Breaking down language barriers. The public favours bilingual staff over interpreters.
Explore the source record for details and available documents.
Asia↗
Biomedical subjects
K Bhui
Publications and source records attributed to K Bhui.
Unmet needs of remand prisoners.
A needs assessment protocol which examines 11 problem areas was devised. This was administered to 277 prisoners on remand at Brixton Prison. We found high levels of unmet need for housing, treatment of substance abuse and neurotic symptoms. Twenty-nine per cent were transferred to hospital under the provisions of the Mental Health Act and about a third of those at liberty to do so complied with a discharge plan. Diversion and discharge planning can potentially meet the unmet needs of remand prisoners.
Adult↗
Psychosexual care in a multi-ethnic society.
Explore the source record for details and available documents.
Asia↗
African-Caribbean men remanded to Brixton Prison. Psychiatric and forensic characteristics and outcome of final court appearance.
BACKGROUND: African-Caribbean men are over-represented in psychiatric and forensic services and in the prison population. A failure of community services to engage mentally ill African-Caribbean men and their presentation through the criminal justice system culminates in a repeated pattern of forensic service and criminal justice system contact. METHOD: We carried out a cross-sectional survey during a one-year period of a sample of potentially mentally ill men remanded to HMP Brixton in south London. Men were interviewed to establish their place of birth, first language, socio-demographic profile, ethnicity, psychiatric diagnosis, levels of alcohol and substance misuse, criminality, violence involved in their index offence, past psychiatric and forensic contacts and outcome of court appearance. RESULTS: Two hundred and seventy-seven men were interviewed. In comparison with White men, African-Caribbean men were more often diagnosed as having schizophrenia and were more often sent to hospital under a mental health act order. African-Caribbean men were remanded in custody despite more stable housing conditions and more favourable indices of lifetime criminality, substance misuse and violence. CONCLUSIONS: Community services, including diversion schemes, should be especially sensitive to African-Caribbean men with schizophrenia who 'fall out of care', who are not diverted back into care and are therefore unnecessarily remanded.
Adult↗
Training and supervision in effective cross-cultural mental health services.
For mental health professionals working in areas with large black and minority ethnic populations, adequate training and continuing supervision are essential in providing culturally acceptable services. Local multidisciplinary training is the most suitable method of integrating training and supervision and developing culturally appropriate services.
Cultural Diversity↗
Transcultural psychiatry: do problems persist in the second generation?
The sociodemographic patterns among minority ethnic groups in the UK are changing. The younger, and in some instances British born, minority ethnic population appears to suffer from higher rates of some and lower rates of other psychiatric disorders. The exact patterns vary according to the ethnicity. Some of the data and explanations for these variations are discussed in this article.
Acculturation↗
Sexual and relationship problems amongst patients with severe chronic psychoses.
Recent studies have begun to examine the complexity and frequency of sexual and relationship problems amongst samples of community resident people with severe psychoses. For the purposes of this study, subjects with severe persistent psychoses and under the care of a single community team were interviewed using a semi-structured clinical interview and structured diagnostic interview of marital and sexual satisfaction. Functional disability was assessed by the Multnomah Community Ability Scale. Amongst those interviewed (n = 53) the prevalence of sexual difficulties was 47.5% and 30.8% for men (n = 40) and women (n = 13), respectively. The majority of men (82.5%) and some of the women (38.5%) were not in intimate relationships; 42.5% of men and 38.5% of women had never had a sexual relationship. Amongst community resident patients with severe psychoses, the level of unmet need for specific interventions (including assessment procedures, psychotherapeutic, pharmaco-therapeutic) for sexual and relationship dysfunction is high. This warrants evaluation of service structures and treatment packages tailored for this group.
Adult↗
The language of compliance: health policy and clinical practice for the severely mentally ill.
This paper appraises the issues surrounding 'compliance' from a biomedical and specifically psychiatric perspective with particular reference to the drug treatment of psychiatric patients and the influential factors in the development of health policy. I examine how existing conceptualisations fail to have a significant impact on the way people with severe mental illness (chronic disorders such as schizophrenia) interact with prescribed medication (usually neuroleptic) and explore what potential insights can be gleaned from the anthropological literature.
