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Mental health, ethnicity, and cultural diversity: evidence and challenges 

Mental health, ethnicity, and cultural diversity: evidence and challenges
Mental health, ethnicity, and cultural diversity: evidence and challenges
Oxford Textbook of Community Mental Health

Craig Morgan


Migration is the primary driving force behind increasing ethnic and cultural diversity in many societies around the world. The movement of people across (and within) national boundaries, be it in search of economic prosperity or fleeing war and persecution, has been a central feature of modern history and has accelerated in recent years (Castles and Miller, 2009). Estimates by the United Nations (UN) suggest the total number of migrants (i.e. persons who have lived outside their country of birth for 12 months or more) is around 190 to 200 million or 3 % of the world’s population (UNDESA, 2004). These estimates do not include settled minority ethnic populations where, increasingly, the majority were born in the countries to which their parents or grandparents migrated. In the United Kingdom (UK), for example, minority ethnic groups now form 12 % of the population, with this rising to over 50 % in some areas of London (e.g. Newham) (Office for National Statistics). In the most recent edition of their textbook, Castles and Miller (2009) identify a number of trends in migration that are likely to have important ongoing political, economic, and social consequences. These include: the globalization of migration (i.e. the tendency for more countries to be affected by migration, both inward and outward); the acceleration of migration (i.e. the continued rise in absolute numbers of migrants in most regions of the world); and the differentiation of migration (i.e. the increased diversity of types and origins of migrants moving to single countries). These trends are already evident in, for example, many European countries, including Britain which has migrants from over 40 countries (Institute for Public Policy Research), and the United States (US) where estimates suggest that by 2050 minority ethnic and racial groups will comprise over 50 % of the population (U.S. Census Bureau, 2004). What these processes point to is an inexorable rise in ethnic and cultural diversity in many countries. This has major implications for the development and delivery of public services and, in particular, poses an ongoing challenge for mental health policy and service provision. It is these challenges that are the focus of this chapter. Three specific aspects are critically reviewed, with examples drawn mainly from the US and the UK: 1) the extent of, and variations in, mental health needs in migrant and minority ethnic groups; 2) access to and use of mental health services among these groups; and 3) proposals for ensuring mental health services are more responsive to the needs of ethnically and culturally diverse populations. To begin with, some definitions are necessary.

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