Assessing the mental health needs of older people
Bracken P, Greenslade L, Griffin B & Smyth M (1998) Mental health and ethnicity: an Irish dimension British Journal of Psychiatry 172 pp.103-105
Irish people in Britain
Debate on ethnicity in Britain has largely focused on skin colour and research has compared minority ethnic groups with a large homogenous 'white' group, particularly with regard to culture, racism and social issues. There is evidence to show that Irish people living in Britain have the poorest physical and mental health record among minority ethnic people.
Irish-born people make up over 1.5% of Britain's population, and people of Irish parentage comprise 4.6%. Irish people are the largest migrant minority in Britain. Mortality rates of Irish-born people exceed those of all residents in England and Wales by 30% for men and 20% for women.
Mental health of Irish people in Britain
Irish people are substantially over-represented as users of psychiatric services, particularly for depression and alcohol related disorders. They are more than twice as likely to be hospitalized for mental health problems than native-born people in England and Wales. Irish rates of schizophrenia are second only to those of African-Caribbean people.
Excess mortality for suicide among Irish-born men and women living in Britain was 26% and 30% respectively. For Irish-born women aged 20-29 the excess was 167% and 74% for men. For the 4 year period 1988-1992 Irish people had an age-standardised mortality rate for suicide of 17.4 per 100,000, which is 53% in excess of the native-born rate. Among second-generation Irish people the excess due to suicide was 25%.
The Irish-born population in Britain is an ageing one, with 26% being over pensionable age in 1993. As up to 15% of older people suffer from depression it is likely that Irish people will continue to be over-represented in mental health services in the future.
It is difficult to explain these marked differences through numerical problems of case definition and case identification in research. It is not the case that Irish people living in Ireland have comparable rates of mental ill health and hospitalization.
Social situation of Irish people in Britain
Most Irish people have come to Britain as migrant workers, and have many similar experiences to other migrant populations. Irish people are twice as likely to be unemployed as native-born people and are more likely to be involved in manual, unskilled and personal service employment.
Many Irish men have sought work in the building industry and have experienced erratic employment, poor conditions and unstable accommodation. Poor housing and homelessness are problems associated with Irish people living in Britain. Irish people have experienced cultural and racial discrimination, often related to the political situation in Northern Ireland and English colonialism.
The racial, cultural and socio-economic issues of Irish-born and second generation Irish people in Britain need to be addressed particularly in relation to mental health service provision. The research category 'white' needs to be re-examined as it is based on a 'black-white' dichotomy influenced by certain understandings of colonial history. Evidence shows that the continued neglect of the Irish in Britain is not untenable, especially in research relating to mental health needs.