Here to Stay Research Conference Presentation will provide an understanding of the lives and experiences of BME with learning disability as an oppressed and doubly disadvantage group – in terms of the process by which these groups and their carers find themselves in sup and at the receiving end of little or no culturally appropriate services. The BME communities in the UK now make up to 10 % of the ethnic minority population in England and Wales, Emerson and Hatton predict this figure will substantially rise by the year However needs of many of these people and services not available. due to the double disadvantage faced by these groups of people as well as the new migrants who have entered the UK in the past ten years.

BME with learning disabilities using health, education, and social services are doubly disadvantage by;- - The interchangeable use of terms ‘culture and ethnicity’ - The colour blind approach - The prevailing culture bias of services - The victim blaming ‘approach’ - The unresponsiveness of community care legalisation - The perpetuation of concepts of differences and ‘differentness’ eg: need for gender specific staff, dietary needs (acknowledging religious festivals and holidays) -Azmi et al’s study revealed Significant language barriers to communication between Asian carers and English speaking services - High levels of economical hardship and social deprivation of informal networks being available to meet considerable support needs - Need for formal support not available for carers looking after people with challenging behaviours (including serious challenging behaviours) - Lack of formal or informal support had over stretched resources of many mothers -The experience of racial abuse in local neighbourhoods and from other service users of staff. Access to and up take of Primary Health Care Services - Aware of GPs, Dentists, hospital services, but not aware of specialist community LD teams or home helps - BME peoples use of GPs and consultation with GP is high. - Both Asian and Chinese’s community’s tend to present to primary health care services with somatic symptoms of psychological distress (cultural rules governing the expression of distress and GPs failing to recognise the psychological basis for the symptoms presented. - Use of traditional healers for some communities, either in place of or as well as conventional.

Ways forward Identify extent of need and make sense of ethnic data to identify patterns and services used. Services to positive revalue and readopt the distinct differentness (of diet, clothing, appearance lifestyles) and relinquish the pressure to ‘fit in’ in to dominant cultural norms and value systems Find out the number of languages spoken and dialects used, use trained interpreters. Services to acknowledge and ensure significant impact of old, the second generation and the new migrant communities and identify new ways of listening to the needs and aspirations of these groups Ensure a senior member of staff within the organisation takes responsibility for services and liaises with local communities organisations, (advice surgery, gender specific services, employment of professionally trained interpreters, use of Black Volunteer Sector, who offer a whole/ combined community care service) Ensure culturally competent commissioning to identify and develop culturally specific services where needed and adapt existing services to include specialist targeted provision and ensure a monitoring process of the structure of services, for eg, flexible respite care services, single sex accommodation as and when necessary adjusting staffing skill requirements, staffing levels and funding, avoid use of bank and agency staff. And looking forward to study and its results with the assumption that its main findings contribute to the development of inclusion for this group of people whom remain invisible within mainstream provision. We need to -Respond to population diversity -Facilitate the development of policies -Improve the availability of prevalence data -Understanding the meaning of learning disabilities from different cultural prospective -Provide better information about learning disability services - Continue to monitor the situation

Azmi, S, Emerson, E; Caine, A and Hatton C (1996) Improving services for Asian People with learning disabilities and their families. Hester Adrian Research Centre /The Mental Health Foundation, Manchester Baxter, C; Poonia, K; Ward L and Nadirshaw Z (1990) Double Discrimination. Issues and Services for people with learning difficulties from Black and Ethnic Community’s. Kings Fund Centre / Commission for Racial Equality, London Nadirshaw Z, (1997) Cultural Issues In O’Hara J and Sperlinger A. Adults with Learning Disabilities; A practical approach for health professionals. Wiley and Sons Nadirshaw Z. Learning Disabilities in D Bhugra; S Shashidharan and R Cochrane (eds) Transcultural Psychiatry. Gaskell Publications / Royal College of Psychiatrists, London. Royal College of Psychiatry (2011) Minority Ethnic Communities and Specialist learning disability services. Report of the Faculty of the Psychiatry of Learning Disabilities working group London.