When you can’t do it alone: Improving access to mental health and related services through shared leadership

When the Mental Health Transcultural Group at Wakefield realised that alone they could not reduce mental health inequalities in BME populations, they got support through the Shared Leadership for Change Award Team. Getting signed approval from the CEOs involved in this team made all the difference in recognising and gaining leadership in tackling ethnic inequalities in mental health.

Background

Mental illness is the largest single cause of disability in Britain, with one in four adults experiencing mental illness at some point during their lifetime (DoH). Mixed anxiety and depression are the most common disorder and self- harm statistics for the UK show one of the highest rates in Europe: 400 per 100,000 populations (MHF). Evidence indicates variations in the prevalence of mental illness across ethnic groups, and a disproportionately higher number of sufferers from ethnic minority background report dissatisfaction with mental health services. Patients from some BME communities are more likely to be detained compulsorily, admitted to hospital and admitted through the criminal justice system than White British patients.

The project

The Mental Health Transcultural Group was established by Wakefield PCT in 2003 as a Social Services and Health initiative following the Race Relations Amendment Act in 2001, whereby it was acknowledged that there was a duty to provide services which are ethnically, culturally and religiously aware and specific. The group was set up to address issues regarding the services provided to Black and Minority Ethnic (BME) communities, including Asylum Seekers and Refugees.

Since September 2004 the group has been chaired by Ruksana Sardar-Akram, Public Health, Wakefield District PCT and has been represented on the Mental Health Partnership Board so that BME mental health issues are at the forefront and an important part of the ongoing strategic agenda.

The project aim is to tackle inequalities in mental health in BME groups and to improve access to mental health and related services through shared leadership. The mental health transcultural group will act as the focus group for the promotion of equality and diversity within mental health services by:

  1. Providing a forum in which people from a range of statutory and voluntary organisations and groups come together to share and develop good practice in relation to the mental health of BME communities.
  2. Challenging discrimination against people with mental health problems and promoting equality of opportunity for people with mental health problems.
  3. Considering and developing good practice in Wakefield District to enable the improvement and development of more culturally sensitive and responsive mental health services to benefit local BME communities.
  4. Providing a Forum through which concerted working can be developed by agencies to enable specific mental health issues affecting BME communities to be addressed.
  5. Developing services which are responsive to the needs of BME communities by encouraging and supporting good practice, taking account of the diversity of the sector.
  6. Identifying funding needs to deliver effective mental health services to meet the needs of the BME communities and presenting appropriate business cases to be considered by the Mental Health Partnership Board.
  7. Developing and implementing health improvement, identifying the desired outcomes and the actions to achieve them, agreeing timing and setting milestones, and assigning lead responsibility and supporting activities through key thematic groups.
  8. Providing a mechanism to discuss informally joint or single agency funding bids aimed at improving the mental health of local BME communities subject to the approval of the appropriate senior staff in the participating Agencies.
  9. Making recommendations to the Mental Health Partnership Board on the improvement and development of mental health services designed to meet the needs of local BME communities.

Partners in the project include various health professionals, Community Development Workers, Community Mental Health Teams, Equality and Diversity staff, Psychotherapists, the Carers Service, Voluntary and Community representatives and users and carers of mental health services.

Making it happen

Recognising the opportunities generated by policy and legal frameworks to reduce ethnic inequalities following the Race Relations Amendment Act in 2001, A Mental Health Transcultural Group was developed as a Social Services and Health initiative with the aim of addressing inequalities in adult mental health. However, having been successful in gaining a Health Foundation award for improving the health of BME communities, the group soon saw it as an opportunity to bring both providers and commissioners together from adult mental health and substance misuse services to tackle mental health inequalities together. The group worked together to identify clear objectives and targets. Key strategic people from primary and secondary care and public health services, including the local authority, substance misuse services, and the acute mental health trust were involved to identify clear objectives and targets for improving access to mental health and substance misuse services through the Health Foundation Shared Leadership for Change Award.

One of the key priorities for the group was to generate and use evidence to raise awareness. Following the ‘Count Me In’ census which showed major inequalities in the number of BME patients being detained in mental health services, research was commissioned to study the experiences of local BME mental health patients. Based on these findings, the Mental Health Transcultural Group was also responsible for commissioning a “Beautiful Minds” DVD using real life case studies to raise awareness of mental health within the community.

Links with BME communities and other disadvantaged groups were crucial for the success of the project. The skills and expertise of frontline staff who attended the Mental Health Transcultural Group were used to inform key areas for action. From this work, a local Mosque was commissioned to deliver mental health promotion as well as trained to raise awareness and appropriately signpost to mental health services. Although the initial focus was on South Asian communities, the work of the MHTG has now expanded to include a focus on vulnerable groups such as asylum seekers and refugees and other minority ethnic communities. The MHTG also includes a focus on BME children’s mental health services.

Future challenges

Currently there is not enough documentation of the work being done in Wakefield. A mechanism for monitoring and evaluation of the project will make the case for further funding and share the lessons learned by the project.

 

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