Example Of Dissertation Introduction On Terms And Concepts
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The aim of this research study is to highlight the factors that undergird the disproportionate number of men who are of African and Caribbean descent in the mental health system in the United Kingdom in comparison to ethnic groups. Indeed, statistics demonstrate that black men often end up in certain situations that render them vulnerable and at risk for developing mental health issues. Many subaltern communities are characterized by salient drug consumption as well as structural and institutional racism that results in higher victimization rates, diffuse crime, and the lack of access to education (Williams et al., 2006). This study explores the role of the criminal justice system in the UK plays in determining how these men are treated in an idiosyncratic fashion by members of a mental health system wrought by institutional racism. Furthermore, it will highlight the efforts which are being made by the UK government to ensure that the stigmatization of Afro-Caribbean men is confronted so that they do not end up being isolated and targeted. It is the aim of this study to underscore the various policies that the UK Government has implemented in order to combat the poor treatment and stigmatization of Afro-Caribbean men by mental healthcare system. Some of these policies the National Service Framework for Mental Health (NSF-MH) Department of Health (DH) 2000 report, Delivering Race Equality (DRE) Department of Health (2005) report, National Health and Care Excellence (NICE) guidelines, Mental Health Act 1983 and 2007 and the Government Department of Health White Paper report (DH, 2004A). Because of my background as an ethnic Afro-Caribbean, I believe that men will feel safer and more open to talk to me. In addition, this report will recommend the mechanisms that need to be implemented to ensure that Afro-Caribbean men are not over-represented in the control side of the mental health care system of the UK.
Examining the extant literature on Afro-Caribbean men, it is unequivocal that “Currently, 49% of black and minority people with lived experience of mental health problems say they experience discrimination from mental health staff” (“Stigma and discrimination,” n.d.). According to the Commission for Healthcare Audit and Inspection's (2007) report, Afro-Caribbean persons and individuals from other Black groups are “more likely to be referred to hospital care from the criminal justice system” (2007, p. 39). Therefore, this statistic means that Afro-Caribbean men will risk of experiencing harsher treatment from mental health personnel which includes constraint and isolation control. In addition, the report reveals further that Afro-Caribbean men are less probable to be “referred to inpatient care” General Practitioners (GPs) or community mental health teams (Commission for Healthcare Audit and Inspection 2007, p. 39). The report noted that the reasons for doing this disparity are varied and complex (Commission for Healthcare Audit and Inspection, 2007). The report noted that the reasons for doing this are varied and complex (Commission for Healthcare Audit and Inspection, 2007). Determining and understanding the connections between mental health and race is a complex process. Nonetheless, it is has been verified that Afro-Caribbean men are more likely to be diagnosed for a psychiatric illness in the UK than members of other ethnic groups because racism and poverty significantly influence psychologists' and psychiatrists' misdiagnosis of Afro-Caribbean men (). Mainstream health services in the UK frequently fail to provide health care service that is accessible and acceptable to minority ethnic groups in the UK. Examples of such negative stereotyping and labelling veiled by the objective nature of science have occurred several times throughout history. At the outset of the twentieth century, the slaughter of the Herero in South Africa took place based on “scientific” that they were a sub-human race (Karleson, 2007). The police are also guilty of arresting individuals based on their race and the underlying assumption that subaltern men, especially those who appear to be black, are biologically predisposed to criminality (Spalek, 2007, p. 43). Thus, it is no surprise that the mental health system in the United Kingdom overwhelmingly mirrors the trends taking place in the criminal justice system.
1.1 Rationale and Outline
During my placement as well as at my current position in a mental health institution, the rationale for selecting this particular topic of this research study evolved. It was during this period that I became interested in the topic of mental health and the socio-cultural implications and issues surrounding of the mental healthcare system’s treatment of black men in the UK. Although I had initially wanted to approach the mental health profession without bias, I still felt a little pessimistic about what my experiences might be like. While working at the mental health establishment, I noticed that things that I have learnt there have significantly transformed my views of the grand narrative that renders Afro-Caribbean men predisposed to mental illness. Speaking to and developing relationships with patients, I discovered that the patients felt relaxed interacting with me and felt comfortable revealing certain information to me. Indeed, I suspect the male patients feel safer talking to me and sharing their experiences because of my ethnic background as an Afro-Caribbean. The patients provided me with invaluable information and shed some light on how the UK society and institutions treats black males, especially within the criminal justice system. It is important to note that patients who have been referred via the criminal justice system had the experience of being treated harshly because of the use of coercion and confinement control against them (Keating, 2007, p. 1).