Anthropology, Cultural↗
A survey of sexual problems amongst psychiatric inpatients.
This paper reports the findings of a survey of 39 men and 17 women who had been admitted to the acute psychiatric wards of an inner London psychiatric unit. The patients were seen within 7 days of their admission and were interviewed about existing sexual and relationship problems. The admissions consisted largely of single men with schizophrenia and married or cohabiting women with affective disorders. Of the men, 62% of those with a diagnosis of schizophrenia, between 63 and 75% of those with affective disorders and 17% of those with other diagnoses reported current sexual or relationship problems. Of the women, 25% of those with a diagnosis of schizophrenia, 50-100% of those with affective disorders and 25% with other diagnoses reported a sexual or relationship problem. The high prevalence of such problems amongst inpatients indicates that such matters should be enquired after and therapeutic interventions considered at the time of admission. We examined the limitations of this work and proposed areas of potential research.
Adult↗
The essential elements of culturally sensitive psychiatric services.
The recent re-structuring of the British National Health Service (NHS) involving a greater emphasis on community treatment has not specifically taken account of the unequal access to mental health services experienced by black people. The greater use amongst black people of compulsory orders, police involvement and reliance on psychotropic medication, although well established, has not influenced policy or led to a strategy to ensure that services appropriately meet the needs of the culturally diverse population in this country. We present the literature on service utilisation by black people and emphasise potential solutions in areas with which black people are dissatisfied. The service structures, ideology and mechanisms presented form the foundations of good practice.
Black or African American↗
Asians presenting to a sex and marital therapy clinic.
This paper presents the findings of a retrospective analysis of the clinic registration forms and case files of Asian attenders of a sex and marital problems clinic over a three year period. An age/sex matched English control group was selected for comparison. Diagnoses, presenting patient complaints, sociodemographic characteristics, time between referral and first attendance and outcome of therapy were examined. Our samples of Asian and English attenders of equal educational and occupational status, when examined as two populations, did not differ in terms of diagnoses, sociodemographic characteristics, time from referral to first attendance and outcome of therapy. Differences in presenting complaints reflected individual unique evaluations of changed sexual functioning. There were, however, clearly problems for the Asian group related to differences of language and culture. It may be that our population of Asians was too heterogenous to enable a valid demonstration of these differences between English and Asian samples.
Adult↗
Asian inpatients in a district psychiatric unit: an examination of presenting features and routes into care.
The case notes of one hundred consecutive Asian admissions at first presentation to a distric psychiatric unit were examined. Asian admissions to Greenwich Hospital comprise a young, well educated group of predominantly Punjabi Sikhs. They present mostly through crisis services often following a domiciliary visit. General practitioners (GPs) were involved in only 34% of referrals although 54% of patients had Asian GPs. They are less likely to be compulsorily admitted than has previously been reported and very infrequently came into contact with police services. Alcoholism was found mostly in male married Sikhs. Psychotic illness accounted for 51% of presentations and neurotic depression for 18%, the latter being the largest single diagnostic category. This study raises questions regarding preferred routes into care for Asians and has service implications when considering establishment of accessible community services.
Acculturation↗
Making sense of 'possession states': psychopathology and differential diagnosis.
Possession is a common manifestation of distress in a multicultural setting. It is increasingly likely to be encountered by mental health professionals who may be unaware of the phenomenon. A review of the literature is presented with clinical guidelines for a culturally sensitive assessment and management.
Adolescent↗
Sexual problems in the psychiatric and mentally handicapped populations.
People with chronic mental disorder, mental handicap or personality disorders may experience difficulties in forming intimate relationships and responding sexually. This review discusses the impact of major psychiatric disorders, mental handicap and substance abuse on sexual maturation and functioning. The significant social, psychological and biological factors are described.
Humans↗
Cross-cultural competencies in the psychiatric assessment.
We live in an increasingly multicultural society and thus the cross-cultural application of assessment procedures is likely to become more common. However, little attention has been directed to the limitations of such unconditional application of what are essentially ethnocentric procedures. This article outlines the limitations of the psychiatric assessment when applied across cultures and presents the template for a culture sensitive assessment.
Cross-Cultural Comparison↗
Somatization disorder.
Explore the source record for details and available documents.
Attitude to Health↗