Zenobia Nadirshaw

Here to Stay Research Conference
Presentation will provide an understanding of the lives and
experiences of BME with learning disability as an oppressed
and doubly disadvantage group – in terms of the process by
which these groups and their carers find themselves in sup
and at the receiving end of little or no culturally appropriate
The BME communities in the UK now make up to 10 % of the
ethnic minority population in England and Wales, Emerson
and Hatton predict this figure will substantially rise by the year
2020. However needs of many of these people and services
not available. due to the double disadvantage faced by these
groups of people as well as the new migrants who have
entered the UK in the past ten years.
BME with learning disabilities using health, education, and social
services are doubly disadvantage by;- The interchangeable use of terms ‘culture and ethnicity’
- The colour blind approach
- The prevailing culture bias of services
- The victim blaming ‘approach’
- The unresponsiveness of community care legalisation
- The perpetuation of concepts of differences and ‘differentness’ eg: need for
gender specific staff, dietary needs (acknowledging religious festivals and
Azmi et al’s study revealed
Significant language barriers to communication between Asian carers and
English speaking services
- High levels of economical hardship and social deprivation of informal
networks being available to meet considerable support needs
- Need for formal support not available for carers looking after people with
challenging behaviours (including serious challenging behaviours)
- Lack of formal or informal support had over stretched resources of many
The experience of racial abuse in local neighbourhoods and from
other service users of staff.
Access to and up take of Primary Health Care Services
- Aware of GPs, Dentists, hospital services, but not aware of specialist
community LD teams or home helps
- BME peoples use of GPs and consultation with GP is high.
- Both Asian and Chinese’s community’s tend to present to primary health care
services with somatic symptoms of psychological distress (cultural rules
governing the expression of distress and GPs failing to recognise the
psychological basis for the symptoms presented.
- Use of traditional healers for some communities, either in place of or as well
as conventional.
Ways forward
Identify extent of need and make sense of ethnic data to identify patterns and
services used.
Services to positive revalue and readopt the distinct differentness (of diet, clothing,
appearance lifestyles) and relinquish the pressure to ‘fit in’ in to dominant cultural
norms and value systems
Find out the number of languages spoken and dialects used, use trained interpreters.
Services to acknowledge and ensure significant impact of old, the second generation
and the new migrant communities and identify new ways of listening to the needs
and aspirations of these groups
Ensure a senior member of staff within the organisation takes responsibility for
services and liaises with local communities organisations, (advice surgery, gender
specific services, employment of professionally trained interpreters, use of Black
Volunteer Sector, who offer a whole/ combined community care service)
Ensure culturally competent commissioning to identify and develop culturally specific
services where needed and adapt existing services to include specialist targeted
provision and ensure a monitoring process of the structure of services, for eg, flexible
respite care services, single sex accommodation as and when necessary adjusting
staffing skill requirements, staffing levels and funding, avoid use of bank and agency
And looking forward to study and its results with the assumption that its main
findings contribute to the development of inclusion for this group of people whom
remain invisible within mainstream provision.
We need to
Respond to population diversity
Facilitate the development of policies
Improve the availability of prevalence data
Understanding the meaning of learning disabilities from
different cultural prospective
Provide better information about learning disability services
Continue to monitor the situation
Azmi, S, Emerson, E; Caine, A and Hatton C (1996) Improving services for Asian
People with learning disabilities and their families. Hester Adrian Research Centre
/The Mental Health Foundation, Manchester
Baxter, C; Poonia, K; Ward L and Nadirshaw Z (1990) Double Discrimination. Issues
and Services for people with learning difficulties from Black and Ethnic
Community’s. Kings Fund Centre / Commission for Racial Equality, London
Nadirshaw Z, (1997) Cultural Issues In O’Hara J and Sperlinger A. Adults with
Learning Disabilities; A practical approach for health professionals. Wiley and Sons
Nadirshaw Z. Learning Disabilities in D Bhugra; S Shashidharan and R Cochrane
(eds) Transcultural Psychiatry. Gaskell Publications / Royal College of Psychiatrists,
Royal College of Psychiatry (2011) Minority Ethnic Communities and Specialist
learning disability services. Report of the Faculty of the Psychiatry of Learning
Disabilities working group London.

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