I sat down to chat with Simran Kaur Khinder of the Diverse Cultures Team in Bedford, run by the South Essex Partnership Trust, to hear her views on all things mental health in the Asian community.
Tell me about mental health in the Asian community:
S: I’m not sure whether we as a community are the sort of people that others feel comfortable to confide in. I did a workshop in the Ramgarhia Gurdwara (Bedford), we were sitting in a circle; I did a presentation on Mental Health and Wellbeing, and one of the themes that kept coming up, was that people hide things, everything in our community is either a taboo or shame. Someone else said we have to keep everything in our ‘dil’ – heart.
Should there be more services for South Asians in the UK?
S: There are lots of services, but how culturally competent are they to meet the needs of the South Asian community? Trying to meet the needs of this community, there needs to be a two-pronged approach. The services need to be culturally competent, but our community needs to ask for the services as well.
SEPT have made a concerted effort to do that. We’ve had workshops; one was on depression in the Sikh community, which was poorly attended. The Gurdwara in the morning was full, jam-packed full, but in the afternoon, people were walking by completely uninterested. But, actually later on I found out, people were quite fearful of being seen to be walking into a mental health workshop. After the session, I had ladies coming to me on the quiet saying my husband has this, he presents like this, one lady said ‘You know people talk.’ Sometimes you’re at a loss on how to break it.
Why does this thinking exist within the community?
S: I think partly it is lack of understanding on what it is. Secondly it is the fear. Even in the general population, there is a fear because it’s not a disease. You can’t see it, so it’s a bit harder to understand. In the past the treatment had awful side effects, the medication in those days was terrible and people were locked away. In a lot of countries where our people come from, that is still what is happening in their countries. People either are locked away because they are considered to mad, or they just roam the streets, there isn’t an in between.
Has there been enough research carried out, with regards to South Asian and Sikh mental health?
S: It’s not a lot, there have been some studies done. One problem is, it’s actually quite difficult to get our people to open up. I think things are changing; people are becoming more open to discussing their issues. The workshops and conferences that we hold, more often than not, we have service users going up and talking about their stories. The most recent one, we had three service users talk about their stories, and we had a couple of people from the audience were so moved stood up and talked about theirs as well. I would say that if the questions are asked, people are willing to share their experience.
Mental health on the whole is very poorly funded, it’s quite often not perceived to be important in the overall scheme of things. If mental health services are for BME’s (Black and Ethnic Minorities) it’s not going to be well-funded, and South Asians within that, are going to be even more poorly funded.
How hard has it been to continue the work that you do?
S: Providing services for BME communities goes in and out of fashion. There was a system put together to assess whether or not a service is culturally competent. As recently as last year, our team was at risk…
Our community are very reluctant to complain. There is a lot of family involvement, which is both positive and negative. You have to understand the community you are working with, because we understand while you are living in a family, it’s safe from a CMHT (Community Mental Health Team) perspective. So those immediate needs will be addressed. If there is a risk of suicide there’s someone in the home, no-one is going to die of starvation – because food will be cooked, the house will be warm. Those immediate needs will be addressed. There’s a lot of dis-empowerment, a loss of parenting roles, issues with school. If you cannot speak to someone, how can you assess them?
What kind of things are people within the Sikh/ South Asian community facing?
S: If we talk about diagnosis, the ones that we deal with have been people suffering from Schizophrenia, depression, post-natal depression, we’ve had people who have manic depression. Many of the women that we deal with, come under the depression diagnosis, and there have been a few men who’ve been diagnosed with Schizophrenia.
Within our community if it is substance related, it would be alcohol induced psychosis. Where the women are concerned, very often it is depression. We don’t see them early enough, but there are young brides that come in, one young lady was pregnant – there was a lot of control within the family – they were threatening to send her back. That is not a healthy place. There was one young lady detained under the mental health act, she had lots and lots of family problems for a long time. In the end she set fire to her child and took a knife to her mother in-law. Within it all, it is the pressure from the family. It is like a lid that just burst open.