Older people from black and
minority ethnic groups: mental
wellbeing
Jill Manthorpe, Jo Moriarty, Martin Stevens,
Nadira Sharif, Shereen Hussein
King’s College London
Outline
Importance of looking
at mental well being,
ageing and ethnicity
Demographic picture
in the UK
Evidence from primary
research
Own research and that
of others
Issues for the future
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Older people from black and minority ethnic groups
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Barriers to knowledge
Still neglected issue in mainstream
research
Just eight per cent of articles in two old
age psychiatry journals included people
form a minority ethnic group (Shah et al.,
2008, 20(5) 1041-5)
Complexities of separating out
multiple factors
e.g. socio-economic status
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International comparisons
UK only country to routinely collect ethnicity data
(Finney and Simpson, 2009)
Important to consider impact of immigration
policies, histories of colonialism, impact of EU
Small scale studies exist (e.g. Lorent et al., 2008)
but often descriptive and practice free…
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Difficulties in definitions…
Measurements confusing and contentious
Ethnicity – can’t be separated from (political) purposes
for which information is collected (Finney and Simpson,
2009)
Longstanding debates about how it should be measured
Widespread differences between studies
Imprecise terms can cloud issues of causation and
attribution (Bhopal et al., 1991)
Definitions of wellbeing (Opposite to ill-being?
Everything? Aspiration? At end of life?)
Definitions of depression – clinical or commonplace
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Why focus on mental wellbeing ?
Change practice, provision
and advocacy
Affects physical wellbeing
Effect on quality of life
Effects on others (carers,
wider social networks,
communities)
Promote equalities
Cost
Dominance of dementia
Becoming more frequent
as professional term and
policy goal
Picture from Westminster
City Council
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Older people from black and minority ethnic groups
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Changing demographic picture
By 2051 estimates of 7.4 million Black
and minority ethnic older people aged
50+, living in England & Wales, with
3.8 million 65+.
Age distribution among different ethnic
groups varies
Many but not all minority groups have
younger age structures
But in future…
Anticipated increase in the proportion of (users
and carers) older people among minority ethnic
groups due to the ageing of people arriving in the
1970s
Differing age structures means that changes will
not be uniform
Different localities will be affected differently
Large groups will be ‘White other’
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Impact of regional/local variations
Different localities have differing proportions of BME older
people
Projections influenced by migration history & settlement
Currently:
30 per cent people aged 65 and over in Brent
20 per cent in Lambeth and Hackney
More areas are likely to have BME older people
(movement inside the UK and longer life spans)
(Lievesley, Centre for Policy & Ageing 2010)
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SCIE practice enquiry
Targeted areas with low BME
populations
Investigated accounts of practice in
social care (including housing with
care) in visits and interviews
Focus on promotion of mental
wellbeing
Three themes in practice: (1)
Language matters but not for all..
Relationships with ‘link’ people and/interpreters
May be ambivalent (Chau, 2007)
Over reliance upon family members questioned
Good quality interpreting can raise quality of care to same
levels as those proficient in English (Karliner et al, 2007)
Importance of recruiting bilingual workers
BUT services few and far between (and many languages) so
practitioners manage:
Wish to use family among some older people
Alert to isolation of the minority…use of new media
Keep eyes open eg family visits falling off…
Potential of personalisation (if eligible)
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(2) Managing relationships
Direct and indirect racism
Tensions, misunderstandings and lack of
knowledge between older people and
families
Little guidance and support for staff
Part of social care work
Zero tolerance to mediation…
Training often ‘food and faith’ based
Diversity of BME older groups being
addressed in some social care provision
(3) Specialist or integrated?
Specialist along which lines? examples –
Day care, Care Homes, Community
groups…cost-effectiveness?
But also intergenerational and also by
interest groups
Need for sensitivity & flexibility as
groups/communities change and bills have
to be paid
Potential of personalisation, housing
wealth…
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Barriers to knowledge
Studies of older
people still have low
numbers of older
people from minority
ethnic groups
e.g. English
Longitudinal Study of
Ageing
Different sampling
strategies may be
necessary
(Manthorpe et al.,
2009)
Photograph from 3YO event
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Discussion
Limited nature of much current research
Most evidence on clinical practice in health
Very little on social care
Tends to be deficit focused
Tends to look at easily identifiable groups
How comparable are concepts such as
‘successful ageing’, wellbeing, isolation, across
different ethnic/migrant groups?
Differences within and between groups
Are the issues the same for carers? And
paid care workers?
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See…
Practice enquiry: Supporting black
and minority ethnic older people’s
mental wellbeing: accounts of social
care practice
scie.org.uk