They were victims too

Afrah Khan (not her real name) is depressed, has been having panic attacks and cannot sleep properly. She and her husband – who has also been depressed – have two young children and are finding it difficult to keep going. Their mental health problems were triggered by the 7 July bombings in London last year. Soon after the terrorist attacks the Khans’ home was raided by the police, who suspected wrongly that the Arab family may have been involved in the incidents.

The raid left the family isolated from their local community. They live in council housing and everyone around them knew why their home had been raided so publicly. Since then Afrah’s children have developed mental health difficulties: their sleep is disturbed; they are more aggressive when they are at home; and they are reluctant to venture outside other than to school.

The Khans have been receiving counselling from the Asian & Arab Families Counselling Service which is run by the Central and North West London Mental Health NHS Trust.

Rabia Malik, senior family therapist and cultural, minority and ethnic services development manager, says that after 7/7 the counselling service had several referrals of people who had been arrested by the police or whose homes had been raided. “The impact on families involved in police raids and arrests through mistaken identity has been immense,” she says. “It has led to fear and isolation.”

The service has also been approached by Muslims who have experienced racist incidents when wearing Islamic clothing, such as the hijab.

The Khan family and others receiving support from the counselling service are not the only south Asian, Arab and Muslim people who have experienced difficulties since 7/7. Within these communities there is a feeling of unease about how they are perceived by other British people, whether every south Asian or Arab person carrying a rucksack on the tube or in the bus queue is viewed as a possible Muslim suicide bomber. These fears – on both sides – are unsurprising given the reaction by some politicians and media.

Just after the bombings the British National Party printed a leaflet for a by-election in Barking, east London, which has a substantial ethnic minority community, showing a picture of the bombed number 30 bus. It was accompanied by the slogan: “Maybe now it’s time to start listening to the BNP.” On 16 July an editorial comment in the Daily Mail questioned whether multiculturalism “encourages extremist minorities to hold British values in contempt”.

In the two weeks after the bombings nearly 200 Islamaphobic incidents were reported to the London-based Islamic Human Rights Commission (IHRC). This was nearly as many incidents as in the first month after the 9/11 attacks in the US. Normally, the IHRC receives about five such reports each week. In a speech at Manchester Town Hall last September, Commission for Racial Equality chair Trevor Phillips said that, since 7/7, Britain was becoming a society “more divided by race and religion” and “leaving communities to be marooned outside the mainstream”.

Britain has 1.8 million Muslims. Half are of Pakistani origin, 30 per cent are younger than 15 and 92 per cent under 50. Intolerance and suspicion of those perceived to be from a certain community because of their appearance can only add to  social exclusion.

Malik says: “When the thing that is valued or practised by a person is seen as threatening by others it can be really difficult for them. How do they keep alive that part of themselves – their Muslim identity – when others do not value it?”

She adds that when people feel this sort of disconnection it may exacerbate the risk factors that result in mental health difficulties. After 9/11 the counselling service noticed that more clients were asking specifically to see a Muslim therapist, which Malik is, as opposed to one from a particular ethnic group or one with a language skill. “The thing that is the most important factor for them is somebody who will understand their religion and culture. It is about that aspect of themselves not being understood [by a therapist] and being concerned about this,” she says.

Andrew McCulloch, chief executive of the Mental Health Foundation, picks up this point. He says it is known that some ethnic groups, especially Islamic Turks and Kurds, shun mainstream mental health services. “People are reluctant to come to what are seen as ‘white services’. They feel they are not going to be understood.”

But community development workers can encourage people from ethnic minorities to use mental health services. A report from the Sainsbury Centre for Mental Health highlighted the work of Bradford-based community development project Sharing Voices, which deals with south Asian, African-Caribbean and African communities.(1) It has been successful in stimulating a wider debate among the local community about mental health issues and has given the community the freedom to find its own way to tackle mental distress.

The government wants to appoint 500 community development workers in England as part of its action plan, Delivering Race Equality in Mental Health, a move that McCulloch backs. He says the workers can be the bridge between a community and the voluntary and statutory sectors and that a community may be able to address its own mental health problems. “We need to understand these are strong communities and the problem is that they are stressed, not that they are deficient.”

Sharing Voices is building on its community development work by undertaking a research project with the University of Central Lancashire into what alternative support Muslims require from mainstream mental health services.

Sharing Voices community engagement worker Kamran Yunis, who is the lead on the research, says the spotlight on Muslim communities since 7/7 has had differing impacts: “For some people it makes them feel threatened but for others it is an opportunity to explain what they truly believe about Islam and say that it is different from the media’s portrayal of Muslims.”

During the initial research respondents have already raised the concept of their Muslim identity in light of the terrorist attacks and how this affects their mental well-being. “People do feel singled out by the indigenous population,” says Yunis. “There is a lot more curiosity around Islam and religious practices and beliefs.”

So how can social care professionals working with south Asian, Arab and Muslim clients address potential mental health problems? Employing staff from the same cultural and religious background is one way, says McCulloch. He adds that treating people as individuals is more important than having an in-depth knowledge about their exact religious beliefs.

Yunis says staff should consider whether a client’s religious background is important to them and respect it. He also recommends signposting users on to culturally appropriate organisations for further assistance.

Malik urges practitioners carrying out therapeutic work to “check their own assumptions” about religion and what they think of it. “Be honest with yourself and then have a dialogue with your client to see whether religion is important in their life. Don’t assume it will be as it won’t always be the case.”

(1) Together We Will Change: Community Development, Mental Health and Diversity, Sainsbury Centre for Mental Health, November 2005