Count Me In

Yesterday the results of the 2008 Count Me In Survey were published. Count Me In is a survey conducted of in-patients of Psychiatric Hospitals nationally in the UK.

The purpose of the surveys which have been carried out annually since 2005, is to highlight discrepancies in services provided and in particular address and focus minds on the disparity of services between that which is delivered for white patients and minority ethnic patients.

Firstly, black patients are far more likely to enter the hospital through the criminal justice system as opposed to the primary care route. This was a factor we have discussed at depth both in the training I received and subsequently at work.

The report itself says

Rates of referral from GPs and community mental health teams were lower than average among some Black and White/Black groups, and rates of referral from the criminal justice system were higher

The need really is about a change in attitudes from practitioners but also if the needs of Black and Minority Ethnic patients are to be met at an equal level the needs have also to be addressed at a primary care and CMHT level.  Being able to talk to and seek help from the GP at the earlier stage is really a crucial part of the treatment cycle. As usual, the earlier caught, the easier solved. Perhaps that’s a gross oversimplification but a part of the difficulties lie in the reluctance or lack of knowledge to treat at earlier stages.

Do CMHTs receive the referrals and find that they are reluctant to refer onto hospital letting situations deteriorate because of the fear of being seen to be lacking in cultural awareness or is it a blind racism where they just don’t offer the same services across the board? Of course, there are many different factors but my instincts would perhaps lend me to consider the first of those two ideas.

This report also confirms that

Rates of seclusion were higher than average among the Black Caribbean, Black African and Other Black groups, and among the Other White group

This figure has stayed pretty much consistent throughout the last four years that these surveys have taken place. I can’t really think of any reasons that this might be the case, unless I fall back to the ‘picking up illnesses later leads to more serious manifestations’ but that wouldn’t necessarily follow through to active treatment.

The other ‘feature’ highlighted in the report is the proportion of mixed sex ward accommodation

68% (the same as in 2007) of patients were not in a single sex ward

There has been no improvement on this. I honestly think that the provision of single sex facilities would work towards an improvement of care overall. The Healthcare Commission‘s definition of ‘single sex’ is broad enough to allow for different areas of a ward to be designated as single sex if there is enough ‘separation of facilities’ to be available – actually, that’s how it is on one of the wards I often frequent – but the proportion of people  who lack this facility is still quite staggeringly high. I imagine there isn’t much change because infrastructures might need to change to some extent – beds as so precious and rare that hospitals can’t afford to have them free to wait for a person of the right gender to fit in. At least it is highlighted as a need though with some hope that it may be actioned.

In fact, the provision of more single-sex accommodation is urged as one of the recommendations at the conclusion of the study.

I have to admit here that I am rather fond of statistics. Hard information. Data. Facts. I know statistics can be twisted but looking at the raw responses to these kinds of surveys allows a more focused determination to produce results.

It’s an interesting document and definitely leaves us with more than a little food for thought.

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