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EMMA- Hello, this is Access All, the 91热爆 podcast about disability and mental health. I鈥檓 Emma Tracey and a huge thank you to the lovely Paul Carter for sitting in the hotseat while I was off on my holidays. I鈥檓 back though, and even though I have barely had time to put away my sun lounger the team have been putting together an absolutely packed show for you. This week: why are people from ethnic minority backgrounds less likely to benefit from NHS talking therapies? A British blind model takes to the catwalk for Copenhagen Fashion Week. And we profile track and field star, Hollie Arnold, as she prepares for the Paris Paralympics.听

MUSIC- Theme music.听

EMMA- Please subscribe to us on 91热爆 Sounds. Tell your friends about us and get in touch. We鈥檙e on the socials @91热爆AccessAll or you can email us accessall@bbc.co.uk. Let鈥檚 get started.听

People from Asian backgrounds are more likely to experience听 mental health problems compared to white people, but they鈥檙e less likely to have successful outcomes following treatment 鈥� that鈥檚 according to the latest UK parliamentary research. The chances of Bangladeshi or Pakistani women improving or recovering from conditions like anxiety and PTSD are 8% lower compared with white women of British heritage. Joining me now is Ayisha, who is of Pakistani origin and lives in Milton Keynes, and also clinical psychologist Dr Hibah Hassan, who works in the NHS in Oxford. You鈥檙e very welcome, Dr Hassan.听

HIBAH- Thanks for having me.听

EMMA- You鈥檝e done some research on minority groups and why they may not be able to access talking therapies, is that right?听

HIBAH- Yes, that鈥檚 right. So, as part of my doctorate in clinical psychology we did some research understanding some of the barriers that people from minoritised groups faced when accessing talking therapies. And this was specifically related actually to specific religious groups; we were wondering about British Muslims and their ability to access therapy. So, if as a Pakistani woman you attend talking therapies and you鈥檙e sat in front of a therapist, a psychologist or a counsellor who doesn鈥檛 seem to understand or ask questions about culture, faith, religion or family, all which are things that are important to you, you might leave feeling like actually that encounter wasn鈥檛 that helpful because the therapist in front of you didn鈥檛 really understand you and you didn鈥檛 feel able to express yourself in the ways that you might have liked to.

EMMA- That鈥檚 really interesting. So, would it be helpful if there were more therapists with similar backgrounds to these women who are struggling to get the good outcomes? And if so, is that likely to happen? Is there a problem in sort of recruitment and training of people as therapists with Bangladeshi or Pakistani backgrounds?听

HIBAH- That鈥檚 a really good question actually and I think there鈥檚 probably two sides to this. So, one side is we can assume that if we had more therapists from a similar background if the therapist and patient were matched they might have better outcomes. But actually the research suggests that that might not be the case; that actually people from South Asian backgrounds might be worried that if they had a therapist from the same background that therapy might not be confidential. Or they might worry that actually what they share in the session might spread across the community. So, we know that people have fears about confidentiality. There鈥檚 also a risk that actually if we place the responsibility on therapists from the same backgrounds that actually we take away responsibility from white British therapists who should also be able to connect with people from different backgrounds or different cultures. So, in the same way that myself as a psychologist I for example have never experienced obsessive compulsive disorder, OCD, I can still be curious about a client who has OCD and I can still relate to them and connect to them. In the same way if I was seeing a client or a patient from a black African background for example, although I鈥檓 not from that background myself, I can still ask questions about their heritage and culture and racism. And we expect the same thing from other therapists too.

EMMA- So, do the work.听

HIBAH- Do the research, ask the difficult questions. The research suggests that actually therapists are really hesitant and reticent to ask questions about race, culture and religion because they鈥檙e scared of getting it wrong. But when they don鈥檛 ask the questions it alienates the patient in front of them because they leave feeling like actually this isn鈥檛 the right space for me.听

EMMA- Now, Ayisha, you鈥檝e had treatment for an eating disorder and you鈥檝e also had some talking therapies. What has your experience been?听

AYISHA- You get 40 sessions, but it probably took roughly 20 sessions for me to begin to feel like I could be forthcoming and open. And even then I know that sometimes my brain would potentially start overthinking.听

EMMA- You鈥檝e talked a lot there about how sometimes it takes quite a while to build up that trust between you and your therapist. And some say that it鈥檚 easier to build that trust if the therapist is from a similar background to you. But you鈥檝e actually had some problems with therapists who have a similar background to you, haven鈥檛 you?听

