seen as valuable, and both therapists and our clients keenly felt its loss. ...
... The stigma of mental health diagnosis was also found to increase social isolation for British Chinese and increase the distress for their caregivers (Knifton, 2012). Cowan (2001) stated that young British Chinese may suffer emotionally because of their partial identification with mainstream British society and pervasive experiences of racism. British Chinese students and their parents said that their experiences of racism were a result of seemingly positive stereotypes of British Chinese (for example, clever and hardworking), which often attract unwanted attention and racist labels (Archer and Francis, 2006). ...
... The Chans could relate to some of the struggles described in Tran's (2009) study: the social stigma of mental illness made them shy away from frequent interactions with the Chinese community in London. However, they were able to embrace the British way of receiving therapeutic support, which was in contradiction to the study on the underutilization of such support by the Chinese population found in the national statistics in the UK (Cowan, 2001). According to the Chans, it was our (the therapists') Chineseness that helped them to be more willing to engage, even though we as therapists see ourselves differently and come from very different Chinese societies and values to them. ...
This paper describes a reflective space created between two Singaporean Chinese systemic psychotherapists and a British Chinese family – the Chans. The family attended the Marlborough Cultural Therapy Centre (MCTC) in London and was given two separate culture‐specific systemic treatments by different therapists, which were reflected upon collaboratively with the Chans. A brief literature review of British Chinese and mental health, culture and reflexivity is described. The authors discuss clinical implications including the impact of British Chinese cultures and the effect of mental health issues on the family. The process and outcomes of the treatment are explained using the frame of reflexivity. Clinical implications discussed include the impact of British Chinese cultures and the effects of schizophrenia and anxiety on the family.
Practitioner points
Reflexivity is an interactional process creating change through repeated awareness, reflection and action related to our similarities and differences
This process may helpfully guide practitioners through therapeutic journeys
Reflexivity is especially important when considering both similarities and differences – even when the therapist is working with clients from a similar (ethnic) culture
Involving clients in the writing process enhances reflexivity for both therapists and clients and in itself can be thought of as a further intervention
... International research reports that migrants, refugees, and ethnic minority groups are less likely to, and report greater difficulty in, accessing or receiving appropriate health care (Armstrong & Swartzman, 2001;Betancourt & Cervantes, 2009;Cowan, 2001;Cummings & Druss, 2011;Garrison, Roy, & Azar, 1999;Murray & Skull, 2004;Pirkis, Burgess, Meadows, & Dunt, 2000;Whitley & Lawson, 2010). As these difficulties result in poorer health treatment and health outcomes, focus should be placed on improving timely access to mental health services (Snowden, Masland, Peng, Wei-Mien Lou, & Wallace, 2011). ...
... The current results are consistent with previous findings that migrants of ethnic minority status report poorer mental health service utilisation compared with ethnic majority patients living within the same geographical region. Similar findings are reported globally, (Cowan, 2001), to African Americans in the USA (Whitley & Lawson, 2010). The current study uniquely assessed two concurrent ethnic minority populations in order to highlight differences in service utilisation, which may occur within the same geographical area. ...
The current research aimed to assess the association between country of birth and use of a specialised mental health service in Sydney, Australia. Patient file data were analysed from individuals who accessed the Clinic for Anxiety and Traumatic Stress in Western Sydney between 1996 and 2010. Patients had undergone a clinical assessment and research interview prior to receiving treatment. Data on demographic information and health history were extracted from these files. South East (SE) Asian- and Middle Eastern-born minority groups were compared with an Australian-born majority group, using country of birth as a proxy measure of ethnicity. Ratios of service use by group were compared with data on ethnicities residing within the local government area health district. Relative to the local population, country of birth minority status was associated with fewer patients accessing the service, with SE Asian-born patients reporting low service use across all cohorts studied. However, Middle Eastern-born patients' service utilisation increased over time, becoming commensurate with the local population. Middle Eastern-born patients reported a significantly shorter delay to seek treatment compared with Australian-born patients, although no significant differences were reported between ethnic minority groups. Differences between SE Asian- and Middle Eastern-born groups in service utilisation patterns over time and treatment delay relative to an Australian-born group highlight the importance of better understanding the impact of ethnicity on service use.
