Recently I took up the post of Development Manager for a Physical and Mental Health Project in Handsworth. On 16th November we held a Health Conference at the Community Fires Station in Rookery Road. Some 50 people attended. Below is the Report.
Report of the Health Conference
Introducing the Physical and Mental Health Project of the Asian Rationalist Society (Britain), Birmingham Branch, 16th November, 2004
1. Introduction Lavkesh Prashar, President, Birmingham Branch, Asian Rationalist Society (Britain) and Chairperson of the Health Conference.
I was pleased to welcome some fifty people to our Health Conference, the first major event arranged by the Asian Rationalist Society (Britain), Birmingham Branch, Physical and Mental Health Project. This was held to present the work of the project, based at 162 Rookery Road and to consult on future priorities.
The Report is both for participants and those unable to attend. It was very good to note that there were so many at the Conference from the Health and Social Care Services and other agencies we work with, as well as potential partners in the schemes we are considering. A feedback form was given out from which we received some helpful responses. We are very grateful for them. The form is also attached to this report and I would welcome any additional comments.
The Asian Rationalist Society responded to the initiatives taken through the Strategic Partnership set up by the major service providers: Birmingham City Council, with the Statutory Health and Police Authorities. This is intended to deliver services more effectively for local needs. This process is progressing along with devolvement of power to district and ward level. The Heart of Birmingham Primary Care Trust saw an opportunity to work closely with communities locally to begin to break down the persistent inequalities in health awareness and care. The Physical and Mental Health Project was set up from September 2003. It is often stated that the Voluntary Sector, involving local agencies, is well placed to identify need, and the Asian Rationalist Society has an understanding of the cultures and languages of the South Asian Community. Effective counselling comes from an appreciation of the background and experiences of service users. Having said that, I must emphasise that all are welcome to use the service, or just drop in to our office in Rookery Road. There are leaflets and videos on health issues, of benefit to those who suffer, or are at risk from heart disease, diabetes and mental illness.
The Conference began following lunch. Guests were met for registration by
Manjit Kaur, ARSB Administrative Worker. Other members of ARSB Management and Staff were introduced. We hope you enjoyed some healthy food and had a chance to talk to other participants.
2. Statistics of Asian Peoples’ Mental and Physical Health in Britain and how the voluntary sector can liaise with the PCT (NHS) to improve services
Dr Harish Mehra, National Secretary of ARSB, presented statistics showing the continuing inequalities in access to health care experienced by black and minority ethnic groups. He referred to research by Ann Davis and Rosemary Littlechild who stated:
“There is an element of unrecognised and untreated psychiatric morbidity in South Asian communities and suicide rates are low among men from the Indian sub-continent but they exceed the national rates in women greatest among the young, the rate in Asian girls aged 15-24 being 60% higher. Young Asian women also have high rates of attempted suicide and are clearly a high risk group in terms of Health of the Nation targets for reducing suicide.” (Davis and Littlechild, 1996)
The research acknowledged the following factors as significant:
• Social relationships and isolation
• Employment status
• Housing and financial circumstances
• Life crisis and prevention of relapse
• Gender, ethnic and social background
To these Dr Mehra added factors which specifically affect the South Asian communities:
• Personal belief and value systems based on myth and superstition
• Physical, financial and sexual exploitation by bogus faith healers
• Lack of knowledge of the British system, rights and legislation.
His own research conducted 3 years ago for Birmingham Social Care and Health Services, confirmed the earlier findings. He concluded that voluntary organisation projects serving minority communities should have stable mainstream funding from statutory agencies.
3. Health Priorities in Birmingham and Community Involvement
Dr Vinod Singh, Consultant Psychiatrist based in Handsworth said that the presentation of statistics had made his talk easier. There was a pattern of mental health across the globe with comparable incidence of serious mental illness. This arose from heart disease, depression, and anxiety. What is different, however, is the way the system in the West responds to people from other countries. There are serious gaps in health service provision which successive governments have failed to address.
By 2010 he predicted that depression would overtake the incidence of heart problems in the South Asian Population. By 2025 diabetes would be the commonest ailment across the globe. He had worked in the mental health services for 20 years and found that 6% more people prone to mental health problems during that time. Black and Asian people were 6 times as likely to be sectioned as the white population. The ability of personnel in statutory agencies to understand Asian languages is problematic. Dr Singh gave the example of how a woman coming from the Panjab could find herself in the situation in this society where her language or culture would not be understood and she would face extreme isolation. In one case such a person was sectioned in the middle of the night and taken to a police station. There the consultant could not understand her and she had to be transferred to a hospital to continue the diagnosis. He said that it was estimated that 45% of people visited their G.P. with a psychiatric disorder but missed getting a psychological prognosis. There was also a psychosomatic dimension to heart problems.
Dr Singh welcomed the Physical and Mental Health Project’s work. He felt strongly that organisations outside the statutory services were playing an essential role in filling the gaps he had described. He looked forward to working closely with us assuring us of his support.
4. Background of the Asian Rationalist Society
Shingara Singh Gahonia, from the Indian Workers’ Association in Derby spoke about the background of the Asian Rationalist Society. He was instrumental in setting up the Health Project. This had been done because of a deep concern about a lack of understanding of health issues and commonly held beliefs, particularly among Asian Communities. It was often believed that ill-health, especially mental illness, may be connected to curses, black magic or Karma theory. They need to understand that there are scientific/clinical reasons and that it is possible to take steps to both prevent and cure ill health. The society opposed those who sought to exploit irrational belief by advertising worthless remedies, while charging exorbitant sums to those who could least afford it. As a result they could well miss out on getting the medical attention they urgently need.