- I kind of reached out to a bunch of different Muslim women therapists, and I tried to get some information about how I should proceed with regards to Ramadan. Unfortunately the response I got was quite worrying, and it sort of made me realise that maybe more needs to be done potentially within our own cultural understanding.听

EMMA- So, were your worries about how to proceed with Ramadan connected with the eating disorder and what kind of responses did you get?听

AYISHA- When you鈥檝e got the mindset of somebody who can very quickly slip into disordered eating you can then be told not to partake in Ramadan. Now, when I reached out to this lady I just tried to explain my circumstances without going into too much detail, and it sort of puzzled me a bit when her response was, 鈥極h well, do you feel like you鈥檙e too weak to fast? It鈥檚 okay, maybe if you fast you might feel stronger鈥�.

EMMA- Lack of awareness maybe.

AYISHA- Yeah.听

EMMA- You鈥檙e still working through things, aren鈥檛 you? Your outcome still hasn鈥檛 been resolved. How are you moving forward now?

AYISHA- Well, at the moment I鈥檓 in an interesting state of limbo [laughs]. I am currently stumbling around because the therapists are trying to sort some other things out with regards to my health so they can try to understand what the best medication is, refer the problems to then guide them with regards to what could be done for my therapy. Unfortunately 鈥� maybe this is a personal flaw 鈥� it takes me quite some time to begin to open up.听

EMMA- Dr Hassan, you鈥檝e been listening to Ayisha; what do you make of what she said? Is her experience familiar to you?听

HIBAH- Thanks for sharing your experiences, Ayisha. I really appreciate you coming forward to talk about these things. I think what you talked about in terms of trust was really interesting and something that I鈥檝e seen. And I guess just to know I鈥檓 not speaking on behalf of all minoritised groups, I鈥檓 definitely not speaking on behalf of you, , but speaking to my own anecdotal experiences this thing about finding it difficult to open up with therapists and finding it perhaps difficult to trust services is a barrier that we come up against quite a lot. So, thinking in talking therapy services you might be offered somewhere from six to 12 sessions for the whole of treatment. And if it鈥檚 taking a long time to build trust and build that relationship then actually you wonder about how effective a short period of treatment is going to be.听

One of the other things I wondered about from what you said, Ayisha, was about your level of control in the decision making process. And actually if you have Bangladeshi and Pakistani women in services where they feel like they don鈥檛 have control or there鈥檚 barriers such as language, if they don鈥檛 have access to an interpreter, or if the therapist doesn鈥檛 explain to them all of their options such as medication or talking therapies, whether we place people in impossible positions where they鈥檙e not able to take control over their treatment, and whether they feel like actually they can鈥檛 advocate for themselves.听

EMMA- Are there other ways of helping women from these communities get better outcomes?听

HIBAH- We know that the charity sector and other voluntary and community based projects exist, and there鈥檚 lot of outreach work that鈥檚 done, so accessing these women in environments which may feel more community based, so thinking about cultural groups or arts and crafts or religious spaces. Outreach work is really important because it builds trust and it tells these women that actually we are willing to put the time and the effort in to understanding and coming into your spaces and connect with you, and shows them hopefully that actually trust can be built.听

EMMA- And it鈥檚 not just women who are affected; 53% of British men of white heritage say that they have had good outcomes from talking therapy, whereas for Bangladeshi and Pakistani men it鈥檚 42%. I mean, what are the consequences, Dr Hassan, of not getting the right mental health support in the long term?听

HIBAH- One of the things that we know is that people from minoritised groups are underrepresented in primary care talking therapy services, but they鈥檙e overrepresented on the other side of the mental health service provision, so we鈥檙e thinking about inpatient services. So, if we miss people at that entry point, so if GPs miss referring people to talking therapies or talking therapy therapists are unable to engage with clients at a primary care level people鈥檚 mental health can deteriorate and they can worsen. And it means that they might then be picked up later on in more difficult circumstances where they鈥檙e less likely to access talking therapy treatment and might be more likely to receive psychiatric support for example in inpatient settings. I鈥檓 conscious obviously of the racist riots and things that are happening right now across the UK and how they might impact how people from South Asian backgrounds might view services and services鈥� ability to help and support or protect them as well.听

EMMA- And how do you think it is impacting people鈥檚 health, mental health watching these reports all the time, people from those communities?听