... The topics relating to services includes: primary care and health checks (Chauhan et al., 2010;Nocon, 2008); mental health and access to mental health services (RCPsych, 2011;Durà--Vilà and Hodes, 2012;Chaplin et al., 2010;McCarthy et al., 2008;Cowan, 2001); housing services (Institute of Public Care, 2010); satisfaction with social care services (Valdeep et al., 2014); evaluation of voluntary services (Rawlings, 2010;Maudslay et al., 2003); barriers to advocacy (Flynn, 2010); accessibility of autistic services (Perepa, 2007); access to services for new migrant communities (Wightman, 2012); improving services (Hatton, 1997 -South Asian;Nadirshaw and Sowerby, 2009;Tonkiss and Staite, 2012;Caton, 2007;Cole and Burke, 2012;Poxton, 2012); and cultural competency (Summers and Jones, 2014;O'Hara, 2003). ...
... China has provided the most immigrants in UK than any other countries since 2013 (Dominiczak, 2013). Despite its large population, many Chinese immigrants are faced with stigma, language barriers and a lack of support (Cowan, 2001). A survey found that close to two-thirds of British people disagree that immigrants could claim welfare benefits until they stay within the European Union for more than three years (The Guardian, 2014). ...
Whether and how immigrants are included in the host society has become a hot topic in the context of globalization. How inclusive a society is for immigrants can be answered by comparing the inclusion of immigrants to near-culture host society and those to a different-culture society. This paper reports the social inclusion and their correlation with health conditions among Chinese immigrants in Hong Kong and the United Kingdom. Two non-probability sample surveys were conducted using the Social and Communities Opportunities Profile and its Chinese version as survey instruments. Altogether 56 new arrivals in Hong Kong and 51 immigrants in UK were recruited through NGOs to participate in face-to-face individual interviews. Both Hong Kong and UK participants reported high overall social inclusion. The two sub-samples shared many similarities in the perceived opportunities and satisfaction of opportunities in various social domains. There was evidence that immigrants in a host society with similar language demonstrated higher perceived satisfaction with opportunities in contact with friends and family, as well as higher perceived opportunities for community involvement than immigrants in a society with a different language. However, overall social inclusion appeared to be independent of one’s health conditions.
... Minority cultural groups show poorer health status overall as they are less able to access or receive timely, adequate care (Armstrong & Swartzman, 2001;Cummings & Druss, 2011). Poor community awareness, inadequate linguistic support and a lack of culturally competent practitioners results in difficulty accessing appropriate services for ethnic minorities in the UK (Cowan, 2001). In the United States the growing disparities in care across different ethnic groups highlights a need for crosscultural medical care, particularly in regards to crosscultural communication (Betancourt & Cervantes, 2009). ...
Communication between cultural groups, termed intercultural communication, is often difficult or not successful within a mental health setting. It is important to gain a greater understanding of intercultural communication, in order to provide appropriate treatment and care. This literature review first defines what is meant by intercultural communication, before examining the literature on the intercultural dynamics that must be considered when working cross-culturally within a mental health setting. Particular focus is given to the clinical interview, as it is the key mode of communication within therapeutic practice. Intercultural communication is a dynamic process, and to be effective many socio-cultural factors must be considered. Theoretical models of effective intercultural communication within a health context highlight the need for clinicians to possess cultural knowledge and communication skills; however, the utility of such models is yet to be assessed. The research suggests that cultural competency training is one method to promote more effective intercultural communication within a mental health setting, with cultural adaptations to therapies and assessment tools shown to increase communication effectiveness.
... Background. The Chinese community has a long history of settlement in the UK, and currently represents the third largest minority in Britain (Cowan, 2001). In common with other BME communities, the social inheritance of health is significant for many Chinese elders (Butt and O'Neil, 2004;Tribe et al, 2009). ...
Community participation and engagement are now meant to be at the heart of health and social care services. In 2008, the National Institute for Health and Clinical Excellence (NICE) developed guide¬lines entitled Community Engagement to Improve Health (National Institute for Health and Clinical Excellence, 2008). However, although these guide¬lines do recognise that many black and minority ethnic (BME) communities often have specific needs, they do not offer detailed advice on how to consult with these diverse communities. Therefore, while health organisations and providers are increasingly recognising the value of community engagement, health practitioners often lack experience of this process and may not know how to start or progress it. This practical guide to community consultations with BME groups builds on the NICE 2008 guide¬lines on how to conduct community engagement. The recommendations have evolved as part of an iterative and critical learning process through the authors’ experiences of consulting with a range of BME community groups over many years. Although this guide is certainly not definitive, it is hoped that it will encourage the development of positive prac¬tice to ensure that the voices of BME community members and other under-represented communi¬ties are heard and integrated into the development, planning and delivery of health services, to help to create more inclusive and person-centred services.
