We have been rejoicing in the experience of working with like-minded people on prospects to improve services for people with dementia and their families of ethnic minority groups.
The argument is that they are not understood by the mainstream services and that they mistrust those services – all compounded by stigma associated with any form of mental illness or disorder. We know that it is not very helpful to lump ‘ethnic minority’ communities into one – because every community is unique – African-Caribbean is not the same as South Asian. Within African-Caribbean and within South Asian there are identifiable groupings with characteristics, needs and strengths which are theirs.
Within the West Midlands the towns and cities have their own trademarks. Within what has become ‘Wolverhampton’ Bilston, Wednesfield, Bushbury, Chapel Ash, Tettenhall, Bradmore, Penn and Graisely are all recognisable places, which have differing pasts and continuingly different presents which apply to peoples of all colours, creeds and class. It is a complicated world we live in.
The preference for top-down standardised models of service does not fit well in this situation. Sandwell has a solution which means working with the eight old townships which find themselves ‘Sandwell’. So rather than work with a population of a quarter of a million, you listen to 30,000 – their languages, their prejudices, their ideas, their measures of what feels OK.
A reference in the BMJ led me to read a paper from Eoin McElroy and others which has looked at: ‘The individual, place and well-being’. An enquiry with interviews of 4319 people in the North West of England. An amazing project which has a measure for wellbeing and asks questions about characteristics of individuals and about the place they live in: employment status, marital status, education, home ownership, non-paid caring, financial difficulty, religiosity, friendships, subjective physical health/Household crowding, housing quality, neighbourhood cohesion, neighbourhood disorder, greenspace usage, club membership, ability to influence local decisions. The individual, place, and wellbeing – a network analysis | BMC Public Health | Full Text (biomedcentral.com)
All those characteristics of individuals were found to correlate with measures of their wellbeing – but so were the characteristics of their lived-environment – and there is a demonstrable interaction between individual and space-based influences on wellbeing.
Not quite a direct match to our musing on how best to serve individuals and families with dementia who find stand-issue provision does not reach them. But it is a start and gives some clues.
Bringing expertise in humility to smaller cells seems likely to work. Which cells might be the next question.