HIBAH- I mean, it鈥檚 terrifying, isn鈥檛 it? It鈥檚 scary to think that there鈥檚 such violence occurring on our streets. And I think it鈥檚 even scarier to think that the structures that are supposed to be protecting us are seemingly not doing that. And if you see politicians and the police with slogans and messages that don鈥檛 feel like they鈥檙e protecting the South Asian or other minoritised groups, I鈥檇 say it鈥檚 not just South Asian groups of course, you might wonder actually why should I trust this therapist in front of me and what does this therapist represent.听

EMMA- We asked NHS England a few questions about this topic and they provided a statement:

鈥楾he NHS is committed to ensuring NHS talking therapies are accessible for all, which is why this year we've rolled out a public information campaign to ethnic minority groups urging them to come forward for mental health support if they need it.鈥�

Thank you so much to Dr Hibah Hassan and also to Ayisha as well.听

HIBAH- Thank you very much, Emma.听

AYISHA- Thank you Dr Hassan.听

HIBAH- Lovely to meet you, Ayisha, as well.听

AYISHA- Yeah, likewise Emma.听

EMMA- Lovely to meet you both. If you鈥檝e been affected by this story you can go onto the 91热爆 Action Line website to find details of organisations who can provide support.听

If the show is sounding slightly more glamorous than usually then that could be because it is Copenhagen Fashion Week. And for the first time one of its shows features a blind British model, and not just any blind British model, but friend of the podcast, the beautiful Lucy Edwards. And Lucy is on the line. Hi Lucy.听

LUCY- Hello. Oh, I鈥檓 just so excited. I can鈥檛 believe you said that in your intro. It鈥檚 a kind of pinch-me moment.听

EMMA- You鈥檙e going to be on the catwalk on this show with your guide dog Molly. And the show has also been made fully accessible for blind and visually impaired people, which is very exciting. Now, Anna Cafone from Hair&Care, which helps blind people to learn how to do their hair, Anna helped to make it happen alongside the Danish Association for the Blind. And Anna is here too. Hi Anna.听

ANNA- Hi Emma. It鈥檚 so lovely to be here. Thank you for having us on. We鈥檙e just so excited, we literally can鈥檛 contain ourselves.听

EMMA- Yes, I can tell [laughter].听

ANNA- Just so much has gone on behind the scenes to make this happen.听

EMMA- Tell me a bit about what has gone on behind the scenes. What is in the show and how did you make it accessible?听

ANNA- So, following on from the success of the first show that we made accessible at London Fashion Week with the incredible inclusive designer Sinead O鈥橠wyer, we wanted to expand on what we had expanded last time. This time round, as well as having the audio descriptions of the looks, we鈥檒l be including swatches of the fabrics so all of our blind and low vision guests who have been invited from the Danish Association of the Blind will be able to feel before the show happens.听

EMMA- Oh that鈥檚 cool, because Sinead is quite big on texture, isn鈥檛 she?听

ANNA- Absolutely. And the biggest goal for us this time round was to champion the inclusion of a blind model to walk the runway.听

LUCY- Yay!听

ANNA- And that鈥檚 why we鈥檙e here with gorgeous Lucy.

LUCY- So cool.听

EMMA- Speaking of the audio description of the looks that you mentioned, here鈥檚 a quick preview of how it sounds. And this is a recording taken from the London show that you did:

AUDIO- Model one wears a black long-sleeved open-weave stretch top with crisscross neckline, made from gathered satin, an elasticated knit. Black floor-length box-pleated culotte trousers where the waistband has a garter like belt and four metal trims.听

EMMA- So, that鈥檚 interesting, she said an open-weave, I wouldn鈥檛 know what that feels like. And she also said a garter style belt in that description, I wouldn鈥檛 know what that is either. Will the blind audience members be more fashion aware than I or will there be a bit of a touch or a chat beforehand?听

ANNA- Yeah, this time round Sinead will also be describing the collection. She鈥檒l go into much more detail about the shapes, the silhouettes, the colours, the fabrics, so that each of the guests can listen to that ahead of the show happening and ahead of listening to the audio descriptions of each of the model鈥檚 looks.听

LUCY- I think also Emma, just to jump in, you are totally the person that we want, if you love fashion and you are visually impaired. This is an industry that we have been shut out of. Like, of course we鈥檙e not going to know these key terms. I鈥檓 learning. But what I really know is I have lived experience of being blind for nearly 12 years now and that, along with Anna鈥檚 knowledge of the industry, makes us a powerhouse.听

