Discrimination stopped Dad accessing care
Imaarl blogs that mental health services could only see her father’s blackness rather than his mental health problems.
Dad got his bipolar diagnosis in the early 1990s following a trauma-induced episode of psychosis. Since then, he has required admission to psychiatric hospitals over 15 times, with each admission becoming increasingly more challenging. In 2017, he experienced a severe episode of psychosis.
He was worrying about a letter that he had received that he did not fully understand. He fixated on this, which resulted in an episode of mania. Dad's registered with a community mental health team, so we contacted them. Unfortunately, they kept saying that he didn't meet the requirements to be sectioned, although he had a whole history of risk factors.
Access to treatment was delayed as he began to experience symptoms of psychosis, and in the meantime his house was overrun and cuckooed. Basically, this meant that people had infiltrated the family home that he’d been living in for over 20 years.
After months of complaints and safeguarding meetings, Dad was eventually taken to hospital under the Mental Health Act. By now, all his property had been stolen. His record collection, bedding, clothing, even the food in the fridge.
“He was kept in a police cell for 12 hours whilst he awaited a mental health assessment. He was then transported to hospital via police escort.”
When Dad was discharged, he moved into supported accommodation. But an appropriate safeguarding aftercare plan wasn’t put in place, and the follow up care was non-existent.
In 2019, he experienced another episode of severe psychosis. So, we began documenting Dad's story via pictures and emails and sent them to the mental health team. We did this for over three years, until he was eventually sectioned. He was kept in a police cell for 12 hours whilst he awaited a mental health assessment. He was then transported to hospital via police escort.
We decided to post Dad’s story live as it was happening. Last year it was estimated that 20-40% of police responses are to calls of people suffering with a mental health crisis. We found this statistic alarming, reflecting the fact that earlier intervention is often denied to families experiencing symptoms of mental illness.
When we accessed Dad’s medical records, we realised that bias and discrimination had prevented him from accessing care. For example, he made many pathological expressions of religion, and these symptoms of his illness were just seen as part of his black identity. A lot of the conversations that we had in the ward rounds were things like “Oh, he had these great missions.” and “Oh, he really does care about black people.” While that is true, this extreme behaviour was a symptom of his illness. They weren't normal characteristics, and they especially were not normal behaviours for him. I feel like many of the things were disregarded because of his identity.
People assumed because Dad had dreadlocks he smoked cannabis. This had been a consistent stereotype expressed by not only the mental health professionals, but the community. Dad was also discriminated against on the basis of his age. He was 56 at the time, and during one meeting, a psychiatrist said “well, you know, your dad is of a certain age now. It's unlikely that he will recover to the way he was before”. We had to keep challenging discriminatory statements.
“We were called hostile, angry and aggressive. All of the discriminatory narratives and biases I suspected that they had about our family were there to see in the medical records.”
My family made safeguarding complaints about the delays. The team admitted errors in their care and compiled a list of actions they wanted to complete. One of these actions was that they referred my sister and I to BAME psychology instead of focusing on the risks for Dad. It was constant gaslighting. If we were emotional, we were called hostile, angry and aggressive. All of the discriminatory narratives and biases I suspected that they had about our family, were there to see in the medical records.
We’ve always felt that there was racial discrimination and bias, but we didn’t think it was going to be so blatant. That’s when we realised that this is a structural issue much bigger than Dad’s individual story.
We’ve faced stigma as a family too. People have suggested there’s an absence of love and support from us as a family. They might have seen Dad in the street when he’s been unwell, begging or chanting, talking about how he misses the kids. We’re constantly getting calls asking if we’ve spoken to our dad. In fact we’ve never been estranged from Dad or had a strained relationship. It's impacted every aspect of our lives. When Dad was unwell, he used to turn up to our school and our jobs. There were so many periods where we couldn’t go to certain areas because he was there.
If Dad had cancer, it would probably be easier because people would be more understanding. But because it's a mental illness, people don’t understand.
I’ve consistently highlighted on social media that Black people are four times more likely to enter mental health services in crisis. When I talk about this and the issue of racial discrimination, many people get defensive and offer their own stories of positive experiences within the NHS or deny structural racism exists because their own stories have been equally as challenging.
The other barrier is that people see the NHS as this great saviour. And whilst it is in many ways, there are inequalities. We need to look at it more like a social justice issue because that’s exactly what it is.
The most difficult part in all of this is seeing Dad's deterioration. He’s always been so supportive to so many people. But to see him now with absolutely nothing, a shell of himself, is heart-breaking.
Dad was raised in Toxteth in Liverpool, and he grew his dreadlocks off the back of the Toxteth riots in 1981 as part of his cultural identity. When he became unwell, his locks became really neglected, and he had to cut them off eventually. He feels like a part of his identity is gone. Dad had perfect teeth before all of this, but he’s now lost them all.
The obvious thing the Government needs to provide is more funding. But it’s more than that. The whole system needs looking at. People need retraining. A lot of the people going into these jobs lack insight and are only textbook taught. They only learn about terminologies, but it’s not practical to real life.
“From Dad's experiences of psychiatrists, I feel many lack insight because they don't have direct access to different communities.”
From Dad’s experience of psychiatrists, I feel many lack insight because they don't have direct access to different communities. It’s the nurses and the support workers that have more of an insight because they have direct contact with the patients.
It took us three years for Dad to access appropriate care. In that time, he’d been displaced twice, lost all of his possessions, lost his teeth and lost so much time in between. Now he’s dealing with the aftermath. The delayed access to care has caused generational trauma for our family.
Dad's story seems shocking. It should be a one-off, but sadly it isn’t. It’s the story of many Black families who have faced bias and discrimination from mental health services, and that’s simply unacceptable.
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