Mental health: ethnic minority carers’ experiences
Dealing with hospitals
Carers of people with mental health problems come into contact with different hospitals departments. If people with mental health problems are very unwell and considered a danger to themselves or others they will be admitted to an NHS psychiatric hospital. Admission can be voluntary or compulsory through being 'sectioned' under the Mental Health Act. The law says that the view of the nearest relative should be considered when a person is admitted to a psychiatric ward. It is also possible to have private health insurance and use private psychiatric hospitals.
Hospital outpatient departments are used by those who need treatment but don't need to be admitted to a psychiatric ward. Some carers we spoke to had to take their relative to an Accident and Emergency department after serious injuries or suicide attempts.
Treatment in psychiatric wards
Many carers said that, when people are very unwell, they are safest and best looked after in hospital. These carers thought it important to work together with medical staff. Some said they trusted the expertise of the hospital staff and were relieved to have some responsibility taken off them.
Leah is happy with her son's consultant and trusts her (recording in Cantonese).
Leah is happy with her son's consultant and trusts her (recording in Cantonese).
When her arrived the hospital, the doctor saw him and asked him to stay in the hospital, give him 3 months to 6 months. The doctor said to me in the period of time if he gets well earlier, he could be discharged at any time. I could also sign to discharge him. But I reckon I should let the doctor to decide, because I am not a professional. If I sign to discharge him, who owns the responsibility if something is wrong? Therefore, I -fortunately the consultant, the chief doctor was very good. She is kind-hearted, is a female doctor. I do not bother what race she is, she is white but I do not bother what race she is, the most important thing is she is good. And when he was ill in the hospital, he could not control his emotions, could not control. So the doctor, since he was in the hospital the doctors have their ways. If he cannot control, they will give him injection or medication. I talked to the doctor, I said now let us do not bother, I said to the doctors and the nurses, let us do not bother who is wrong and who is right, he has illness. We hope, I hope, as I am the mother, to cooperate with the doctors and nurses to make him recover soon. My mind is like this.
Her son complains about the nurses, but she is grateful to the medical staff (recording in Cantonese).
Her son complains about the nurses, but she is grateful to the medical staff (recording in Cantonese).
The consultant and the psychiatric nurses are very nice. He always said to me, he said the nurses scolded him or what, but I did not listen to him. Because he was ill but he did not realize and he could not control himself. Someone told me, he said, “your son was not cooperative with the doctor. He was reluctant to take tablets and was not cooperative with the doctor.” I would not get angry and I explained to him. I said, “If he could be cooperative with doctors, he did not need to stay in the hospital.” So that person said, “yes that is right, that is right.” Sometimes I was very grateful, when he was discharged I sent a card, I was very grateful to the doctors and nurses.
Other carers, however, didn't think people could really get better in psychiatric wards. Some said that people who were in psychiatric hospitals long-term were 'just locked away' with very little to do. One woman asked 'how can you have so many people sitting around smoking and watching TV - do they think it is worth sectioning people for that?' And she wondered' 'how does that equip you for when you leave?'
People also said that hospital care seemed mostly to involve medication, and that there was not enough psychotherapy or activities to occupy patients, or spiritual care.
Nick's son has had little psychotherapy; and he thinks there is a dearth of psychotherapy in...
Nick's son has had little psychotherapy; and he thinks there is a dearth of psychotherapy in...
Really? Over the twelve years?
Yeah, in that ward. And that doctor was very good, but he did stir it up a bit for him. But that man left for a nicer job in America. And the next psychologist, he just come in the post now this month, and hopefully he'll get a chance. You see, everybody knows that this is a mental illness, that he'll need a lot of talking to get it out of you or whatever it is. But there's no money in studying the proper psychotherapy. So even the Prime Minister recently said there's a lot of people with depression and all and therapy will help bring them back to work. Well where is the money? He's not investing any money for psychotherapy. There are no psychologists on the ground, this is the problem.
