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Older people from black and minority ethnic groups: mental wellbeing. Jill Manthorpe, Jo Moriarty, Martin Stevens, Nadira Sharif, Shereen Hussein King’s College London. Importance of looking at mental well being, ageing and ethnicity Demographic picture in the UK - PowerPoint PPT Presentation
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Older people from black and minority ethnic groups: mental wellbeing
Jill Manthorpe, Jo Moriarty, Martin Stevens,
Nadira Sharif, Shereen Hussein
King’s College London
19/04/23 Older people from black and minority ethnic groups 2
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
19/04/23 Older people from black and minority ethnic groups 3
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
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…
19/04/23 Older people from black and minority ethnic groups 4
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
19/04/23 Older people from black and minority ethnic groups 5
Why focus on mental wellbeing ?
Change practice, provision and advocacyAffects physical wellbeingEffect on quality of lifeEffects on others (carers, wider social networks, communities)Promote equalitiesCostDominance of dementiaBecoming more frequent as professional term and policy goal
19/04/23 Older people from black and minority ethnic groups 6
Picture from Westminster City Council
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’
19/04/23 Older people from black and minority ethnic groups 8
19/04/23 Older people from black and minority ethnic groups 9
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)
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
19/04/23 Older people from black and minority ethnic groups 11
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)
(2) Managing relationships
Direct and indirect racismTensions, misunderstandings and lack of knowledge between older people and familiesLittle guidance and support for staffPart of social care workZero tolerance to mediation…Training often ‘food and faith’ basedDiversity of BME older groups being addressed in some social care provision
19/04/23 Older people from black and minority ethnic groups 13
(3) Specialist or integrated?
Specialist along which lines? examples – Day care, Care Homes, Community groups…cost-effectiveness?But also intergenerational and also by interest groupsNeed for sensitivity & flexibility as groups/communities change and bills have to be paidPotential of personalisation, housing wealth…
Barriers to knowledge
Studies of older people still have low numbers of older people from minority ethnic groups
e.g. English Longitudinal Study of AgeingDifferent sampling strategies may be necessary (Manthorpe et al., 2009)
14
Photograph from 3YO event
19/04/23 Older people from black and minority ethnic groups 15
Discussion
Limited nature of much current researchMost evidence on clinical practice in healthVery little on social careTends to be deficit focusedTends to look at easily identifiable groupsHow comparable are concepts such as ‘successful ageing’, wellbeing, isolation, across different ethnic/migrant groups?
Differences within and between groupsAre the issues the same for carers? And paid care workers?
See…
Practice enquiry: Supporting black and minority ethnic older people’s mental wellbeing: accounts of social care practice
scie.org.uk
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