... RCP, 2003;YoungMinds, 2006) and the PRC (e.g. Yip, 2005;Zou, 2006) has indicated that young people living in both countries are known to be at risk of a similar range of mental health difficulties (Cowan, 2001). However, Chinese people, rather than their British counterparts, are thought to be more likely to present with more severe and enduring mental health problems when they first approach mental health services (Li & Logan, 1999;Yip, 2005). ...
Aim: In this study we aimed to investigate whether Chinese international and British home students at a university in the United Kingdom differed in their attitudes towards seeking psychological help. Method: The total sample comprised 323 participants. Participants completed measures to assess their attitudes toward seeking professional psychological help (recognition of need for psychological help, stigma tolerance, interpersonal openness, confidence in mental health practitioners). Results: Chinese students reported significantly less interpersonal openness than that reported by British students. Contrary to prediction, however, no significant group differences were found on any of the other mental health attitudes (i.e. recognition of need for psychological help, confidence in mental health practitioners or stigma tolerance). Within-group contrasts also showed that Chinese students reported lower scores on interpersonal openness than on stigma tolerance and confidence in mental health practitioners. In contrast, British participants reported less confidence in mental health practitioners and recognition of the need for psychological help than reported for stigma tolerance and interpersonal openness. Conclusion: The findings highlight the need for a greater understanding of students’ cultural inclinations toward mental health issues and cultural attitudes that may hinder and/or facilitate students’ access and engagement with psychological services in higher education institutions.
... It is essential to improve family members' understanding of BD and its treatment. This is consistent with other UK-based studies 25,26 who investigated the process of life adjustment in response to migration and found that inadequate linguistic support hindered dealings with mainstream professionals. These studies also found a dearth of culturally competent practitioners and poor community awareness of mental health issues resulting in poor the information being communicated to Chinese people with mental illness and their caregivers. ...
To explore the dynamic between Chinese people with bipolar disorder (BD) and family functioning.
Nine New Zealand Chinese with BD were interviewed. Data analysis was guided by content and thematic approaches.
Four themes summarised from the interviews included: (1) family members are the primary resource; (2) many facets of recovery from BD is integrally linked with caregiving; (3) quality of family relationships is associated with acceptance of the illness; and (4) perception of caregiver burden motivates self-care.
The findings support the need for mechanism that can minimise the risk of adverse family functioning associated with BD and the need of professional involvement when working with these families.
... ''0800 telephone helpline'', ''face-to-face counseling'') and if they would feel comfortable referring a family member or friend to them, Chinese respondents were significantly more likely to answer ''none of these'', while NZ European and Indian were more likely to indicate ''some, but not all of these''. Numerous international studies on problem gambling and mental health in general have demonstrated that Chinese tend to not seek help or delay seeking help from the social support or specialized human services that are available in their communities (Cowan, 2001; Loo et al., 2008; Wang, 2006; Wang et al., 2004). The implications of these findings include: ...
Purpose
The purpose of this paper is to analyse attitudes, understanding of gambling and gambling related harm among Asians in New Zealand using secondary data from the New Zealand 2006/07 Gaming and Betting Attitudes Survey (GBAS).
Design/methodology/approach
This survey interviewed 1,973 nationwide randomly selected youths and adults (≥18 years) using structured questionnaire. Chinese ( N =113) and Indian ( N =122) data were analysed separately to compare between them and with NZ Europeans (N=792). Descriptive analysis was carried out and was subsequently tested for significant correlations by weighted ( p <0.01) and un‐weighted ( p <0.05) variables.
Findings
A higher proportion of Chinese males (66.8 percent) represented in the survey compared to Indian (43.0 percent) and NZ European (48.9 percent) where Chinese consisted of more youthful age structure. Chinese respondents were more likely to be in the lowest income bracket (NZ$10,000) compared to others. Among the ten gambling activities “casino table gambling” and “casino electronic machines” (slot‐style machine) were most popular among the Chinese where Indians preferred “gambling/casino evening”. A significant proportion of Chinese were unwilling to refer family or friends to gambling help services despite believing that gambling does more harm than good. Pre‐committed gambling sum was the most common harm minimising strategy suggested by participants. They believed education and consultation could deter youths from harmful gambling.