Angela thinks people with mental health problems need a firm hand and spiritual care.
Angela thinks people with mental health problems need a firm hand and spiritual care.
Some carers worried about the safety in psychiatric wards. One person's elderly aunt, who had dementia, had been sexually abused by another patient. Based on her own experiences, another carer felt her father wasn't safe in hospital.
Having been attacked herself, Elaine worried about her father when he was in hospital (played by...
Having been attacked herself, Elaine worried about her father when he was in hospital (played by...
Resources vs. the duty of care
Some talked about a lack of resources in mental health services, which meant that wards were understaffed, or unqualified personnel were used to save money. Carers had sympathy with hospital staff because of their demanding jobs, including 'being shouted at' and the 'risk of being beaten up'. They also mentioned the long shifts and 'poor pay for nurses'. But they also felt that hospitals should take their duty of care seriously, and not hide behind 'restricted resources'. For example, some said the food in hospital didn't suit people's diet and was unhealthy. Since 'healthy eating is not rocket science,' hospital food could be made more nutritious and culturally appropriate.
People also talked about neglect, such as their loved ones not being changed or fed as often as they needed, their medication being wrong or left untouched, people getting dehydrated as well as a lack of privacy and dignity.
Ramila thinks people with mental health problems should be given the privacy of their own room.
Ramila thinks people with mental health problems should be given the privacy of their own room.
People ought to have their own privacy and their, you know, I think the example that some of the carers have given is that, if you lose a, -break a leg or something like that or if you go in the ordinary hospital, then you're treated OK. I was trying to say, OK they'll get their own accommodation, but it's not true. But that's just a visionary thing I have. But at least they have got their privacy which, and people, -I feel more than in mental health services really, but ideally my idea would be that each person gets their own room. Because it's needed, where they're emotionally so upset, they have been so damaged by something or the other that they need their own space, and then also communal space. And a lot of effort to be made, I mean not anybody giving up on anyone really, because I've, you know, come across people with mental health problems and, underneath their psychosis or whatever it is, I'm talking about schizophrenia mainly, -but there's such a nice person there with love, understanding, wish, desires, wants. And sometimes when professionals only see those sort of people for consultation for five, ten minutes, they, I wonder whether they see this wonderful person and the personality behind it. Or then I think, you know they're giving up on this person. There should be a hope that this person will get better, and they will be able to visit some, -whatever life they want to, rather than thinking, oh no they'll never get better, which is what I've heard a few times.
People with mental health problems in general hospital wards
People with mental health problems sometimes need hospital treatment for physical conditions and are sometimes moved between general wards and psychiatric wards. Some carers reported a lack of communication between different wards or between hospitals, which sometimes meant people missed out on treatments, or were not seen as 'whole persons'. Lack of communication between services meant carers often knew more about the situation that the professionals involved.
Elaine's father was sectioned and moved from the general ward to the psychiatric ward against her...
Elaine's father was sectioned and moved from the general ward to the psychiatric ward against her...
The psychiatric ward could not provide all the treatment her father needed and did not have notes...
The psychiatric ward could not provide all the treatment her father needed and did not have notes...
Many carers talked about how general hospitals wards 'did a good job clinically' but didn't have the resources to look after people with mental health problems. One man even commented: 'If you ever get sick, don't go to hospital, they are dangerous places!' Some therefore felt they needed to be involved in hospital care to make sure their loved ones were safe and treated well. One carer thought her father wouldn't have survived had it not been for her nursing background.
She felt staff had given up on her father and so she intervened (played by an actor).
She felt staff had given up on her father and so she intervened (played by an actor).
While in hospital for observation after suffering a seizure, another carer's husband (who had dementia) did not get out of bed for a week, and couldn't stand up when he came home. Since then, both have been housebound because of his immobility.
Last reviewed September 2018.
Last updated February 2013.
Copyright © 2024 University of Oxford. All rights reserved.