Mental health articles

OF mental health care and mentally ill

Respecting diversity

This is having the ability to deliver interventions which takes full account of the diverse nature of service users in terms of age, disability and gender, and demonstrating respect for their culture, spirituality and sexuality. Issues relating to race and culture are particularly relevant. ‘Black and minority ethnic patients have worse access to, experience of, and worse outcomes from mental health services than the white majority population. In other words there is discrimination – direct or indirect – in mental health services’ Speech by Rosie Winterton, Minister of State for Health Services: Race and Mental Health, Tackling Inequalities Conference, 8 March 2005 The Sainsbury Centre for Mental Healthreports on the negative experiences of black people in relation to the prescription and administration of medication. Black service users receive higher doses of psychotropic medication, and administration was seen to be coercive and punitive. Fear of professional power compromises the service users’ right to become involved in their treatment decisions or question professional decisions regarding medication, whose attitude they consider to be paternalistic and condescending.

Practising ethically Inherent in the mental health nurses’ central accountability to the service user is the recognition of the service users’ rights: the right to take an active and informed role in their medicationrelated treatment decisions, the right to a safe and effective drug regimen, and the opportunity to consent, or not, to treatment. Promoting these rights against confl icting professional viewpoints is a diffi cult responsibility. Practising ethically also involves working with the service user’s aspirations, for example of becoming medication free and taking an honest, non-judgemental and neutral stance to medication-related issues.

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