Carter’s report on Shafilea Ahmed‘s death (Parents jailed for life, 4 August) highlights a tragedy for the communities and her siblings but it also raises broader complex issues for society as well. Carter is right in her observation about cultures in collision. In the late 1990s we published a series of studies on rates of self-harm across communities. These studies showed rates of self-harm in south Asian women aged 18-24 were three times higher than their British counterparts. They were more likely to attempt self-harm as a result of domestic violence, alcohol abuse and cultural conflict. This is the vulnerable age when individuals start to assert their identity and move away from home and individuate.

Prior to writing the reports we presented these findings to members of south Asian communities, largely women in public meetings in south and west London. Women and men who attended responded by saying that they knew this was going on and urged us to educate parents, peers and the wider community about the causes. We produced educational leaflets which in a follow-up study revealed that the knowledge about self-harm and potential sources of help had gone up.

Education about cultural values and the role that cultural assimilation can play is critical if future tragedies such as this are to be avoided.
Dinesh Bhugra
Professor of mental health and cultural diversity, King’s College London

See the original article on the Guardian site

A leading psychiatrist has warned of the ‘massive problem’ of depleting numbers of mental health doctors.

Professor Dinesh Bhugra, the outgoing president of the Royal College of Psychiatrists, said not enough British doctors were training as psychiatrists while visa restrictions meant foreign doctors could no longer fill the gap.

He said 14 per cent of consultants posts in the UK were either unfilled or filled by a locum. An additional 209 consultants intended to retire or resign soon.

‘This is a huge, a massive problem,’ Prof Bhugra told the Guardian.

‘We will be left with a dangerous vacuum of help for people with mental health disorders or will be forced to get special dispensation from the Government to recruit heavily from countries who can ill afford to lose their mental health professionals.

Many have shown symptoms of anxiety and depression such as sleep disturbance, a sense of hopelessness, lack of appetite and tearfulness. Professor Dinesh Bhugra, Dean of the Royal College of Psychiatrists, and one of the authors of the study, said: “These findings are extremely worrying. We have discovered that a normally robust and highly-committed group of professionals is feeling very demoralised.

“The Government has a moral obligation to ensure that the next generation of doctors does not feel disenchanted with their profession.

“We would suggest that all trainees in posts in the UK are assured of the jobs as soon as practically possible so that the level of uncertainty and anxiety can be reduced.”