I discovered that these stereotypes and pejorative language used to limn Afro-Caribbean men in a negative fashion reified the salient perceptions about the mental health system in relation to race. Popular discourses frequently construct blackness as threatening, and this fear of a nefarious Other directly impacts the relationships between medical professionals and black patients (Keating & Robertson, 2004). As a result, Afro-Caribbean patients delay seeking medical help from these services. McKenzies (2007) argued that blackness in the United Kingdom was synonymous with poor mental health, calling the construction of blackness an epidemic that healthcare services cannot fix (McKenzies, 2007). This stigma poses the greatest obstacle that black men who are mentally ill have to confront. Moreover, Afro-Caribbean men receive harsher treatment in in-patient services than members of other racial and ethnic groups do (Keating, 2007). I gleaned these conclusions from my interactions with Afro-Caribbean patients who were eager to share their personal struggles with me. They trusted me to honour their confidentiality regarding their medical issues while also supporting them. Eventually, it became apparent that the negative treatment that patients endured on a quotidian basis shaped their medical issues.
In addition, by speaking with my family and companions regarding their mental health problems, I noticed that their reactions generally supported the patients’ reports about negative perceptions of Afro-Caribbean men. When I would remark that my job entailed conversing with patients who suffered from mental illness, that statement would usually elicit the immediate response: “Isn’t that a dangerous occupation?”, “Do you see patients alone?” and “Are they not bad and dangerous?” It was these questions that me that enabled me to realize unequivocally that overwhelming ignorance regarding mental health issues in the Afro-Caribbean community as well as society at large persists. This realization cultivated a sense of curiosity to ascertain the underlying causes of the mental health issues that a large portion of the Afro-Caribbean male community confronted on a quotidian basis. This curiosity and desire to learn more fuelled my desire to focus my research project on this subject and all of its nuances.
It is important to note that it is quite easy to take for granted the implied meanings of the words race, ethnicity, and culture. However, when conducting research within these disciplines and paradigms, one needs to remain cognizant of making a clear distinction between the denoted and connoted meanings of the terms that are being used (Spalek, 2008, p. 43). In my use of the terminology ‘culture,’ this concept is intended to mean “‘integrated patterns of human behaviour that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious or social groups’” (as cited in Egede, 2006, p. 668). Another definition of culture as it pertains to the context of health implies that culture is a “‘unique shared values, beliefs, and practices” which are indirectly connected to a “‘health-related behaviour’” (as cited in Egede, 2006, p. 668).
It is a difficult matter to define the concept ‘race’ because as highlighted by Egede (2006, p. 667) the word has “historical, political, and social baggage” attached to it. Egede (2006, p. 667) explains that race is more of a “social construct than a biological construct.” However, for the intents and purposes of this research study, race will be defined as a category of “humankind that shares certain distinctive physical traits” (Merriam-Webster Dictionary.com, n.d., para. 1). A litany of studies have shown that chief police officers in the United Kingdom have proffered statements that both denoted and connoted black people with the significance and meaning of race in a complex and nuanced fashion (Spalek, 2008, p. 43).
According to Dictionary.com, ethnicity is a “social group that shares a common and distinctive culture, religion, language” and so on (“Ethnicity n.d., para. 1). Furthermore, Egede (2006) notes that the concept of ethnicity is to further “differentiate racial groups.” However, Egede (2006, p. 667) reveals that the current definition of ethnicity is “arbitrary and ill-defined.” Nevertheless, for the purposes of this research ethnicity will be defined as a social group within a particular race, namely the Black race. The social group which will be the focus of this research, as noted previously, is the Afro-Caribbean men.
This dissertation will be divided into five separate sections in a thematic fashion. The first chapter will explore the extant literature on the structural and institutional explanations for why Afro-Caribbean men are disproportionately represented in the British mental health system. This section will include a discursive analysis of the construction of race and the material consequences it has on those stigmatized as subaltern within the framework of mental health discourses. The second chapter covers the methodological approaches and outlines the schema used to conduct the study, the kind of information collected, and the methods used for collected the data. The third chapter will focus on the ethical dimensions for this dissertation topic. The fourth section of this research study will cover the results of this investigation and provide a meticulous analysis of the collected results and provide an in-depth discussion of these results. The fifth chapter will focus on discussing the themes that emerged from the literature review and the conclusions gleaned from the study as well as the applicability of the results on social work practices and theory. The final chapter will analyze the conclusions and discuss the flaws of the study as well as suggestions for future research. Moreover, a list of recommendations for social work practices will be proffered.
