Tatiana Chekryzhova | Dreamstime . com
‘ BAME communities are not resistant to treatment , nor are they naïve about treatment services . The realities are closely linked to cultural barriers to access , lack of choice and poor experiences of engagement in available treatment .’
A greater investment is required to improve access and develop culturally appropriate treatment and recovery services . Knowledge of lived realties , intersectionality and cultural issues is vital in supporting BAME people effectively – cultural context is critical in understanding who people are in terms of their world view , attitudes , beliefs , cultural backgrounds , ethnicity , faith , family dynamics , religious practices and their history . The role of cultural empathy , lived experience and ability to connect are at the heart of building trust and developing equality within the therapeutic relationship .
CORE ELEMENTS The purpose of appreciating the culture of an individual in recovery is to better understand who people are intrinsically and how to help them . In order to do this , it ’ s not enough just to understand their dietary needs , religious holidays or what faith they belong to . The most important element of a person ’ s culture is their psychology – what are their core beliefs ? What is their faith ? What is their attitude to family ? What is their experience of stigma , racism , oppression and prejudice ? What are their communication styles ? What are their concepts of disease , health , addiction and recovery ? How do all of these things impact their relationships , their identity and their reasons for developing substance problems and their need for recovery and wellbeing ?
Without these core elements of deep cultural understanding and the ability to foster a genuine sense of connection and belonging , approaches to addiction and recovery for BAME communities will remain stuck under a low ceiling of effectiveness and continued poor psycho-cultural engagement by treatment providers . Cultural competence training can help to some degree to improve interpersonal communication but cannot replace culturally appropriate community-led support .
INTEGRATION We need services that are fit for purpose and that have the capacity to reach and engage people who need help . The value of integrated services running alongside BAME
OBSTACLES TO ENGAGEMENT
1 BAME communities face significant health , social and structural inequalities . The recent pandemic is reported to have pushed these health inequalities from bad to worse .
2 BAME communities face severe difficulties in accessing health services , particularly mental health and drug and alcohol treatment . Language barriers , stigma , cultural differences , and institutional racism prevent people from accessing , engaging and completing treatment , and making them more likely to come into contact with the criminal justice system .
3 Research highlights that BAME communities would benefit from culturally responsive recovery models , but currently there is no incentive in the system for developing or investing in such services .
4 Local and national commissioning arrangements often underestimate the level of needs among BAME communities which results in stark BAME under-representation in treatment services .
5 Commissioning processes have failed to capture and respond to unmet BAME need , and engage with BAME communities in designing and delivering culturally appropriate services .
specialist community services must now be a priority – they can both draw on each other ’ s assets and produce an overall stronger integrated system to benefit the community as a whole . They can share knowledge and expertise wherever one is lacking – the right support from the right people and organisations is key in establishing a stable and lasting recovery .
Equal access to treatment and recovery is the way forward , but to make this happen there must be significant investment in specialist community and lived experience led service providers to address gaps , inequalities and unmet need for under-represented groups . Give people a choice of service providers , treatment options and embrace approaches that work , be it psychosocial , culturally specific , faith-based or spiritually informed models to transformative recovery and wellbeing .
RECOMMENDATIONS
1 Robust research should be carried out to adequately assess the level of health needs among people from BAME communities .
2 National drug policy must reflect the evidence gathered and develop specific recommendations to address the service gap for people from BAME backgrounds .
3 Local and national commissioning organisations must work alongside people from BAME backgrounds in the design , delivery and assessment of service provision to ensure that the service offer meets their needs .
4 Local commissioning arrangements should introduce ring-fenced spending for BAME-specialist services that can deliver culturally responsive and high-quality treatment and recovery services .
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