Psychiatric Services for Black and Minority Ethnic Elders

Psychiatric services for black and minority ethnic elders have to-date received little attention. This is understandable, as the 1991 census revealed the number of white elders as 10 times greater than that of elders from all minority groups. This quantitative relationship may change with the 2001 census. The diversity of ethnic origins in small cohorts scattered throughout the UK, and the lack of knowledge about how to access services has led to an under-representation of the psychiatric needs of this population. To compound this situation, traditional beliefs held by ethnic elders and a firm view that support will be forthcoming from the extended family are frequently not shared by the younger ethnic minority population. Information about mental health issues is currently not effective, as it relies on translated leaflets and posters rather than on more appropriate mechanisms such as disseminating information through GPs and other stakeholders.

It is recommended at present that all acute psychiatric services for ethnic elders involving assessment and treatment should remain within mainstream psychiatric services. An emphasis of ethnic awareness and sensitivity by training staff in culturally sensitive issues is to be encouraged. Services providing continuing care in the community should be developed specifically for the appropriate user group. Efforts could be made to recruit a racial mix for multi-disciplinary staff reflecting the population served. Two earlier Council Reports (CR10 and CR48; Royal College of Psychiatrists, 1990, 1996, respectively) and a recent working party chaired by Professor John Cox reinforced by the National Framework for Older People (Department of Health, 2001) made the point that ethnic elders need accessible and appropriate mental health services.

There is an urgent need to establish a reliable and informative database of good practice for ethnic elders. A way forward is to create a website linked to the Faculty of Old Age Psychiatry's website at the College. This new development will also serve the purpose of offering interested specialist registrars opportunities for their special interest sessions and could lead to research defining the appropriate services for ethnic elders. There is a wealth of projects still to be explored.