Salla Anthony, Newbigging Karen, Joseph Doreen, Eneje Emachi
City University of London, London, United Kingdom.
Department of Psychiatry, University of Oxford, Oxford, United Kingdom.
Front Psychiatry. 2023 Jul 11;14:1173591. doi: 10.3389/fpsyt.2023.1173591. eCollection 2023.
Independent mental health advocacy was introduced in England to protect and promote the rights of people detained under mental health legislation. However, shortcomings in access and delivery to racialised people, raising concerns about equity, were identified by a review of the Mental Health Act. The development of culturally appropriate advocacy was recommended. While the term culturally appropriate may be taken for granted it is poorly defined and limited efforts have conceptualized it in relation to advocacy. Ideally, advocacy operates as a liberatory practice to challenge epistemic injustice, which people experiencing poor mental health are at acute risk of. This is amplified for people from racialised communities through systemic racism. This paper argues that advocacy and culturally appropriate practices are especially relevant to racialised people. It clarifies the importance of culture, race and racism to the role of advocacy, and understanding advocacy through the conceptual lens of epistemic injustice. A central aim of the paper is to draw on and appraise cultural competency models to develop a conceptual framing of cultural appropriate advocacy to promote epistemic justice.
英格兰引入了独立心理健康倡导服务,以保护和促进依据心理健康立法被拘留者的权利。然而,一项关于《精神健康法》的审查发现,在为种族化群体提供服务的可及性和服务提供方面存在不足,这引发了对公平性的担忧。审查建议发展具有文化适宜性的倡导服务。虽然文化适宜性这个术语可能被视为理所当然,但它的定义并不明确,并且在倡导服务方面,将其概念化的努力也很有限。理想情况下,倡导服务应作为一种解放性实践,以挑战认知不公正,而心理健康状况不佳的人极易面临这种不公正。对于来自种族化社区的人来说,由于系统性种族主义,这种情况会更加严重。本文认为,倡导服务和具有文化适宜性的做法对种族化群体尤为重要。它阐明了文化、种族和种族主义对倡导服务角色的重要性,并通过认知不公正的概念视角来理解倡导服务。本文的一个核心目标是借鉴并评估文化能力模型,以构建一个促进认知公正的文化适宜性倡导服务的概念框架。