Fixing the System: Older People from Ethnic Minorities Face Institutional Bias When They Access Care, Says Trevor Phillips. His Commission for Equality and Human Rights Will Target Inequality in Everything from Mental Health to Care Homes
Bright, Martin, New Statesman (1996)
When Trevor Phillips's step-father developed Alzheimer's and ended up bedridden, the last thing his Guyanese family wanted was for him to enter the care system. "As a family, we did pay over the odds to have him cared for at home because it's part of the tradition," says Phillips. "But also the institutional biases within the system meant you couldn't be sure if you put your grandad in a home, or in my case my stepfather, that [the staff] would have any idea what sort of person he was, what he needed, how he lived."
In the jargon this is "intersectionality"--an ugly word for an ugly problem. According to Phillips, a combination of race and tradition on one side and institutional bias or lack of understanding on the other conspire to make elderly people from the ethnic communities and their families deeply fearful of going into care.
So what's the answer? "Well, the answer isn't to tell ethnic minority people, you're wrong, you have to put them in a home," he says. "The solution is to make the options race neutral, so you need to make sure care homes do understand what the needs are of a Pakistani or Bangladeshi person of advanced years who may not have all their capacities functioning."
Phillips, who is chair of the new Commission for Equality and Human Rights from 1 October, wants to make these deeply embedded institutional inequalities a priority of the organisation. He believes the issue of care is at the heart of this new mission. "Care highlights a number of new things that need to be addressed. It could be material for anybody at some part of their life, either because they are in care (children, older people, those who are going through a mental health episode) or because they may be carers. Almost all women in their forties and fifties now face the possibility of being the one who has to look after an ailing parent, just as they have got the children out the door."
The new commission combines the work of separate bodies previously responsible for protection against race, gender and disability discrimination. It will also monitor other forms of inequality such as age discrimination and homophobia. Phillips is convinced the new body will help tackle problems where multiple layers of inequality are at work.
"It's got more money. It's got more powers," he says. "There aren't, at least in theory, bits of the map we can't touch. There won't be any confusion about who is responsible for certain things." Phillips cites an example from the care agenda: mentally ill young black men. "The biggest single scandal in my view in this country is the treatment of young black men in the care of the mental health system." He adds that the word "care" is ironic here. "Who is really responsible for this? Is it the disability rights apparatus? Or is it the race equality apparatus? We don't have that problem any more: it's us."
Phillips is determined to address why more young black men appear prone to schizophrenia and psychotic episodes than their peers from other racial groups. As a scientist (Phillips was a chemistry student at Imperial College London), the new chair of the CEHR says he does not accept that this is explained entirely by racism.
"There is a series of things that happen to young black men which herds them into this system, and once they are there holds them there. They start by being differentially, economically disadvantaged, but economically disadvantaged doesn't make you prone to psychotic episodes."
This is sensitive territory and Phillips knows it. The triggers for mental illness are certainly more prevalent among young black men, who are more likely to underachieve at school, more likely to be excluded from school, and more likely to find themselves in the criminal justice system and on the margins of society.
But Phillips is adamant that the mental health system itself is failing to stare the problem in the face. "Now you could say that the system should fix them. …