Mental health: ethnic minority experiences
Being in hospital for mental health problems
Here, people describe what it was like to be in a psychiatric hospital or on a mental health ward in a general hospital. For experiences of being admitted to hospital see 'Being sectioned under the Mental Health Act'. People described going through a range of emotions when they entered hospital, from feeling upset, helpless and confused to feeling happy (see HY Leung's story) and relieved.
Michael was keen to go to hospital and escape the abuse he was suffering in the community.
Michael was keen to go to hospital and escape the abuse he was suffering in the community.
Relationships with hospital staff and patients
Several people refused to talk when they first arrived because they felt concerned about what might happen, including one woman who felt she would “never be able to call myself normal again”. Others felt they had no one to turn to, although some people did make friends during their stay. Although some had visitors while in hospital, not everyone felt they could trust or talk to their visitors. One woman had a visitor who told her, “if you don't cooperate with them then I am not going to come and visit you anymore.” [See Sara below] People also mentioned feeling as though no one understood or believed them while they were in hospital.
Some people said they felt hospital staff had been very good and caring: “The staff were okay, really good. Some of the staff you can get on more better than others, but all the staff have been really understanding because I've been in the same hospital all the time. The staff get to know you."
Others felt staff could be indifferent or unsupportive, including one man who thought they had “lost all humanity” and talked to him in “regimented way”. One woman found it difficult because no one could understand why she wanted to self-harm (see 'Anxiety, negativity, mania & loss of energy'). Another woman said her community mental health team were good but being in hospital was a “different ball game” [see Dolly below]. One man accused staff of drugging the patients (see Michael's story) and some felt their treatment was affected by their ethnic background (see below).
Sara describes the "horrible" attitude of staff when she was in hospital. (Played by an actor).
Sara describes the "horrible" attitude of staff when she was in hospital. (Played by an actor).
And they were, you know, they were quite horrible. But, you know, I would try and tell my Dad and he wouldn't believe me. And people wouldn't believe me because they were the professionals and he would say, 'Well they're psychiatrists, they're doctors, they've got twenty years' experience. If they say you need this medication then you need it.'
And I didn't really, you know, I didn't have any one to turn to. One of my neighbours would come and visit me and she would say, 'If you don't cooperative with them then I am not going to come and visit you any more.' So it was like other people around me, sort of thought that they were doctors and that they were trying to help me, and they were doing their best. And they actually weren't helping me at all. They were making me worse and I kept saying, 'This is not helping me. It is making me worse.' But, you know, nobody would listen.
And I mean when I came out after nine months in there, of just, you know, I was really scared of the other patients as well who were quite severely psychotic, a lot of them. And [3 sec pause] the whole, I think the whole ward situation I just found it very confusing. I didn't really understand what was going on. And, and I think their idea of whether you were getting better was whether was whether you cooperated with staff and you kept quiet and you agreed that you were ill and you needed medication and I never did. I was always kind of saying, 'Well, I am not schizophrenic. I don't understand why you're giving me this treatment.' And then they would say, 'That's lack of insight and that is denial. You've got no insight and that means you are even sicker then they are already saying you are if you don't agree that they are right.'
A few people felt that the high number of hospital staff who were recent immigrants were unable to understand them, partly because they didn't understand British culture and that was part of their identity. Others thought that professionals from a minority ethnic background would be better able to understand and identify with them (see 'Outpatient & community services').
Michael says staff were unable to speak English very well and that there was a "cultural gap"...
Michael says staff were unable to speak English very well and that there was a "cultural gap"...
But you could imagine what it would be like to have, have people like that to, and I'm not talking about people from, let's say the, the West Indies, or India, or Hong Kong who speak their own indigenous version of English which I would call, they're native English speakers, but they're not British native English speakers, right. I'm talking about people whose everyday language is a, a non-European language but when they come to school they read and write in English.
And there is no attempt to recognise the cultural gap. So, of course, their version of the social model is a very, very alien one. And so when they counter patients who are more cultured and educated and who say, well actually you're not understanding me and you're not understanding other people and you're not understanding your own job, they react in, in this very aggressive way. Because it's like the patients are saying the emperor has no clothes. And you're taking away from them the competence in the very area that they could excel in, which is the medical area. And that could be an avenue to critical thinking and to all these, if I were, in charge of this I would make sure that everybody had a grounding in, in, in straight medical nursing, let's say two years of that and then did another two years of psychiatric nursing. But actually it's a completely separate stream.
Many people found it difficult to identify with other patients in hospital, either because they were unwell or because there few people from the same ethnic background as themselves. One man said he was attacked by a patient because he is Black. Many people felt vulnerable because of the sometimes unusual behaviour of other patients. Some felt afraid and described conflicts, threats and attacks. Mixed sex wards were unpopular.