EMMA- Sure.听

LUCY- And we鈥檙e going to do this.听

EMMA- You have done so many things: you鈥檝e been a Radio 1 DJ; you鈥檝e been helping a company to make their AI stuff more accessible for blind people; you鈥檙e an author; you鈥檙e a TV presenter. Now you are a fashion week runway model. How does that feel?听

LUCY- It makes me have goosebumps. I cannot believe that this is happening, it鈥檚 so crazy. When I went blind, like, nearly 12 years ago now I didn鈥檛 think that this would ever happen in my lifetime, I just didn鈥檛 believe it. This kind of representation, the fact that we鈥檙e talking to you guys now, and the fact that it鈥檚 happening and it鈥檚 the start of something, I really do feel like there is a massive movement.听

ANNA- Absolutely.听

EMMA- That鈥檚 good. And what about the practicalities, Lucy, of doing the catwalk? I mean, can you fall off a catwalk? How many times are you doing it before you do the real thing? Do you have to change outfits? What are the practicalities for a blind person in this?听

LUCY- I have these really cool shoes, but I have literally been going up and down my house so many times in them because I鈥檓 like, I鈥檝e got to look fashion, darling. So, I鈥檓 going up and down my kitchen with Miss Molls, and she鈥檚 had so many treats. And then we鈥檝e had two fittings in the UK, and one was the other week at Anna鈥檚 studio. And basically we just walked up and down, up and down. And we even got the model who was coming to walk in front of me to get Miss Molly to sniff her and be like, hi Miss Molls, this is the model in front of you.听

EMMA- Okay, so you鈥檒l have a model ahead of you and Molly, your guide dog, will walk slightly in front of you obviously, behind that model. So, a guide dog one of the commands can be, 鈥楩ollow, follow鈥� and it can help the dog to follow whoever鈥檚 in front of you. So, you wanted to get her used to the model that she鈥檇 be following on the day?听

LUCY- Yeah.听

ANNA- And what we鈥檝e also done, Emma, is work with the team to have tactile markings on the runway.听

EMMA- Lucy, what鈥檚 next for you? I mean, is there anything left?听

LUCY- [Laughs] oh bless you, Em, that鈥檚 so funny. Just more and more activism really. I think for me it鈥檚 about changing the way we just see fashion and make-up and beauty. We need to delve deeper. I think this is a hole. Me and Anna are on a mission and we can鈥檛 be stopped.听

EMMA- Thank you very much Lucy Edwards, now model, and also to Anna Cofone from Hair&Care. Thank you.听

ANNA- Thank you.听

LUCY- Thanks Em.

EMMA- Another place known for its fashion is Paris, but actually what鈥檚 going on there at the moment is the Olympics, so it鈥檚 all about sport. And I cannot wait for the Paralympics at the end of August. We鈥檝e got another athlete profile for you. This time it鈥檚 track and field star Hollie Arnold:

MALE- Paris, Grass Roots to Glory.听

HOLLIE- I鈥檓 Hollie Arnold and I鈥檓 an F46 javelin thrower. This will be my fifth Paralympics. Oh my god, is it the fifth!? [Laughs] When you look back at my first Paralympics I was 14. It was amazing, I didn鈥檛 have any pressure. Now of course it鈥檚 that pressure of going out there and performing. But you know what, in some ways I really like that.听

MALE- Not the gold that she was hoping for, but Holton-le-Clay鈥檚 Hollie Arnold has claimed a bronze medal at the Paralympics in Tokyo.听

HOLLIE- It has been a real up and down since Tokyo 2021. I鈥檝e had a real big dip for a few years. I鈥檝e finally come back up, I鈥檝e found myself again, I鈥檝e got my spark back, I鈥檝e got an amazing support team, a new coach 鈥� all of this difference we want to take that on the stage. And I think hopefully we鈥檝e still got a little bit more time to just go and have fun. Honestly, I can鈥檛 wait.听

Coming back from the World Championships I was such a high, you鈥檙e always going to come back down, so I鈥檝e kind of just been finding my feet again and being really honest with myself and being like, you know what, I鈥檓 not in the most amazing happy-happy place. But you鈥檝e got to come back to real life, you鈥檝e got to make sure you check yourself, make sure your friends, my friends know when I鈥檓 not okay as well. They鈥檙e like, 鈥楢re you good?鈥� I鈥檓 like, 鈥榊eah, yeah鈥�. They鈥檙e like, 鈥榊ou鈥檙e not yourself鈥�. And I鈥檓 like, 鈥榊eah I am鈥�. And they鈥檙e like, 鈥楴o, you kind of hide behind a smile鈥�. And I think that鈥檚 the important thing is just be honest with yourself. But I speak to my psychologist, I鈥檓 really close to my family and friends, so I always check in. It makes such a difference because then you feel like, you know what, I鈥檓 not alone.听

