Substance use problems in a multicultural Scotland - Jac Ross presentation 26 July 2007

Making our service work for BME communities Jac Ross Corporate Inequalities Manager – Disability & lead for Addictions and Equalities GGCNHSB

Defining equalities groups The National Alcohol Plan defines equalities groups as: ‘a range of different groups reflecting diversity in race, disability, sexual orientation, language, social origin and religion that may experience inequality or discrimination.’

Institutionalised discrimination “ the collective failure of an organisation to provide an appropriate and professional service to people because of their race, gender, disability, age, sexuality, faith or other characteristic. It can be seen or detected in processes, attitudes and behaviour which amount to discrimination through unwitting prejudice, ignorance, thoughtlessness and racist stereotyping which disadvantages minority ethnic people” GLA statement – adapted from William MacPherson’s Stephen Lawrence Enquiry Report’s definition of institutional racism

The current situation… Reported drug use in BME communities is less than in the white communities in Greater Glasgow Patterns, trends, methods and quantity of consumption are similar BME communities drug use is increasing BME communities use drugs for the same range & complexity of reasons as the white communities

The current situation (cont’d) BME communities have poorer access to services BME people are less likely to come forward to services We do not know if BME communities’ outcomes are better or worse than the white communities

It’s 2025….

Treatment All services are accessible and culturally competent All staff are confident in intervening appropriately Where necessary there are black specific service to accommodate specific needs Treatment options are culturally appropriate Services are planned to meet the needs of a diverse community

Access to services Services are viewed by the BME communities as for them and meeting their needs There is trust between services and the communities they serve Language is no longer a barrier to service access Fear of being stereotyped by service providers is not an issue

Prevention The links between structural issues such as poverty and racism and addictions are well understood and used to drive the prevention agenda Media messages incorporate the needs of a diverse community Upstream activity reduces the number of BME people using drugs / alcohol as a consequence of social isolation and stress.

Why isn’t it like that now? Workers say… We don’t have the resources We don’t have the skills We don’t understand the issues We don’t have the time We need to get on with our normal jobs This makes me uncomfortable

Is cultural competence enough?

What do we need to do to make this better?… Recognise and accept our services reflect societal discrimination & challenge it Value our staff skills and enable them to work in this area through training Integrate a diversity model into the planning of services

What do we need to do to make this better? (cont’d) Design our services as flexible and responsive to all – we have a changing population Reject the notion that we treat all services users the same - we don’t and we shouldn’t Accept that someone’s identity is part of who they are and therefore part of the intervention too.

Designing an inclusive model from scratch… Ensure BME issues are represented in strategy and policy drivers Plan services which have equality at their core, build this in from the start Involve BME groups in the development of the service Ensure a training plan is in place, including monitoring ethnicity Nagina Malik, GAS

Designing an inclusive model from scratch (cont’d) Establish a lead practitioner for BME issues in each service, come together in a forum Develop outreach / community engagement to promote services Ensure there are resources to promote the service appropriately

Principles underlying this approach Integration of all equalities groups agendas – a common framework based on anti discriminatory practice & service user involvement A conceptual shift in our understanding of the issue – it is not an add on Taking a systems approach – Blackpool Rock!