This document discusses the importance of diversity and cultural competence in health care. It notes that the world's population is becoming more diverse, with non-Western countries accounting for most of the world's population growth. It also discusses how culture can impact people's experiences and expectations of health care, and the importance of addressing stereotypes and developing culturally appropriate services and policies to help reduce health inequalities. The document emphasizes partnership and community engagement to help build trust and tailor services to diverse patient populations and communities.

1. ???
The Challenge of Diversity
Kensington & Chelsea World Mental Health Day 2007

2. Rules
1. The good news and the bad news
2. This is not a one way presentation
3. You must talk
4. I tell stories
5. You can too
(see #3 above)
6. Have fun!

3. It’s not about
telling you off

4. “All change starts when
people get together and talk
about the things they care
about.”
Margaret Wheatley

5. Why a focus on diversity is
important for everyone

6. Global Demographics
If only 100 people lived in the world, there would be:
• 57 Asians.
• 21 Europeans.
• 14 people living in North & South America.
• 8 Africans.
• 52 women.
• 48 men.
• 70 persons of color.
• 30 Christians.

7. • Changing
demographics and
the rise of the
visible minority (in
some places the
majority)

8. In the UK:
• Only two-thirds of London school children
speak English as a home language
• They speak a total of 307 languages
• 7.5 % of the total population (4.3 million
people) were born outside the UK
• In 2002 over 100 000 people entered the
country to seek asylum

9. The changing NHS

10. Culture
We all have it

11. Symbols are words, gestures, pictures, or
objects that carry a particular meaning
which is only recognized by those who
share a particular culture. New symbols
easily develop, old ones disappear.
Symbols from one particular group are
regularly copied by others. This is why
symbols represent the outermost layer of
a culture.

12. Why does culture matter ?
• Strong evidence of health inequalities along race
and ethnicity.
• Systematically worse health outcomes for
members of minority racial and ethnic groups.
• A greater dissatisfaction with health services
expressed by members of minority groups.
• Because “culture” affects medical experiences, it
is a vital component in effective care.

13. stereotypes

14. Stereotyping
When someone claims that
members of another culture all
share the same, often inferior or
offensive characteristics.

15. Types of stereotypes
• racial e.g. Red Indians in cowboy films are
seen as bloodthirsty savages
• gender e.g. women are bad drivers
• age e.g. old people are said to be very
forgetful
• religion e.g. Catholics families have a lot
of children
• profession e.g. all lawyers are greedy

25. Heaven
and Hell…
• Heaven is where the police are British, the
cooks are French, the mechanics are
German, the lovers are Italian and it is all
organised by the Swiss.

26. •Hell is where the police are German, the
cooks are English, the mechanics are
French, the lovers are Swiss, and it is all
organised by the Italians.

27. Where do stereotypes come from?
• Parents and family
• The media
• Friends
• Education (school, university)
• Travel
• Laziness
• Fear
• Envy
• A sense of superiority
• Lack of experience of people, etc.

28. Culture and diversity no longer
a black and white issue.

35. Facts Which Make Awareness of
Cultural Diversity a Priority
• By 2025, developing countries will
account for 85% of world’s population
compared with 77% in 1992

36. How can services
deal with
difference ? Practice
Culture
Cultural
competence
Policy

37. People are probably more tied to their
cultural and ethnic beliefs when ill than
when feeling well. Illness is stressful and
may lead individuals to what is known and
comfortable.
Foundations of Nursing, “Transcultural Healthcare,” Foundations of Nursing.

38. In Mental Health care setting, culture
affects how people;
• Label and communicate distress
• Explain the causes of their mental health
problems
• Perceive mental health
• providers
• Use and respond to
• treatment

39. Why is Equality and Diversity
important to all of us
There are many reasons e.g
1. Modernisation of the NHS and public service (quality of
service).
2. Matching the increasing Diversity of the population to
the servers it services.
3. Needs a good knowledge of the community, there
health and social care needs so provision can be
made.
4. Address any current inequalities and review policy
5. To ensure the trust does not actively discriminate
against anyone by failing to provide equal access to
jobs or the service we supply.

40. Some good examples

41. Supporting Diversity
• Embrace differences
• Create opportunities for positive visions of
self
• Utilize materials that represent a variety of
individuals
• Exhibit genuine appreciation for the
students and the child’s worldview

42. Safe spaces

43. Intervene early

44. Education and advice

45. Implications of diversity
1. There are now multiple views of what is
meant by ‘health’, ‘illness’, & ‘medical
treatment’
2. There are now multiple notions of ‘body’ and
‘self’
3. Many minority & refugee communities feel in a
vulnerable and disadvantaged position
4. In medical treatment, health policy, and
medical research the ‘one size fits all’
approach is no longer appropriate

46. • Appropriate, cross-cultural health
care is impossible without
partnerships based on trusting,
respectful, and responsible
relationships between health care
providers, patients, their families, and
communities.

47. Speed Networking
• Try to sit opposite someone you don’t
know very well
• Describe a health improvement initiative
that you have been involved in that went
well
• 5 minutes each