HATE CRIME AND HEALTH SERVICES
Hate crime: new insights, new solutions – Dr Chih Hoong Sin
The evidence base on hate crime continues to grow in the UK and internationally. The Leicester Hate Crime Project for example, recently launched the report of its two-year research, the largest primary study to date looking at hate crime.The team has been able to expand upon the range of victim groups and experiences typically covered within conventional studies of hate crime, thereby giving a voice to victims who have tended to be peripheral or ‘invisible’ within research and policy. There is a wealth of new insights, and it is vital that we act upon them to bring about improvement in our response to hate crime.
I have been fortunate in having the opportunity to work at the nexus of evidence, policy and practice; and have supported a number of police services and local authorities to improve systems and response. More recently, my efforts have focussed on the role of healthcare agencies in supporting hate crime victims and helping to prevent hate crimes. Until such time as other agencies see hate crime as something they can and should be doing something about, rather than simply thinking that it’s a matter for the police, we cannot really tackle this pernicious problem effectively.
Treatment and support
First, hate crime victims suffer a range of physical and/or mental harms. Healthcare agencies have an obvious role in treating and supporting victims. Their response is, however, lacking. While most, if not all, hate crime victims require some form of mental health support, referral to such support is not always enacted by healthcare professionals in primary care (e.g. general practitioners) and acute care settings (e.g. Accident and Emergency).
In addition, the healthcare response is often strictly in terms of the clinical treatment of the condition or symptom the patient is presenting with (e.g. physical injury). Victims of hate crime rarely get referred or signposted to services and support that help promote holistic recovery and wellbeing.
Second, the health service does not as yet sufficiently recognise that it has a role in helping to prevent hate crime. There is still a widespread perception that it is a matter for the police. By only treating the direct physical and/or mental symptoms stemming from having experienced hate crime, healthcare professionals often do not link up with the police. Hence such incidents are not recorded, and remain invisible.
Healthcare agencies can play an important role in picking up early signs of (repeat) victimisation through sub-criminal incidents that have significant impact on the victim’s mental health, and are corrosive over long periods of time. We cannot adequately tackle hate crime until we look at the issue of hate incidents, as the evidence tell us that the latter often escalate into the former if not dealt with. From the healthcare perspective, conditions such as stress, depression, hyper-tension, anger, self-harm, anxiety, etc. may be symptoms of ‘something else’ happening in victims’ lives.
Third, as healthcare is a caring sector, we can overlook the fact that healthcare settings may enhance risk and some professionals may actually be perpetrators of hate crime. In recent years, high profile scandals in care homes and other institutionalised care settings have drawn attention to this fact. There is growing recognition of the need to treat these as hate crime rather than simply ‘care failings’ or ‘abuse’. In the Winterbourne View hospital scandal, for example, treating the events as hate crime allowed the sentence to be uplifted using Section 146 of the Criminal Justice Act.
Towards a hate crime care pathway
Leicestershire has been amongst the first areas to respond to the challenge to get the health service to acknowledge its multiple roles in relation to hate crime. Recognising both the ‘victim’s journey’ and the conditions that healthcare professionals work under, a hate crime healthcare pathway is being developed by bringing together victims and agencies in the statutory and community sectors to explore how the various components may be joined up without undue burden to healthcare professionals while providing victims with seamless care. Tackling hate crime requires effective multi-agency response. Key partners in health, social care, housing, and education all have a role. Leicestershire Partnership NHS Trust and its partners should be congratulated for its vision, and commitment to an issue that can so easily fall off the radar when money is tight.
(For other material we have produced in relation to hate crime, please visit www.opm.co.uk)
Dr Chih Hoong Sin