Dolly felt vulnerable on a mixed ward when the male patients made sexually explicit comments.
Dolly felt vulnerable on a mixed ward when the male patients made sexually explicit comments.
And you have to understand these people are the most vulnerable people, at their most vulnerable. And But, I mean I did say to one nurse. 'I used to work in a supermarket and if I had spoken to a customer the way you've spoken to me, I would have lost my job. But you won't lose your job, you know, you won't lose your job even though you're, you're dealing with really vulnerable people.'
Views of hospital
Although some hospitals were described as OK - for example, one man described a respite unit as “somewhere where you could go and relax” - many people recalled mainly negative experiences using words such as “horrendous”, “horrible”, “harrowing” and “traumatic”. A few people had been in hospital recently, while others were hospitalised in the 1960s and 1970s: “I had two voluntary admissions in the 1990s in a modern psychiatric ward in a general hospital. A vast improvement on the old Victorian mental hospital building I had stayed before”. One man who had never been in hospital saw them as “nasty” places. Some said the hospital was dirty, including one man who had asked his doctor to admit him to hospital after he attempted suicide.
Anton wanted to go to hospital until he discovered what it was like inside.
Anton wanted to go to hospital until he discovered what it was like inside.
The only time is when I took the first overdose, they took me and they kept there.
But was that just a regular hospital or was it a mental health hospital?
No. It, it was a mental health hospital.
Okay
Yes, yes.
And what was that like for you?
Oh a horrible place. Previously I've asked the psychiatrist when I used to feel bad like this, can't fend for myself, 'Oh please doctor, why don't you stick me in the hospital? Then at least I will get a plate of food, and rest.' He said, 'No, no, Anton, they're horrible places. You wouldn't fit in there.' I didn't believe it, but when I ended up for two days. Oh, oh, such horrible places. Firstly, no one told me where the toilet is, where the tea machine is. Where this, that and the other. Then there are other patients who want to pick a fight with you The staff. I think they have lost all humanity. They talked to you in a regimented way. That's the thing. And then you are in a locked ward. And then at certain times you get your food. Say at 5 you will get a dinner and you will get a cup of tea, then you can't go and have another cup, you will wait until the next morning. And then trying to phone up the outside world, unless you have got a mobile, Plus, the place was dirty, filthy, You are there, there's no library to read. They had one television. Even that you don't have use the use of the knobs. They'll put it on, if you like it, you like it, that sort of a business, and then what do you do the whole day? You're like a zombie there. There's nothing to do. So that was driving me mad. So then I wasn't keen, I came back. Otherwise I would have got sectioned, if you got sectioned, next time when you feel ill, then they will come and take you.
Reena went to one hospital that was so awful it would make you unwell and she made a complaint about it. (Audio in Bengali, text in English).
Reena went to one hospital that was so awful it would make you unwell and she made a complaint about it. (Audio in Bengali, text in English).
After five weeks they transferred me to [another] hospital. After getting there and looking at the situation, I did not stay there. I phoned my daughter and said come quick. It was so smelly and such an awful place. It was better to die at home. I complained about it. Now they have changed it, they have brought it into [another] Hospital. I said if it is like this I won't stay here; on top of that I will make a complaint against you. At least you get the carpet changed. They were eating and going to toilet at the same place. They sent me there for three months. But I left within the hour. The nurse said, “If you don't like it get out now.” She said to my daughter, “If you love your mum take her out now, otherwise she can't get out before three months.” So my daughter wanted to see the senior doctor. They said she couldn't before the next day. She insisted on seeing him straight away and told me to put proper make up on so that if the doctor came he would see that I was not ill. I did accordingly and came out and also complained. Because anybody staying in that environment would get ill, rather than getting better, one would get worse. My condition got worse in that hour. I came out from that hospital fresh and became ill in there. So I planned if I had to die, I would die at home rather than staying at that hospital.
Activities and treatments
In hospital, there can be a variety of activities or occupational therapies “that will pass the time 'til you get better”, including watching television, videos or DVDs, playing games, exercising, going on trips, sewing and cooking. A few people remarked that in hospital there was “nothing to do, so that was driving me mad”.
Many people disliked being in hospital on have been sectioned under the Mental Health Act, even if they knew it was the right thing for them. This was because it meant they lost their freedom and couldn't leave if they wanted to. Even informal patients might be on a locked ward. Because hospital is a “closed environment” one woman remarked that your behaviour can't go unnoticed. Others mentioned how there was a strict routine in hospital (see Anton's story) and they were treated “like cattle”. A few compared hospital with prison, including one woman who recalled how her suitcase was searched (see Jay's story).