5. Health Promotion Activities in the Physical and Mental Health Project
Tari Atwal, ARSB Physical and Mental Health Project Co-ordinator, explained in detail the current services available and ways in which a healthy life-style is being promoted. He explained that this was in partnership with the NHS and Heart of Birmingham teaching Primary Care Trust. While counselling and therapeutic treatment for mental health problems was at the heart of the work, health promotion included exercise (e.g. a weekly 2 km walk as part of the Walk 2000 initiative), and provides information on healthy eating. The Counselling/Therapies Service provides help with stress management, advice on diabetes and heart disease, and presentations are available from the NHS, the Heart Foundation etc. Counselling services are available at weekends by appointment.
6. Address by Councillor Talib Hussain
Councillor Talib Hussain, Cabinet Member for Local Services on Birmingham City Council, was invited to speak. He felt it important to say clearly what is wrong with and get together to serve the community. NRF funding was available for some of these activities. We need to say what the day to day difficulties are. He emphasised the human need for services we were providing irrespective of faith or cultural background, and felt it was important that they should be available to everyone.
7. Future Developments of the Project
John Tyrrell, Development Manager of the ARSB Physical and Mental Health Project, spoke about a range of priorities which needed addressing. The aim was to look at major issues addressed by the Health Authorities and other agencies which identified gaps in service provision. They all refer to the urgent need to combat persistent inequalities in access to health care and appropriate treatment. Some of these could be prioritised in the development of the Physical and Mental Health Project.
We responded to the consultation report of the Birmingham and Black Country Strategic Health Authority report “A Wider View”. They noted the differences between those who are able to manage their own health and act as health promoters and those unable to access information. We agreed with this view adding that we were in position to help, the Asian community in particular because of a deep knowledge of culture and language. The report also refers to the fact that race inequality is closely associated with health. As the presentation notes there are acknowledged inequalities in access to health care and in treatment given.
Reference was made to Dr Mehra’s statistics about women from South Asian community being at risk. The Government has recognised and set this issue as a priority. We wish to respond.
The report “Mental Health and Social Exclusion” from the ODPM (June 2004) is emphatic that employment is a route out of social isolation which can be so damaging to mental well-being. MIND also produce a resource pack for employers to help them understand mental health issues and help those who need support back into employment. This is clearly an issue, which needs addressing, and we considering a project in partnership with other voluntary organisations.
8. Questions and Answer Session
In the feed back session there were probing questions about the quality of service ARSB could give. Reassurance was given that only those qualified would give treatment and that it was not an alternative to medication if individuals had been prescribed that treatment by their G.P. General Practitioners in the area have been contacted and some are referring patients to us. Methods used for counselling were supported by authoritative sources. A view was put forward that we were attempting to do what the NHS should be doing. If a patient needs to be referred to an NHS service then that will happen. However if it is not necessary and treatment is appropriate pressure can be taken off statutory service providers. By promoting healthy activities and diet, and by informing people of ways in which they can help themselves stay healthy or manage their own and their family’s health, services can become more effective for those in need of specialist care.
Raj Joye, Mental Health Commissioning Manager in the City Council’s Social Care and Health Department, said that he welcomed the fresh approach that this organisation was bringing to mental health. It is good to see a perspective that was lacking. The service is innovative and that is why the Social Care and Health Service is working with the organisation to give support in building its capacity to be effective.
Dr Anna Frankel, Senior Regeneration Manager from Heart of Birmingham tPCT represented Dr Jacky Chambers. She congratulated ARSB for an interesting programme and emphasised how important the work is. It needed to be reiterated yet again to those working in the NHS the need to listen to what people in the community were saying. The Strategic Partnership between City Council, the Health Service and other agencies had provided an opportunity to engage with communities, but she felt that services available were neither adequate to meet need, nor were there effective structures in place to engage local organisations and communities. There was a need to formalise these to create opportunities for the NHS to do this.
Harman Banger from Victim Support felt that the Police Authorities were more advanced in ensuring that the voluntary sector played a key role in service provision. He felt that the Health Service could use this as an example of good practice.
9. Written responses- results from 25 returns1. This area needs more attention
2. The emphasis is about right
3. This is not important
1. 2. 3.
Promoting a healthy lifestyle 13 11 1
Organising activities 16 6 3
Counselling therapy 17 4 3
Opposing those who exploit beliefs 12 5 5
Priorities for development:
Targeting women’s health needs 19 3 1
Identifying employment opportunities 16 7 2
Work with schools 16 6 2
Training for counsellors 14 7 4
There was a wide range of comment. One participant saw the Society as a mediator the medical field and the community where people could be “LISTENED TO”. A number of respondents suggested that we strengthen our networks with other organisations. Representatives of Age Concern wished to meet with us to consider services to those over 55.
The need to work strategically with the statutory health services was mentioned, since priorities may be determined by funding.
The work of the organisation in raising the profile of health issues and level of awareness was commended along with the ability to “map evidence of gaps in the provision of health services”.
In terms of the presentation while some felt it was informative, others felt attention could be made to developing presentation skills. There were a number of comments about making a distinction between the Health Project and the Rationalist philosophy.
There was some discussion about appropriate methods of counselling. We stressed that staff working for the Project have qualifications and experience and that methodology used is in accord with that recommended by leading clinical professionals in the field.