Black Minority and Ethnic Communities -

Barriers to accessing Alcohol & Drug Services in Nottingham

‘In all walks of life we frame our understandings based on the lens we apply and the lives we have lived’

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BAME communities are not adequately represented in Alcohol and Drug treatment figures and support services. There are many reported reasons for this including barriers to accessing commissioned services, in brief:

‘Improved engagement with people from BME backgrounds in the development and delivery of culturally appropriate mental health services could facilitate better understanding of mental health conditions and improve access’. BMJ Open 2016.

‘Peer-led recovery services, that include those from local minority communities may have an advantage over mainstream clinical services in that they can provide a cultural understanding as well as lived experience, and can serve as role models of recovery within communities, encouraging others to seek help themselves’. Rapid evidence review: Drinking problems and interventions in BAME communities, 2019.

'Experiences of mainstream services: a lack of diversity and cultural knowledge among staff in mainstream services for drug and alcohol recovery was reported as preventing them from adequately understanding and meeting the needs of BAME people with addiction.  The belief systems of BAME communities are rarely known or understood by mainstream service providers, and therefore they are ill equipped to provide the necessary support’. Project Ahryzen, 2019.

National & local evidence – under representation of BAME communities in treatment

‘National and international evidence has revealed inequalities in the health, and the healthcare experiences, of Black and Minority Ethnic groups. Many of these communities experience health inequalities and to tackle this we need services that are truly responsive, accessible, and culturally appropriate’. Health Needs Assessment of the Black and Minority Ethnic Populations within Nottingham City 2017. 

‘It has long been recognised that people from Black and Minority Ethnic (BME) backgrounds are under-represented in alcohol treatment services’, Bayley and Hurcombe, 2011.

‘..a key benefit of having specialist BME services running alongside mainstream drug and alcohol services, it was proposed, is that both have assets that the other can draw on to produce an overall system that is stronger as a result...both types of services running alongside one another is that it enables service users to exercise choice over how they engage with treatment’, Adfam 2015.

NDTMS National Statistics for Alcohol and Drug Treatment.

The NDTMS National Statistics for Alcohol and drug treatment for adult’s report that; 

•    White British 222,775 (84%) - made up the largest ethnic group in treatment
•    Other white groups 5% 
•    No other ethnic group made up more than 1% of the total treatment population

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https://www.gov.uk/government/publications/substance-misuse-treatment-for-adults-statistics-2017-to-2018/alcohol-and-drug-treatment-for-adults-statistics-summary-2017-to-2018   

Nottingham city has an estimate population of 325,300, with around 35% BAME (Black, Asian & Minority Ethnic) according to Nottingham Insight 2017 and 1 in 10 people are affected by substance misuse as stated in (Nottingham Adult Substance Misuse Document published in 2015). 

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Local NDTMS Statistics for Alcohol and Drug Treatment; 

The local picture for BAME communities in Nottingham - 2017/18:

Nationally and locally BAME communities are underrepresented in treatment. This is not taking into account those that do not come forward for support and suffer in silence. BAME communities in general are not accessing or engaging mainstream support due to stigma, shame and trust issues. In addition to this there is no culturally appropriate support or options provided to respond to the complex issues being experienced by most BAME individuals..

BAC-IN recognises that there is a need for BAME people seeking recovery to have a service that meets their need and who can confidently respond to their complex cultural issues.  

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BAC-IN provides a culturally specific, peer led forum that acknowledges diversity, values difference and embraces a choice of cultural, faith-based and spiritual perspectives to addiction recovery and rehabilitation. BAC-IN provides an alternative approach and offers:

The essence of lived experience, addiction recovery and cultural expertise is at the heart of BAC-IN’s guiding philosophy and organisational principles enabling all our staff to engage effectively with people we support.   BAC-IN staff and volunteers reflect the ethnic backgrounds, experiences and lived realities of those we aim to support which leads to sustained engagement and more positive outcome.

‘We are strengthened with a sense of belonging and connection within an authentic space that genuinely mirrors our experiences and realities’.

As an organisation we recognise the many challenges and cultural issues being faced by those seeking help and the impact of addiction on families. We understand that fear, shame and trust issues can prevent many from reaching out for help. 

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The local mainstream services are doing some good work providing generic support, advice and treatment for the general population however  there is a dis-connect between the experience of BAME communities accessing help and the perceptions of how well service providers are catering for all communities is polarised.

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This misperception leaves many of those seeking help unsupported and isolated, often resulting in health deterioration and further multiple disadvantage. Many BAME people remain unsupported and deal with issues in isolation often leading to detrimental health problems which later become challenging to address i.e. mental health, poverty, family breakdowns, domestic violence, unemployment, offending and health crises resulting from lack of appropriate intervention and lack of culturally responsive treatment/support options.

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Community based services in many instances are left to respond to these consequences often under pressure and are under resourced financially from local commissioning. 

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This compelling evidence shows that immediate system and structural change must take effect as BAME/BME communities have been for far too long ignored, disadvantaged and gravely under-served.

Further Evidence - Research and Consultations;

Dr Gurprit Pannu, Associate Medical Director NHS, ‘Alcohol use and alcoholism is on the rise in South Asian populations. Alcohol related harm in Asians is costing the NHS and Social Services too much. For every 100 white men dying from alcohol related causes there are 160 Asian men dying’. BMJ 2009.

(Click on relevant  image to link to documents)

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The unspoken alcohol problem among UK Punjabis

The Lammy Review
An independent review into the treatment of, and outcomes for, Black, Asian and Minority Ethnic individuals in the Criminal Justice System

British Asian Men and the Rise of Alcohol Abuse

The unspoken UK Punjabi alcohol problem - BBC News

Mental Health Foundation 

Black, Asian and minority ethnic (BAME) communities