Research limitations/implications
This survey highlighted gambling behaviours and thoughts of the ethnic minority population in New Zealand. Study outcomes would be valuable in formulating ethnic specific preventative programme and may have policy implication.
Originality/value
There has been limited research on gambling behaviour of ethnic minorities in New Zealand. This paper fills some of the gaps.
... ''0800 telephone helpline'', ''face-to-face counseling'') and if they would feel comfortable referring a family member or friend to them, Chinese respondents were significantly more likely to answer ''none of these'', while NZ European and Indian were more likely to indicate ''some, but not all of these''. Numerous international studies on problem gambling and mental health in general have demonstrated that Chinese tend to not seek help or delay seeking help from the social support or specialized human services that are available in their communities (Cowan, 2001; Loo et al., 2008; Wang, 2006; Wang et al., 2004). The implications of these findings include: ...
What role does food play in the construction of social identity? The research outlined in this chapter aims to explore whether and to what extent Chinese cultural food influences the social and health dynamics of the Chinese in the UK. The chapter draws on ethnographic fieldwork to explore how food shapes the social identity of British Chinese. The healthy diet and food culture departing from traditional beliefs were found to be heavily influential to the Chinese communities in constructing social identities. Findings in the forms of interviews and observational data reveal an intertwined relationship between the understanding of food and health decisions. A commonly shared belief among the respondents is that they simply do not need to engage as much in the British health system due to a superior lifestyle centralised around the Chinese diet compared to the rest of the UK population. Healthier Chinese eating behaviour based on steamed rather than fried food is considered by the Chinese in the UK to be more advanced than the food in the host UK society. The processual development of Chinese cuisine to gain popularity in UK society since the 1980s formulated an escape point for the Chinese to challenge the power structures enforced by their migration experience. The continuous existence of Chinese takeaway shops developed a sense of group charisma among the Chinese in the UK over time. This chapter provides evidence for the social power of food consumption, diet and cuisine of the Chinese culture in balancing the power differences faced by the ethnic minority. Despite being considered a less socially interactive ethnic minority, findings show that the British Chinese use food as leverage to construct social confidence in the host society.
Background: Chinese international students are the largest group of international students in the UK. Although there is considerable research into acculturation and acculturation stress of these students, little is known about their mental health experiences.
Methods: A narrative review of the literature was conducted looking at literature published between 2009 –2019 in order to learn more about the mental health experience of Chinese international students in the UK.
Results : It is difficult to confirm whether Chinese international students in the UK experience heightened risk of psychological distress, as argued by studies on other countries. However, these students do seem less likely to seek formal mental health support compared to home students, but rather rely more on informal support from friends. While Western mental health models are likely to be favoured by these students, certain cultural beliefs around prevention and cause of mental ill health might be present.
Conclusion : Chinese international students in the UK are diverse and we still do not understand enough about their mental health experiences, which is a concern given the continued growth of their numbers. Caution is necessary when interpreting how some cultural factors are reported. China has undergone vast changes in recent years so drawing on studies that date back too far might not accurately capture Chinese youth today. The literature acknowledges that there will be new aspects to the experiences of mental health of these students, including new societal pressures relating to studying abroad. This paper also discusses gaps in our knowledge and practical steps that can be taken to support Chinese international students’ psychological wellbeing while studying in the UK.
Background:
People with from minority ethnic communities face inequalities in health and health care. This systematic review considers the question of what we know about the health and health care of children and adults with intellectual disabilities from ethnic minority communities in the UK.
Method:
Studies published from 1990 to 2018 were identified via electronic literature databases, email requests and cross-citations. Studies were reviewed narratively in relation to identified themes.
Results:
Twenty-three studies were identified, most commonly focusing on South Asian communities. Very little information was identified on physical health or physical health care, with the identified evidence tending to focus on mental health care, access to specialist intellectual disability services, and inpatient services.
Conclusion:
Little is known about the health status of people with intellectual disabilities from minority ethnic groups in the UK. It is clear that they may experience barriers to accessing specialist intellectual disability services and other forms of health care.
