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Director of mental health to lance the 'festering abscess' of institutional racism

Exclusive by Matilda MacAttram
19/8/2005

Professor David Sallah, the UK’s first Black director for ethnic mental health services is resolute in his commitment to driving through reform despite health campaigners' fears that the Government’s handling of new Mental Health Bill will undermine his work in improving services.

Professor David SallahIn a recent interview Professor Sallah talked about his plans to stamp out the ‘festering abscess of institutionalised racism’ that was highlighted in the David Bennett Inquiry report in his role as director of NIHMHE’s (National Institute for Mental Health in England) BME health programme.

‘I was under no illusions that this work wouldn’t be challenging when I took up this post,’ Sallah admitted in response to the latest developments on the Mental Health Bill. ‘But both the Government and professionals in this sector know that it is imperative that we see a reduction in the common negative experience of Black services users. Part of my role is to have targets in place to ensure we have real improvements and real change.

quoteThe Government and professionals in this sector know that it is imperative that we see a reduction in the common negative experience of Black services usersunquote

His comments come amid furore over the Government’s time tabling for the Bill, which is scheduled to be debated in the House of Commons this autumn.

Health experts have condemned moves to rush through the Bill without a proper Race Impact Assessment (RIA) and consultation with the community. Slammed as racist when it was published last September, human rights and race equality champions are concerned that without major changes to the Bill it will lead to more African Caribbean’s being forced into psychiatric care.

While well aware of these developments Sallah has determined to focus NIMHE’s resources on redressing the current DOH statistics which show that Black people make up almost of third of patients in medium secure services and a fifth in high secure despite making up less than 4% of the population. African Caribbean’s are also six times more likely to be sectioned than their white counterparts’ despites similar rates of ill health.

‘The three principles we are basing our work on are to improve access, the experience and aftercare of African Caribbean’s who use mental health services and we plan to do this in various ways.’ Sallah explains.
‘To reduce the numbers of Black people within psychiatric care there needs to be greater health awareness in the community. That way it will be easy to recognise the early warning signs if a friend or relative falls ill.’ Distrust of mental health services has meant that many in the community will not approach services until their condition is critical and then they end up sectioned and treated at the harsh end of psychiatry.
‘Funding for 80 community development projects will be a key part of the resources that promote mental health awareness in the community. We know that the earlier a condition is caught the better it is for the patient and these projects and the appointment of 500 community development workers will begin to make this happen.’

quoteThe three principles we are basing our work on are to improve access, the experience and aftercare of African Caribbean’s who use mental health services and we plan to do this in various waysunquote

Sallah is well aware that the reluctance of African Caribbeans to use mental health services because of the stigma association with mental illness, but that is only part of the problem.
Black people more likely to be misdiagnosed, over medicated and forcibly restrained when in hospital and this Sallah acknowledges means that there needs to be fundamental changes in the way professionals work if his target of ensuring an equitable service for all is to be met by 2010.

‘In the Delivery Race Equality programme that I am leading, there will be extensive cultural competency training programme for all NHS mental health staff, from consultant psychiatrist to carers and cleaners.’ Sallah assures me. ‘We want to train everyone who works in this sector to have a greater understanding of the communities they serve.’

The outcry which followed publication of the Bennett Inquiry Report into the care and treatment of David Bennett who died after he was held face down by five psychiatric nurses for almost half an hour sent shock waves to the very heart of the establishment exposing to the nation inhumane way Black mental health patients are all too often treated.

As a panel member on the Bennett Inquiry Sallah has been personally touched by this, he told me: ‘sitting on these panels is not a nice experience. It is very distressing, to be honest.’ ‘To listen to patient’s relatives who just want answers to what has happened, and then on the other hand you have the professional staff who will say to you that they have done the best that they could. It is very hard to have to work through all of that.’

Obviously one of the driving factors behind him taking up this job he added: ‘I am determined to make sure that no other family has to go through what the Bennett family did, with good practice this sort of tragedy can so easily be avoided.’

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Resources:

pdf The recruitment and retention of BME staff in the NHS

pdf Race Equality Foundation briefing: The impact of racism on health inequalities

pdf Race Equality Foundation briefing: Effective communication with service users

pdf Race Equality Foundation briefing: Improving the quality of palliative care

MIND: Rights Guides

pdf BME Needs Assessment: Diabetes and Hypertension

pdf Independent Inquiry into the death of David Bennett

pdf Draft Mental Health Bill

Links:

Nightingale Declaration

hyper GUIDE to the Mental Health Act.

MyHealthnet

Black People's Mental Health Association

Cancer Black Care

Black and Asian Therapists Online

African HIV Policy Network

National BME Mental health Network

The Afiya Trust

BMESpark

Fanon Care

The Federation

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