When in hospital, many people were given some form of treatment, including medication, talking therapy or electroconvulsive treatment (see 'Talking therapies & ECT or our section on experiences of ECT). A few people also described having little choice about taking medication, including one man who felt he was heavily medicated because he is Black - something he felt indicated institutional racism; he later accepted his treatment, forcing himself to trust the staff (see Devon's story). One woman said “most of the time you just try and dodge your medication” [see Mae below]. (See 'Prescribed medication & side effects' and 'Not taking prescribed medication”). One man, however, found it difficult to access care for his physical health (see Michael's story).
Experiences and views of discrimination & appropriateness of services
Some people described experiencing or witnessing discrimination and thought that the mental health system was institutionally racist (see Devon's story), “we've had a lot of problems in hospital and the way they give you medication and the way they restrain you. Most of the times the nurses: hands are tied but some of them can be real bullies.” Others felt assumptions were made about them and their needs.
Mae experienced discrimination when in hospital and was "slung out" of hospital for not co...
Mae experienced discrimination when in hospital and was "slung out" of hospital for not co...
I mean I remember the doctor gave me Val-, gave me a prescription for Valium one time and I thought oh I've had enough of this life, I really have and I just went home, bought a bottle of vodka and took the whole bottle of tablets and drunk a bottle of vodka. Well they said it was the vodka that saved my life because I brought most of the tablets back up [laughs] but I still wouldn't stay in hospital and get the help needed because I just didn't trust people, I'd never trusted people, you know. If it, when, when I was young and I can remember being examined by a doctor after I'd run away, a physical exam down below and he said, 'Oh she's sexually active.' In those days they didn't talk, but I wasn't sexually active, I hadn't had sex with anybody with consent it was what had happened with my brothers and my dad, my stepdad so, you know. And when I was in the mental hospital they did have me on Lithium and things like that but most of the time you just try and dodge your medication anyway, everybody did it if they could. So'
Why, why did you do that?
Because you didn't want to be a zombie, you know, most of the time you'd be falling asleep you'd just be, it's like, it's a chemical cosh, you know, and you don't want that. You want some control in your life and that is probably why a lot of people like schizophrenics whatever when they come off their medication they don't realise what a danger they're committing to themselves, you know. You don't realise, because you don't want that chemical cosh in the hospital'
Oh yeah I used to get beaten up and slung in the pads but that's going back, you know, that was, in those days that was just natural for it to happen in mental homes. You've got to remember that's going back to, that's just the early 60s.
To everybody?
To every, but mostly to me, to me this is what I'm saying because I was the only black person in, no there was another black man in there but'
So more so for black people?
Yeah I felt, I felt yeah, yeah. Because I mean when I got slung out it was for, it was for beating up this, this Salvation Army girl who used to blow her trumpet in my ear and really piss me off, you know. and I beat her up and, and he said to me, I can remember his words, what the doctor said to me, 'You black people are nothing but trouble, you bring violence,' he said 'I'm telling you to get out of the hospital.' And that was that.
Dolly says she saw staff use more force and more medication for Black patients; she also says...
Dolly says she saw staff use more force and more medication for Black patients; she also says...
I have seen plenty of examples of that. I mean when I've been in hospital, and say somebody has been acting up. I have noticed that if a white person acts up, that nurses will just talk to them. But if it's a Black person, they would have physical force used on them. And you, and yet, like there was one time I remember, but that, the person who was causing the most trouble was the white person. So there's a kind of inherent racism that is, is there. And I've noticed that, that they get the stronger medication. It's just, you know, if you tell people they don't believe you, but if you have gone through the system it is just so obvious, that, you know, Black people have a terrible time if they are in hospital, you know. I mean that's one thing I hope to change by highlighting it in the way I speak to people and in my writing. I mean' you know, how many black people have come out of the hospital in a coffin, you know? There's your answer really.
How about you? Have you experienced racism do you think at the hands of the system?
Kind of, not in a vicious, vicious way, people are making assumptions that because I am partly Asian that they will just automatically assume I eat curry and speak Urdu or Hindi and I can't even, I can only speak English. I can some sign language, but I can only. They kind of assume that, you know, they are helping, but you know you should ask first. You know, don't speak to me in Urdu and assume I understand you know [laughs]. It's very silly really it is.
Another man was made to wear a straightjacket on one occasion but said if he was treated differently, he didn't think it was because he is Black.
Lorenz was placed in a straightjacket but says he does not think it was discrimination, although...
Lorenz was placed in a straightjacket but says he does not think it was discrimination, although...
Have you?