1.3. Research questions
It is the purpose of this study to answer the following questions:
How and in what ways do Afro-Caribbean men enter the mental health system?
How far does shame and stigma in the Afro-Caribbean community prevent men from accessing mental health services?
What are the challenges, tensions, and dilemmas social workers face in this mental health system?
4. 1.4. Aims and Objectives
The aims and objectives of this research study include the following:
1. To demonstrate the extent to which negative perceptions of Afro-Caribbean men hinder them from looking and receiving the professional help they need.
2. To present data showing the over-representation of Black men in the control side of the mental health system in the UK.
3. To illustrate the conditions under which Afro-Caribbean men enter the mental health system.
4. To recommend best practices that could be implemented by mental health professionals to improve the level of service given to Afro-Caribbean men.
1.5. Overview of Policies and Legislative Responses to the Overrepresentation of Afro-Caribbean Men in the Mental Health System
1.5.1. National Service Framework for Mental Health (NSF-MH) Department of Health (DH) 2000 Report
The proposed problem of this research study centers on the construction of blackness from the standpoint of the mental health system and why there is a disproportionate amount of Afro-Caribbean black males in the British mental healthcare system. The National Service Framework for Mental Health (NSF-MH) Department of Health (DH) 2000 report acknowledge that in the Afro-Caribbean population (particularly young men) the “rates of diagnosis of psychotic illness are high” when compared to the white population (National Health Service [NHS], 2000, p. 17). The report also noted that mental health professionals had the tendency to administer physical therapies rather than talking therapies and be admitted to “secure services” (NHS, 2000, p. 17).
The report also admitted, as mentioned previously, that Afro-Caribbean men are more likely to be sent to a mental institution by the criminal justice system rather than by “GPs [general practitioners] or social care services” (NHS, 2000, p. 17). The NSF-MH 2000 report mentioned that the stigma attached to mental illness can be “compounded by racial discrimination” (NHS, 2000, p. 17). The report acknowledged the fact that Afro-Caribbean men are often denied access to “appropriate assessment, treatment and care” (NHS, 2000, p. 17). The report recommended that all mental health services must be planned and implemented in collaboration with “local communities” and should involve “service users and carers” (NHS, 2000, p. 17). The NSF-MH 2000 report indicates that this needs to be done to “reduce the present inequities” and “match the needs of black and minority ethnic communities” (NHS, 2000, p. 17).
1.5.2. Delivering Race Equality (DRE) Department of Health (DH) 2005 Report
The Delivering Racial Equality (DRE) Department of Health (DH) 2005 report is an action plan which underscores the steps that should be taken to ensure that Afro-Caribbean persons (specifically men) receive proper care in mental health facilities void of racial discrimination (DHS, 2005). The action plan was the UK Government’s response to a 38-year old Afro-Caribbean man who died after being restrained by staff for approximately 25 minutes on October 30, 1998 (DHS, 2005).
The report recommended that all who work in the mental health services receive training in “cultural awareness and sensitivity” and all managers and clinical staff should receive “mandatory training in all aspects of cultural competency, awareness, and sensitivity” (DHS, 2005, p. 21). In addition, the DRE-DH 2005 report suggests that there should be training to “tackle overt and covert racism” and “institutional racism” (DHS, 2005, p. 21). The report adds that these trainings should be “regularly updated” (DHS, 2005, p. 21). The other recommendation indicates that all mental health services should indicate, in writing, policies dealing with “racist abuse” (DHS, 2005, p. 24). The action plan mentions that this written policy should be disseminated
Furthermore, the DRE-DH 2005 report recommended that there should be concerted efforts to facilitate engagement by communities, which should be supported by 500 Community Development Workers (DHS, 2005). The implementation of community-oriented policies is to be facilitated by the Black and minority ethnic (BME) mental health programme delivered by the National Institute for Mental Health in England (NIMHE) and the Department of Health’s “wider BME programme” (DHS, 2005, p. 38).
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