This new edition of Mental Health in a Multi-Ethnic Society is an authoritative, comprehensive guide on issues around race, culture and mental health service provision. It has been updated to reflect the changes in the UK over the last ten years and features entirely new chapters by over twenty authors, expanding the range of topics by including issues of particular concern for women, family therapy, and mental health of refugees and asylum seekers. Divided into four sections the book covers: Issues around mental health service provision for black and minority ethnic (BME) communities including refugees and asylum seekers. Critical accounts of how these issues may be confronted, with examples of projects that attempt to do just that programs and innovative services that appear to meet some of the needs of BME communities a critical but constructive account of lessons to be drawn from earlier sections and discussion of the way ahead. With chapters on training, service user involvement, policy development and service provision Mental Health in a Multi-Ethnic Society will appeal to academics, professionals, trainers and managers, as well as providing up-to-date information for a general readership. © 2009 Selection & editorial matter, Suman Fernando & Frank Keating. All rights reserved.
This paper reports the findings from an online survey that explored the perceptions of 111 leaders within community mental health organizations in Ontario about how responsive they are to the service needs of people from diverse cultural-linguistic groups. The findings show that more than half of respondents said they engaged in 20 of the 27 practices that promote cultural responsiveness. Comparisons of community organizations with different service philosophies found only one difference in terms of engaging in culturally responsive practices. Specifically, the difference was in whether or not staff received ongoing training in how to work with people from the cultural-linguistic groups the organization serves. These data provide a baseline against which progress can be measured toward greater cultural responsiveness in community mental health organizations in Ontario.
Purpose
– Research evidence concerning the mental health of the Chinese population in Britain is much more limited than for other ethnic groups. The purpose of this paper is to get a better understanding of the mental health needs of Chinese children living in the North East of England and their parents’ experiences and knowledge about the mental health services.
Design/methodology/approach
– The authors invited parents from two Chinese language schools to complete the Strength and Difficulty Questionnaire (SDQ) and a seven-question self-report questionnaire.
Findings
– In total, 76 out of 158 questionnaires returned. The mean scores of SDQ were lower than those reported in China, Hong Kong and UK. Only 43 per cent of parents knew how to seek psychiatric help if they suspect their children have mental health problems. Also, almost one-third of the parents believed that language barrier would be an obstacle for them to seek help.
Originality/value
– This is the first study in UK to look at the mental health of Chinese children and young people from their parents’ perspectives. This is also the first study in UK to compare their mental health wellbeing (via using SDQ) with their counterparts in other countries. This study has brought some clarity and new information to light about this ethnic minority group.
This paper discusses the main ideas of the Diversity Based approach to culturally sensitive practices in health and social care services.This approach is important in emphasizing the fluid nature of culture, the diversity in cultural groups and the impact of inegalitarian and racist power relations on their life. Chinese people in the UK are used as an example to demonstrate how exploration of the diversity of ethnic minority groups could strengthen cultural sensitivity. Some methods for the realization of the Diversity Based approach, such as the culturagram and user involvement, have also been highlighted.
This paper studies the problem that health and social care practitioners, intending to satisfy their ethnic minority users’ cultural preferences, end up providing services against their wishes. In particular it points out that this problem is caused by over-emphasising two key assumptions of ethnic minority groups. The first assumption is that all members of the same ethnic minority group organise their health and social care according to their cultural principles. The second assumption is that their cultural principles are monolithic. Demonstrating that these two assumptions may not necessarily be applicable to all ethnic minority groups, this paper discusses the diverse strategies used by Chinese people in Britain to organise their health and social care, and the differences between their two important cultural principles, Taoism and Confucianism. In order to demonstrate to professionals and the Government that they should not over-emphasise these two assumptions and that they need to pay attention to ethnic minority groups’ diverse needs, the paper suggests that different ethnic minority groups may need to unite to increase their influence in the service provision process. However it also warns that this tactic may lead to the subordination of minority group interests in the articulation of those large groups.
Traditional Chinese medicine (TCM) is a rapidly developing healthcare practice. This exploratory case study of the role of TCM reveals how the use of TCM in a Chinese National Healthy Living Centre (CNHLC) raises the visibility of TCM as a Chinese cultural practice and challenges the relationship between ‘traditional’ medicine use and Chinese health inequalities. In this charitable mono-ethnic context, TCM performs a plural function: on the one hand, Chinese ethnicities are a social disadvantage, providing rational justification for a culturally specific TCM service. On the other hand, the Chinese provision and use of TCM ‘fills the healthcare gap’, providing counter cultural means of building Chinese health and social capital in the UK healthcare market.
