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"The world of dementia is colour blind; the world of black and minority organisations is dementia blind" as quoted by Professor Mary Marshall in our CNEOPSA (Care Needs of Ethnic Older People with Alzheimer's) European study (1998).

PRIAE is credited for pioneering the agenda and driving the development of mental health care strategies for BME elders. Mental health services to black and minority ethnic elders had received little attention until PRIAE published its work on dementia and ethnicity entitled "Dementia matters Ethnic concerns" which was translated into a film which was seen as first of its kind in the UK and across Europe. The CNEOPSA study received the Glaxo award of commendation and the then Health Minister, Rt Hon Paul Boateng called it 'impressive and authoritiative'.

Previously mental health research and literature in BME communities was limited and did not fully scope the barriers, difficulties and systematic failures that existed for those that suffered from mental health illnesses. The CNEOPSA study, PRIAE developed in 1997 concentrated on increasing awareness and taking action to develop culturally appropriate knowledge and practice in dementia care for the benefit of BME elders became PRIAE's leading project in mental health in 1998.

Barriers facing BME elders

The prevalence of depression and dementia the two most common disorders in old age are often undiagnosed in BME communities. They experience not only the health disadvantages that come with it but severe barriers in acquiring help, support, treatment and understanding. Poor access to mental health services is related to a variety of factors including factors associated with potential patients and their family due to the cultural stigma attached to mental health illnesses as well as care and mental health professionals, policymakers, BME organisations and mainstream providers that directly influence the patient experience and outcome. For PRIAE's definitive guide that helps both elders and their families, and professionals working in the mental health field please see our publication "Managing Better Mental Health Care for Black and Minority Ethnic elders (2010)" - a five part resource guide and film.


Dementia is also difficult to diagnose in BME elders which may derive from insufficient knowledge within families, communities, and individuals themselves in fear of exclusion and non acceptance. Another factor is that most cognitive tests are developed and standardized in one ethnic group which may not be appropriate for another ethnic group because they are influenced by culture, education, language, sensory impairments, anxiety and unfamiliarity with test situations. Translation services are therefore key in helping screen and diagnose BME patients as needs and expectations are different for all patients.


The implication of PRIAE's work in dementia is that while we have lifted the area and exposed the realities faced by BME elders in mental health which is included in the National Services Framework for Older People, appropriate instruments prevalence rates, clinical and non clinical understanding of how dementia (mental health generally) is expressed in behavior, is yet to be fully developed.