A different language for mental health
The rise of mental health issues in Muslim communities is a concern that is constantly raised in the course of our health work.
During our work in diabetes, cardio-vascular disease and perinatal mortality, nurses and doctors have constantly raised depression as an issue among their Muslim patients. There is a recognition that not enough is being done to tackle this in terms of education for patients and practitioners.
A Bangladeshi mother with three children recently described to us the difficulty of being with a husband who suffers from depression. She is the sole wage earner, living in a deprived area of London. She has some family support but her husband refuses to accept he needs any type of therapeutic help. There are also cultural taboos surrounding mental health, which she has to contend with. This Bangladeshi mother told us how her story was repeated a number of time across the estate she lived in.
A report released by NHS London towards the end of 2011 stated that about 8,000 people from BME groups have dementia and this is projected to nearly double over 12 years in areas such as Tower Hamlets and Brent where there are significant Muslim populations. According to the report obesity and diabetes mellitus are some of the risk factors in the development of Alzheimer’s disease. This is of extra concern for some minority groups where diabetes rates are already 6 times higher among Asian communities compared to the white population. As a result London NHS recommends that local dementia services should also cover equalities issues including the extent to which they meet the needs of people from BME groups with dementia.
As with all our health work, resources are needed that widen the language around mental health so that the vocabulary that is used makes sense to patients and their families. This may well involve using the language of faith but also using film, music, or art to create a more intellectually, emotionally, and spiritually relevant education campaign. And, as in our other work, practitioners and communities have to contribute in the making of these resources if deep change is to take place.
There is also an economic argument as the cost of mental health problems will rise dramatically across a number of conditions over the next decade or so. A report by the King’s Fund in 2008, showed the costs of mental health problems in 2007 and what they would be in 2026 in England. For dementia, for example, the cost in 2007 was £14.9 billion predicted to rise to £34.8 billion in 2026. A 2012 report by the LSE and its Personal Services Research Unit, states “whether such as increase would be widely seen as affordable”.
This same LSE report analysed the economic payoffs of a range of interventions in the area of mental health promotion, prevention and early intervention. The report concludes that the payoffs from interventions can be spread over many years. Most obviously this is the case for programmes dealing with childhood mental health problems, which in the absence of intervention have a strong tendency to persist throughout childhood and adolescence into adult life. However, the overall scale of economic payoffs from these interventions is generally such that their costs are fully recovered within a relatively short period of time. The report also states that many interventions are very low cost and a small shift in the balance of expenditure from treatment to prevention would have greater benefit in both health and monetary terms.