Yeah I've been put in a room which I thought my foot was growing [laughs] oh and that, the difficult thing in a hospital there's more mental disturbance, very much so before I got well. I went in disturbed and it sort of escalated in the hospital until drugs started to work better. But I, one time I thought my foot was growing and I was, I was just as long as the room, it felt that, it's sort of the imagination takes away. But am I affected by being Black? You know, I often say I hadn't, I'm Black but I didn't, I hadn't had much discrimination until I, shall I say I didn't really recognise it as discrimination because of my way of thinking, I said everybody should be right to one another and so on, I never see a discrimination. People now tell me, '[Lorenz] you were discriminated against in certain ways because you're Black and so on.' Regarding, especially with our neighbour dispute where he, he was basically racist with me, saying racial remarks and so on, that was definitely seen as racial. But beforehand I see him just normally taking out his frustration on another person rather that saying it's because I'm Black he's taking his frustration out on me. So I don't look at my colour first, I look at the person to say you, we're both human, you look at each of us as communicating with one another rather than you're black and I'm white or whatever and saying because I'm black you're treating me this way. I really truly, to tell you the truth I should look at more my colour that's where the, but I don't. I can't because I never started doing that.
A few felt that hospitals weren't culturally sensitive and failed to provide a range of culturally appropriate food. One woman found it difficult to communicate without a translator and was very concerned that the doctors would misinterpret her behaviour.
Jay couldn't identify with her surroundings and thought they were not culturally sensitive.
Jay couldn't identify with her surroundings and thought they were not culturally sensitive.
The staff were, I won't say they're indifferent, they just did what they did. But none of it emulated anything that I was familiar with. The food we ate was English food, unless we cooked and then it would be something different. It was predominantly tasteless, the cooking. The salt and pepper type cooking that nobody likes, but that's what existed. Just a general feeling that, you know, when I was talking and, and started talking to people in my latter weeks, you know, I would, sit there and crack jokes and, and be quite animated and quite loud and, 'Can you keep it down please,' 'Why?' 'Because you're a bit loud,' 'But why do you want me not to be loud? Am I disturbing somebody?' 'No, but it's a bit loud.' 'I don't understand. What's the problem?' But that sort of thing. It's just not taking into account that, you know, as a black person from the Caribbean you meet other people from the Caribbean, you're cracking jokes based on maybe something that you identify that you have in common. Because a lot of the time in there you're trying to make connections with people. Whereas before you was in there, maybe you weren't able to make connections, and we did. And me and these two other girls, we spent a lot of time talking about common ground. And it was funny sometimes. And sometimes it got a bit loud. 'But it's daytime and we're in the garden. What's the issue, sort of thing? So, yes, it, that, that was strange. And also just generally there was nothing, no one to support you. They just, there was just lip service to the word support. There was no real support. There was no real tangible thing that you could take away that helps you to get on with your life or rebuild your life. And it wasn't culturally sensitive. To, to say that, you know, 'From a cultural point of view you may experience this. This is a good coping mechanism for this and this and this.' And there was none of that, there was none of that. 'Just get out there and sort yourself out,' you know. There was none of that kind of help. And I do find that is still around now, you know.
She felt worried and sad when she couldn't communicate with the doctor in hospital. (Audio in Cantonese, text in English).
She felt worried and sad when she couldn't communicate with the doctor in hospital. (Audio in Cantonese, text in English).
Distressing things happened around me; people stripping naked and wandering off, people crying, I saw many of these incidents, but could do nothing about it. One morning after taking the medication the night before, I experienced a very unsettling and frightening sensation I had never come across before. It was, as though my head were not physically present. Then I felt many images swirl and flash across my mind, I saw images of my brother, some of my family and of people I'd never met. I was scared as I didn't understand why I would experience this. I stayed in the hospital for 6 months. I found that sometimes I could walk properly but sometimes I couldn't. I have to hold on the trails and take one step at a time to get around. Because of the language barrier and without interpretation, doctors didn't understand what was happening to me and probably thought that this was just bizarre behaviour of a mental patient. Even now, there are times when a part of my head feels strained and constricted forcing me to close my eyes for comfort. I was once forced to go to the hospital canteen for breakfast even when I was very tired and while my head was again in a constricted state, I felt very helpless and frustrated. I asked the steward why I must go as I wasn't hungry anyway. The nurses just said I must go, so I had to close my eyes and walk while supporting myself against the walls. This was the only way I could move around while my head was in feeling this way. All during breakfast, I still had my eyes closed as my migraine persisted. Then I started crying. I cried because I could not understand how I had come to this state, why I had these migraines and why I had to queue up for breakfast when I wasn't even hungry. I was never like this before! Other patients and staff saw me crying and they tried to offer words of comfort, but of course, they did not know the real reason why I was so heartbroken.
Leaving hospital
A few people said they were discharged because of their behaviour (drug taking, violence) and failure to co-operate [see Mae above]. Others were gradually released, at first coming out during the daytime only, or going on a daily basis to a day hospital. One man said he was eventually released because he was not “genuinely ill”, although he felt they gave him a more serious diagnosis instead. Others considered the implications of being hospitalised, including one woman who felt “very, very lucky to get out of the psychiatric system, because a lot of the people don't manage that”.
Last reviewed September 2018.
Last updated June 2015.
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