FEMALE- Lincolnshire has bagged its first gold at the Rio Paralympics.听

HOLLIE- Do you know what, I am really excited, but I鈥檓 feeling everything. It鈥檚 always a whirlwind of emotions. You go from literally oh my god I can鈥檛 wait, to like, oh my god, what if everything goes wrong. And then you go in the betweens. But you know what, this is what we do for a living: we train day in and day out for these major games. And I think that instead of feeling like it鈥檚 daunting I just want to do everything, I just want to leave it all out on the field and let鈥檚 just give it a go.听

I think the crowds don鈥檛 realise how important they are to us. Being able to hear their noises, being able to get them clapping. I always put my javelin between my legs and I鈥檓 getting them going and I鈥檓 like, 鈥楢rgh!鈥�. That is just a whole atmosphere in itself. I just think having them there and obviously people being able to see their family and friends in the crowd. I鈥檓 sure there will be kids there and hopefully banners and flags. This is what we want, we want to celebrate sport. Paralympic sport is incredible and it needs to be shown worldwide.听

The little 14 year-old Hollie in Beijing in 2008 is not the Hollie in 2024. And I think that just mentally I鈥檝e been able to deal with a lot. There鈥檚 been a lot happened in my career so far, and I think it鈥檚 just being prepared, it鈥檚 just going for it. I know I鈥檝e got an amazing family and team around me to support me and do everything they can. We鈥檝e still got more to go, but being a happy Hollie is certainly a dangerous Hollie.听

You learn so much with time, you know: you learn from your mistakes; you learn from winning; you learn from losing. And I think that everything in one you take that pressure, that fire in your belly, as me and my dad always say, to every game, every major, and you go out there and you just do your best. You鈥檝e got to do what you love and you鈥檝e got to love what you do.听

MALE- Paris Grass Roots to Glory, listen and subscribe on 91热爆 Sounds. 听

EMMA- That is nearly it for this episode, and it has been absolutely lovely to be back in the hotseat. But what鈥檚 great too is that we鈥檝e had some fab messages while I鈥檝e been away about stories that we鈥檝e covered. Catriona got in touch about our story around Australia and the struggle for British people who are disabled or who have someone disabled in their family getting into Australia or staying in Australia because the government there are worried that that person would cost too much. Now, Catriona has lived there for 12 years now, and she did eventually become a citizen but the medical process, she says, was very tricky. And Catriona goes on to say, 鈥業 was much less disabled when I got through, but I cost the government heaps in the end鈥�. So, thank you for sending us on that feedback, Catriona, and delighted to hear that you鈥檝e been listening to stories that are relevant to you. That鈥檚 what we鈥檙e here for.听

We also heard from Alexander. Alexander was listening when we talked about ableism in football a couple of weeks ago. And he actually just happened to be the photographer at the FA disability football match where our fabulous guest, Willoughby, was playing for Norwich. And Alexander was really taken with the story and he said that these conversations are exactly the kind of thing that needs telling far and wide.听

Listen, you can go back and hear every episode of Access All on 91热爆 Sounds. And if there鈥檚 anything in any of those episodes that caught your attention please do let us know because we absolutely love to hear from you. We鈥檙e accessall@bbc.co.uk on the email. We鈥檙e on the socials @91热爆AccessAll. And do you know what, you can even send us a WhatsApp, a voicemail or a text message, just put the word Access before you start your message. And we鈥檙e on 0330 123 9480.听

Also this is [siren sounds] your final warning. That鈥檚 stupid, sorry. It is your last chance to apply for our show at the Edinburgh Festival. There are tickets online now at the 91热爆 Shows and Tours website. The show is on Friday 9th August at 3pm at Dynamic Earth in Edinburgh. And I cannot wait. We鈥檝e got Adam Hills, we鈥檝e got Dan Tiernan, we鈥檝e got political comedian Matt Forde, and Blue Peter presenter Abby Cook. I spoke to her just as she started her job on Blue Peter, but that was ages ago, and I cannot wait to find out how she鈥檚 been getting on. Thank you so much for listening. Chat to you next time. Bye.听

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MALE- Newscast is the unscripted chat behind the headlines.听

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