Parents from ethnic minorities with mental health problems and their children

The Social Care Institute for Excellence’s analysis of research findings behind specific social work practices.

Research findings suggest that in the UK about 4% of all parents with dependant children have mental health problems, with lone parents being particularly vulnerable and women being more vulnerable than men. It is unclear how many of these are from ethnic minority communities as there is little reliable data about the number of ethnic minority parents treated by mental health services.

However, it is known that the stigma associated with mental health problems can be made worse by racial discrimination and that many people from minority communities are reluctant to seek help from services. Parents from ethnic minority communities are more likely than others to be referred to mental health services through social services and the criminal justice system.

Mental health problems invariably make a parent’s job more difficult. Additionally, children may experience some of the same social exclusion as their parents and so may be more vulnerable to a range of other negative experiences and outcomes, including bullying, high levels of stress, an increased risk of mental health problems, and the risk of being admitted into care. Children who undertake caring responsibilities may have an interrupted and incomplete education.

Consequently, opportunities for further and higher education and for employment may be limited. In the UK some 30% of children who are carers are supporting parents with mental health problems, and more than 15% of these carers are from ethnic minorities.

There is evidence that these children and young people may themselves be at risk of developing mental health problems, although this may be caused by the responsibility of caring or because of familial factors. Having mental health problems in childhood indicates a higher risk of continuing difficulties in adulthood.

Feeling stigmatised

While a range of professionals, such as teachers, social workers, and primary care workers, are potentially well-placed to identify problems, some young carers are wary of revealing their difficulties, feeling stigmatised by teachers and other children, and, when their circumstances are known, finding that little support is forthcoming. Good observation and assessment skills are essential for those professionals who are key to children’s lives. Poor communication between children’s and adult services further increases the vulnerability of children in situations where coherent and co-ordinated support is needed.

For children from ethnic minority families, feelings of exclusion may be exacerbated by broader perceptions of racism and discrimination in services. One study, for example, found that some ethnic minority children who cared for a mentally ill parent thought that they were being treated in a discriminatory way because although school officials knew of their situation they did not make allowances for it. However, this is just a single study and more research is needed to understand the particular circumstances of ethnic minority families. The complexity of establishing an effective relationship between ethnic minority groups and services is revealed in another study which established that service providers and teachers were sometimes uncertain of whether to intervene because of their fears of being seen as racist for doing so.

Parents and, through them, their families, need to be fully involved in service planning, development and review at both individual and structural levels to ensure that services are relevant, accessible, and acceptable. Children themselves may ask for help for their parents with identification of mental health problems and may be more able to talk to teachers or voluntary sector staff than to official mental health workers. Ethnic minority parents and their children need a safe environment in which to receive care and to discuss problems which they may feel render them vulnerable.

Practitioners’ messages

• Adults with mental health problems often experience social exclusion. The burden of poor mental health makes the complicated job of parenting more difficult for them. Parents from ethnic minorities are no different and they may have additional difficulties caused by racism.
• Reluctance to access services may result in mental health problems becoming more severe before diagnosis, treatment and support.
• Mental health problems among parents, compounded by lack of treatment and support, can have enduring effects upon their children and contribute to their over-representation in the care system.

Further information

This article is based on a Social Care Institute for Excellence research briefing: Ethnic Minority Parents with Mental Health Problems and their Children. Scie research briefings provide a concise summary of the research knowledge in a particular topic and signpost routes to further information. They do not provide a definitive statement of all evidence on a particular issue. Scie will be updating the information in this briefing with more detailed research in the area of parental mental health, including ethnic minority parents, in the future.

● Ethnic minority parents with mental health problems and their children:  www.scie.org.uk

● Parental Mental Health and Child Welfare Network  www.pmhcwn.org.uk/

● Refugee Council  www.refugeecouncil.org.uk

● Runnymede Trust  www.runnymedetrust.org

Research abstracts: ethnic minority parents

Author National Institute for Mental Health in England

Title Positive steps: supporting race equality in mental health care

Publisher National Institute for Mental Health in England, 2007.

Abstract Compiled with the help of healthcare staff and service users, this resource can be used by anyone working in mental health, primary and social care.

Every person, whatever their background, should expect to receive the same standard of care from mental health services. However, evidence suggests that this does not always happen and that the treatment experience of patients from different sections of the community can vary. For example, research confirms that ethnic minority service users have disproportionately high rates of admission to in-patient services and are more likely to experience detention, seclusion or restraint.

Black patients are also likely to report a worse experience of care in mental hospitals compared with other ethnic groups. The reasons for this situation are complex. What we do know is that the treatment received by service users should be tailored to their individual needs and not be affected by other factors.

Author Rethink

Title Moving forward: living life with mental health problems. A guide for black and minority ethnic communities

Publisher Kingston upon Thames: Rethink, 2006.

Abstract As many as one in four people in the UK will experience some kind of mental health problem in the course of a year. If you are from a black and minority ethnic group there are specific issues which may affect you.

This booklet provides basic information on the specific issues you may face, as well as more general information on topics such as medication, physical health, alternative treatments and drugs and alcohol. It also includes a list of services specifically for ethnic minority groups, and details of where to get more information on any of the issues which may affect you.

Author James Page, Gill Whitting, Carl McLean

Title Engaging effectively with black and minority ethnic parents in children’s and parental services

Publisher Department for Children, Schools and Families, 2007.

Abstract This research project, exploring how children’s and parental services can engage effectively with black and minority ethnic parents, has concluded that one of the most important factors is to avoid labelling individuals as “BME”.

The research was carried out for the Department for Children, Schools and Families, and looked at good practice in several areas. It found that the label BME was unhelpful where service providers come to see all minority ethnic groups as being a single group.

The starting point for engaging minority ethnic parents is to recognise their inherent diversity and to tailor services appropriately, rather than taking a colour blind approach.

There is evidence that staff in children’s and parental services tend to make assumptions about ethnic minority parents on the basis of their background, which tend to be unfairly judgemental.

Culturally specific programmes which strengthen cultural identity and aim to raise parents’ confidence in their cultural heritage were found to be important in improving attendance.

This article is published in the 11 September edition of Community Care magazine under the headline Ethnic minority parents with mental health problems