“People don’t fit in neat boxes”

Making sure everyone gets the treatment they deserve is a big job, Melba Wilson tells Mark Brown

“Nobody’s gonna believe me if I’m saying it’s all rosy in the garden for people from black and minority ethnic (BME) communities. I’d be looking like somebody who doesn’t know what they’re talking about. But nor is it serving any purpose to always be painting a negative picture.”

Melba Wilson, head of the national government funded action plan Delivering Race Equality in Mental Health (DRE) is keen to underline what has been achieved in the first four years of the programme’s five-year life span. “It was an ambitious action plan,” she says. “Five years was a short time to expect that we could create a sea change in the way things are done. There’s been a lot of good work coming out of it; getting in touch with people, finding out the stuff from them, doing stuff with them as a result. DRE is concerned with improving services to people from black and minority ethnic communities who use mental health services.”

Five year plan

The five-year Delivering Race Equality in Mental Health programme (DRE) was set up in January 2005, partially in answer to recommendations made after the death of David “Rocky” Bennett, a young black man who died on 31st October 1998 after being restrained, face down, by at least three mental health nurses at the Norvic Clinic in Norwich. The independent inquiry team headed by retired judge, Sir John Blofeld, delivering their report in 2004 found evidence of institutional racism in mental health services and made a number of recommendations about the ways in which services could better meet the needs of people from BME communities. Building on these recommendations, DRE has carried out research, funded 500 officially sanctioned community activists known as Community Development Workers and 500 researchers, supported and developed 80 engagement projects and explored the needs of people from BME communities in regards to mental health (see page 25 for a week in the life of a Community Development Worker).

Working with communities

“If you’re a mental health service user, you can be from a BME community and face stigma and discrimination in that community because you have a mental health problem,” says Wilson. “My job in leading a programme like this is to work with communities both about creating a greater awareness within the community about mental ill health but also enabling vulnerable people to get the care that they need, when they need it.”

At 61, Wilson is a veteran of struggles for equality, both within mental health and within racial equality. Her work with DRE has brought both of these things together and she is proud of its achievements so far: “I think one of the biggest changes is that because there’s been a programme called Delivering Race Equality in Mental Health, you’d be hard pressed to find anyone who didn’t think that they needed to address this in some way. We have contributed to the thinking about how services can be adapted to better meet the needs of people from BME communities.”

“What people from diverse communities say is that when they go into services they feel afraid,” says Wilson. “They don’t feel they’re listened to and quite often people say they’re poorly understood. That means they get a diagnosis that they don’t think works for them and get medication and treatment intervention which also doesn’t work. Often people from BME communities enter a service at a point of crisis. They’re vulnerable, they’re confused. They may or may not have family involvement. They can feel that decisions are being taken over which they have no control and over which their family or their friends have no input either. My job is to try and make the communication between people who use services and people who provide them easier.”

An issue for everyone

Wilson is robust in making the case that there should be specific work to make sure that people from BME communities get the care that they need. She says: “If you’re in the south west, in Cornwall or Devon, people ask ‘why have a programme like DRE there? There are no people from BME communities in those areas’. There are black and minority ethnic people all over this country. In those areas there are large numbers of Polish, Portuguese and Chinese communities. The DRE programme covers a range of communities from refugees and asylum seekers to the principal minority communities, to Irish or people of Mediterranean descent.”

Wilson sees equality as an issue that concerns everyone: “People don’t fit in neat boxes and if you’re running a programme which is about reducing inequality in mental health services, you really need to be talking to people about understanding that wide swathe of diversity. There is a heap of difference between how a young African Caribbean man will view going into a service as opposed to how an elderly Asian woman will view going into a service. It’s about helping services to see what gets in the way but it’s also about helping and supporting them to understand what helps as well.”

Obviously proud of the DRE’s achievements, Wilson is aware that no amount of policy will change things if it is not put into practice: “I think you need to be grounded fairly regularly in the kind of nuts and bolts stuff of ‘what does this mean to a person day-to-day?’ Are GPs seeing people from BME communities and if they, are what are they doing for them? Are they referring them to early intervention services? Are they getting assertive outreach? Are they getting psychological therapies?”

Put on the spot and asked to suggest what someone should do if they feel that they might have problems with their mental wellbeing, Wilson doesn’t hesitate to answer: “I think you should expect to go to your GP and chat about how you are feeling,” she says. “Have your GP listen to you and take stock of what you’re saying and discuss with you a range of options for what might be troubling you. You should expect understanding. When you really talk to people, all they’re asking is to be treated as a human. We’re all human beings.”

This article first appeared in the Summer 2009 edition of One in Four magazine

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