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Ethnicity: An Agenda for Mental Health Edited By D. Bhugra and V. Bahl. 1999. London: Gaskell. 262 pp. £25.00 (pb). ISBN 1-901242-15-3

Published online by Cambridge University Press:  02 January 2018

David Ndegwa*
Affiliation:
South London and Maudsley NHS Trust, Mental Health Unit, 108 Landor Road, Stockwell, London SW9 9NT
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Abstract

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Copyright © 2000 The Royal College of Psychiatrists 

This book is a useful addition to the limited modern literature on the health of ethnic minorities. It has 24 short, well-written, easy-to-read chapters. Most are reviews of selections of current UK literature and some are research reports. The authors are modest in their reviews, acknowledging gaps in knowledge and the limitations of previous research methodologies. Appropriate emphasis is given to the use of research approaches valid to the cultures under study. The chapter by Marcus Richards and Melanie Abas on ‘Cross-cultural approaches to dementia and depression in older adults’ is particularly good in this respect. It reports ongoing work in the development of a screening tool for depression in older adults.

A broad range of subjects is covered. Most of the material is not new. However, some of the chapters, for example that on pathways into care by Dinesh Bhugra, Rachael Lippett and Eleanor Cole, offer a broad and interesting perspective that is missing from current literature on pathways. The chapter by Sangeeta Patel on the ‘Role of general practitioners in the management of mental illness in ethnic minorities’ is also interesting and good in understanding current problems in primary care. A number of chapters reiterate current good practice in service planning and provision, information which can be found in publications from mental health charities and recent Department of Health guidelines, particularly the importance of listening and involving users and ethnic minority communities in the planning and running of services. Given the ambitious sounding title of the book, case reviews of what works and what does not work would have had more impact. A particularly interesting chapter, however, on the way forward in making services more appropriate to ethnic minorities, was that of S. P. Sashidharan on a non-institutionally-based service in an inner-city multi-racial and multi-cultural area of Birmingham. This describes the background and process in developing a new service which draws interesting parallels with similar developments in Italy. While home treatment services are not new, setting them up with a view to addressing the concerns of ethnic minorities in an urban area is new. One hopes that such schemes will be successful in the short and long term.

Some of the review chapters, particularly that by Kwame McKenzie and Robin Murray, are well argued, but one is left wishing that there was more on environmental risk factors — perhaps the authors should consider racism as an environmental stressor and explore it in some depth. Given the potential significance of the findings of the Fourth National Survey of Ethnic Minorities there should have been an opportunity for a broader and more critical review in the chapter by Sunjai Gupta.

I feel this is a good introduction for those who are unfamiliar with the subject. Trainees and practising psychiatrists should make a point of reading it as one frequently gets the impression that their knowledge of the subject is over-influenced by the more hysterical UK literature, particularly that suggesting an epidemic of schizophrenia in people of African descent.

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