Sir: In 2005, the Department of Health for England set a five-year action plan, Delivering Race Equality in Mental Health Care. The aim was to encourage the development of services that were more appropriate and responsive to the needs of both adults and children in Black and minority ethnic communities.
The review aims to identify the extent and nature of research on mental disorders and their care in immigrant populations in three major European countries with high levels of immigration, i.e. Germany, Italy, United Kingdom (UK).
Peer-reviewed publications on the subject from the three countries between 1996 and 2004 were analyzed. The research questions addressed, the methods used, and the results obtained were assessed.
Thirteen papers reporting empirical studies were found from Germany, four from Italy and 95 from the UK. Studies addressed a range of research questions and most frequently assessed rates of service utilization in different immigrant groups. The most consistent finding is a higher rate of hospital admissions for Afro-Caribbean patients in the UK. Many studies had serious methodological shortcomings with low sample sizes and unspecified inclusion criteria.
Despite large scale immigration in each of the three studied countries, the numbers of relevant research publications vary greatly with a relatively high level of empirical research in the UK. Possible reasons for this are a generally stronger culture of mental health service research and a higher number of researchers who are themselves from immigrant backgrounds in the UK.
Overall the evidence base to guide the development of mental health services for immigrant populations appears limited. Future research requires appropriate funding, should be of sufficient methodological quality and may benefit from collaboration across Europe.
The Chinese community in the UK has existed since the latter half of the 1800s and traditionally has been perceived as insular and self sufficient (Lynn, 1982). In the 1960s and ‘70s, there was a large influx of Chinese into the UK to work in catering businesses. Many of the children of this generation were born in this country; with this group now in their early adulthood, there is more integration into the indigenous population. However, there is still an impression that Chinese psychiatric patients are under-represented in the services, but as yet, there has been little psychiatric research carried out among the Chinese in the UK. This study examined briefly the level of contact with, and difficulties encountered in, managing Chinese patients by psychiatrists in Merseyside.
This paper examines the psychological reactions towards university transition with cultural relocation. Both personal factors (cognitive failures, locus of control) and environmental factors (perceived academic and social demands) are considered in this specific stressful context. General psychological symptoms and homesickness were measured. Result from a prospective study showed that homesickness is a common psychological reaction amongst Chinese students studying in Britain. This was quite separate from other psychological symptoms, and the two were influenced by different personality and environmental factors.
An excess of psychotic illness in Black people has been found in cross-sectional studies. Little is known about the outcome of psychosis in different ethnic groups in the UK.
To compare the incidence, nature and long-term outcome of psychosis in different ethnic groups.
A five-year, prospective study of an epidemiological cohort of people with a first contact for psychosis.
Age-standardised incidence rates for schizophrenia and non-affective psychosis were higher for Black and Asian people than Whites. Stability of diagnosis and course of illness were similar in all ethnic groups. During the fifth year, Black people were more likely than others to be detained, brought to hospital by the police and given emergency injections.
The nature and outcome of psychotic illness is similar in all ethnic groups but Black people experience more adverse contacts with services later in the course of illness.
Asian Americans are a diverse and rapidly growing group within the US population. The aim of this chapter is to demonstrate how Asian Americans may understand mental health conditions and to help mental health clinicians, educators, and researchers develop a thoughtful and flexible approach to evaluating and working with Asian American patients. This approach will involve consideration of each person’s unique health beliefs, culture, language, family, religion, narrative, genetics, pharmacological history, and relevant life experience. While cultural beliefs and research about particular issues and trends within the population will be reviewed, Asian Americans cannot be treated as a monolithic group.
This article provides an overview of the culture, religion, attitudes and backgrounds of Chinese minority groups living in Britain. It demonstrates the need for greater awareness of Chinese families and an improved system in relation to services for people with learning disability. The paper suggests that more appropriate services should be made available to Greater Manchester's Chinese families which have a member with learning disabilities. Professionals should be more competent to understand Chinese families and to enable them to take advantage of developing services.
