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Our Voice: the Pakistani Community's View of Mental Health and Mental

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Our Voice: the Pakistani Community's View of Mental Health and Mental 1 our voice: the Pakistani community’s view of mental health and mental health services in Birmingham report from the Aap Ki Awaaz project © Rethink 2007 2 The CSIP/UCLAN Community The Aap Ki Awaaz Project Engagement Model (Your Voice) The research that is described in this report “Birmingham and Solihull Mental Health Trust are is a Community Engagement Project and was delighted to have had the opportunity to support commissioned by CSIP (Care Services Improvement Ajaib and the community researchers in undertaking Partnership) and UCLAN (University of Central the research associated with the Aap Ki Awaaz Lancashire) in 2006 as part of the Delivering Race project. It is imperative that we listen to what Equality in Mental Health Care (DRE) strategy. communities have to say not only about mental DRE is an action plan for achieving equality and health but also about the services they receive and tackling discrimination in mental health services this report goes a long way in getting the voice of and draws on three key publications: our local community heard. The whole team have demonstrated a high degree of sensitivity and • National Institute of Mental Health England professionalism in their approach and are to be (2004a) Inside-Outside: Improving mental congratulated on the way that they have engaged health services for black and minority ethnic the local community on this very important issue. communities in England. National Institute for I am confident that while this particular piece of Mental Health England. work has been concluded the partnerships and • Blofeld J (2003) Independent inquiry into the collaboration it has brought together will continue death of David ‘Rocky’ Bennett. HSG (94) 27. to thrive”. • Department of Health (2003) Delivering Race Lakhvir Rellon Equality: A Framework for Action. London: HMSO. Director of Diversity, Birmingham and Solihull Mental Health Trust The UCLAN Centre for Ethnicity and Health model describes how a Community Engagement project must have the community at its very heart. “Aap Ki Awaaz Project is a true reflection and There are three principle features: demonstration of the strength of the DRE building • It is essential to work through a host community block around engaging communities. It is a organisation (in our case Rethink) demonstration of real life engagement, where it is the community talking to the community; in their • The host organisation must have good links to own language, breaking down the big barriers and the target community (in our case the Pakistani engaging with people who are our brothers, sisters, community in one locality in Birmingham) aunts, uncles; our community and family. • The research project should involve members of On behalf of CSIP/ NIMHE West Midlands I am the local community in carrying out the research honored to say a few words to support the crucial project (in our case this was eleven members of voices and journeys that Ajaib Khan has made, both the Pakistani community who became Aap Ki personally and professionally and how well he has Awaaz Project Community Researchers). lead and encouraged a fantastic and dynamic team of community researchers. This report and project is just the beginning of the journey where under the guidance of Rethink, we can continue to work to improve mental health care and services for our Pakistani Muslim brothers and sisters now and in the future”. Ranjit Senghera Race Equality Regional Lead, CSIP West Midlands © Rethink 2007 3 Foreword We are delighted to have been able to play a part in the community engagement project that has led to the publication of this report. The Aap Ki Awaaz Project shows the difference that research grounded in the real-life, day-to-day experiences of people can make. There are important findings throughout the report, These appear serious barriers to better mental which deserve careful thought and reflection – health, but other findings suggest they are backed up by concerted action from all of us surmountable. Respondents expressed positive who are concerned with improving our personal, personal views toward people who have community and society-wide mental health and experienced mental illness and the hope that people well-being. could recover with the right support. These are strong foundations. We may not be surprised by some of the findings, for instance, that the stigma of mental illness is a barrier People who speak out about their mental health to better mental health in the Pakistani community – experiences are powerful agents of change and as it is everywhere, or that more culturally sensitive there are strong indications that they will find support services are needed to engage with the community. within their community. These are important confirmations of evidence amassed from across mental health and all our As a membership charity that provides services communities. They are part of the reason why the across England and Northern Ireland, we are Department of Health’s Delivering Race Equality committed to ending stigma and discrimination work is so important. through the work we do every day. This report will help us to achieve our commitment. But many of the findings are new, thought-provoking, worrying at times, but also full of opportunity for us all to engage meaningfully with the breadth of issues that affect the mental health experiences of people from the Pakistani community. We must be concerned that so many people Paul Jenkins told researchers that negative portrayals of the Chief Executive, Rethink Muslim faith impacted on their sense of mental health. Almost two-thirds of Aap Ki Awaaz Project respondents said that mental illness was not culturally accepted in their community, while many reported a sense of fear and shame and a desire to keep mental illness secret. © Rethink 2007 4 Summary The research in this report was carried out by a group of community researchers in the West Midlands who were supported by the CSIP/UCLAN ‘Community Engagement’ programme. The research topic was chosen to support the work of a Rethink community development programme seeking to raise awareness of mental health issues and assist mainstream services to better engage with the Pakistani community. The project became known as the Aap Ki Awaaz Project (Your Voice) and was one of 40 community projects who took part in the CSIP/ UCLAN programme 2006/07. Background Results The aim of this research was to explore the Pakistani We carried out 152 interviews with members of the community’s view of mental health issues, and Muslim community. understand how individuals would like their mental health needs supported by service providers. This Individuals provided positive personal views of topic was chosen by the research team as one mental illness: that could contribute in practical terms to better • 88% felt people can recover from mental illness engagement and improvements in the mental well- being of the Pakistani community. • 82% would try to understand the person and their illness • 77% would sympathise with the person Methods • 67% would talk to the person Through the community engagement programme, • 61% would respect the person the group of eleven community researchers carried out face to face interviews among the Pakistani “Mental health is key health. If it’s good you can community, ran focus groups with service users and implement your religious and social activities carers, and distributed a postal survey to mental effectively, with positive outcomes” health service providers locally connected to the project based in Birmingham. “Good mental health is everything. If it deteriorates it not only affects one person but all those linked to It is important to highlight that the study sample you become upset” does not claim to be representative of the Pakistani community’s view of mental health (dimaghi sehat) These views however are contradicted by and mental illness (zehni bemari). However, the study respondents views of the Pakistani community provides a clear reflection of important issues in the view of mental illness (zehni bemari): community, which compliment findings from other • 83% believe the Community want to keep it secret research studies, and highlights action points for both • 78% believe the Community are ignorant of it the community and service providers to build upon. • 76% believe the Community are ashamed of it • 69% believe the Community think it is magic and possession • 58% believe the Community fear it © Rethink 2007 5 “Our community is not aware of even better health, few people accessed them from the Pakistani so mental health is far away from their thinking” community rather than poor quality of provision or lack of cultural sensitivity. However when asked “A taboo issue. We don’t like to talk about it, we never what services people would like it was locally based, mention it when someone in the family is suffering” culturally sensitive, multi-linguistic provision. We asked about perceptions and influences on mental wellbeing. Conclusion • 74% felt culture and family traditions within the Pakistani community impact upon We found that there is fear, shame and secrecy perceptions of mental health surrounding mental health issues among the Pakistani community in Birmingham. We also found • 64% felt mental illness is not culturally that the current perception and media publicity of accepted in the Pakistani community Muslims in Britain is affecting mental health and • 61% felt current perceptions and media well-being in the community. The research team publicity of Muslims is affecting their mental make several recommendations. The challenge is health and well-being for the Pakistani community to engage with efforts to promote mental health awareness and well-being We also asked about views of mental health within the community, and for service providers to services: 52% were not aware of any local mental step up efforts to provide more culturally sensitive health service provision.
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