Addresses the topic of psychopathology among Asian Americans by reviewing the current state of research on Asian Americans, which, in many respects remains quite limited. For heuristic purposes, the authors propose a multicomponent model for the analysis of psychopathology among Asian Americans. The components of this model include (a) Vulnerability, (b) Experience, (c) Manifestation, and (d) Prevalence. In positing a Vulnerability-Experience-Manifestation-Prevalence model, the authors have delineated 4 common components of psychopathology to examine the importance of cultural and minority group factors in each component. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Synopsis
The present study compares the efficacy of the GHQ-12 and the Chinese Health Questionnaire (CHQ–12) in Cantonese speaking Chinese primary-care patients living in Greater Manchester, using relative operating characteristic (ROC) analysis. We did not find that the Chinese version offered any advantage over the conventional version of the GHQ in this population. Stepwise discriminant analysis however confirmed the value of individual items in the former pertaining to specific somatic symptoms and interpersonal relationships in differentiating cases from non-cases. Information biases, arising from the lack of a reliability study on the second-stage case identifying interview and the unique linguistic characteristics of the Chinese language may have affected the overall validity indices of the questionnaires. The study also examines the effects of using different criteria to define a case, and shows that with increasing levels of severity, there is an improvement in the diagnostic performance of the two questionnaires as reflected by areas under ROC curves and traditional validity indices. Possible explanations of these findings are discussed. The scoring method proposed by Goodchild & Duncan-Jones (1985) when used on these questionnaires had no demonstrable advantage over the conventional scoring method.
A three-month prospective collection of primary care data from general surgery attendances in an inner London Health District was carried out to inform the setting of contracts for psychiatric services. This involved 21 general practitioners (GPs) selected from a total of 102 in the District. Information was collected on mental health disorders detected by GPs among the attenders, the resultant volume of care provided by the GPs, the referrals made to secondary care and other agencies, and the types of care identified by the practitioners as appropriate for a patient but which are currently not accessible or available. We found that 45.9 per cent of all patients (17,319/37,733) registered with the 21 GPs were seen in three months. There was an overrepresentation of White and Black Caribbean patients and an under-representation of Bangladeshi, Chinese, Black African and Black Other patients in the study population. Mental health disorders were detected in 13.3 per cent (2304) of all attenders. The commonest problems were depression (17.7 per cent), acute stress reaction (15.5 per cent), anxiety (15.1 per cent), drug abuse (7.2 per cent), schizophrenia (5.8 per cent) and alcohol abuse (5.3 per cent). It was found that 37.3 per cent (860) of all attenders received medication, 66.5 per cent (1532) were counselled by the GPs and only 4.4 per cent (102) were referred to a psychiatrist; 16.3 per cent (375) of those with mental health disorders were identified by the GPs as having a service need which the District's psychiatric service could not meet.(ABSTRACT TRUNCATED AT 250 WORDS)
The psychological health and adjustment to life in Britain of a sample of first- and second-generation Chinese immigrants were measured. It was predicted that problems with the English language, inadequate social support, value differences, and unfulfilled expectations would induce more symptoms of psychological distress and depression in first-generation than in second-generation Chinese immigrants. Overall psychological health, and hence adjustment, was good. There was evidence for language problems and unfulfilled expectations, but not social support and value differences, being linked to mental health in the second generation. Evidence linking mental health to other personal variables was found in both generations.
This UK-based study compares the pathways to the psychiatric hospital and the provision of in-patient and after-care for Asian, black and white patients with non-affective psychoses.
Two overlapping samples of 120 patients, 40 from each ethnic group, were drawn; one on admission and the other at discharge. In addition to socio-demographic data, details were obtained on the pathways to care and the in-patient episode. An assessment of needs and service provision was undertaken 3 months post-discharge. Patient satisfaction was ascertained at each stage.
Asian and especially black patients experienced more complex pathways and had higher levels of both involvement with the police and compulsory detention than their white counterparts. They were less likely to perceive themselves as having a psychiatric problem or as needing to go into hospital and expressed less satisfaction with the admission process. Black patients, as compared to Asian but especially white patients, were more often detained in hospital against their will, confined to the ward and treated within a secure environment. However, there were few differences in satisfaction with hospital care. Likewise, perceptions of unmet need, provision of after-care and satisfaction with services were similar across the ethnic groups.
The implications of these findings are discussed. The potential of early intervention programmes and home treatment services to address the ethnic differentials identified in this study merit consideration.
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