Positive Steps online
Supporting race equality in mental healthcare
Ideas for action > Services
Across England, innovative ideas are being put to the test by practitioners, patients, carers and the wider BME community. The following case studies show how appropriate and responsive services can be successfully developed.
Case Study
Reaching BME carers at home: Tower Hamlets
Case Study
FOCUS Dementia carers' support group: Manchester
The Family Welfare Association's (FWA) Carers Connect project provides practical and emotional support to carers of people with mental health difficulties in the London Borough of Tower Hamlets.
FWA enables carers to:
- Gain the knowledge and skills to find appropriate services, benefits and grants
- Access education and employment opportunities
- Resolve debt and housing issues
- Find a little respite for themselves
Tower Hamlets is one of the most deprived boroughs in the UK and is home to large BME communities, particularly Bengali and Somali. The problems of access to mental health services here are exacerbated by the stigma these cultures attach to mental illness.
To provide appropriate carer support in a private and safe environment, FWA has recruited a team of Sylheti, Somali and Arabic-speaking workers from the local community to make local home visits. By being aware of religious, cultural and spiritual needs, the team can establish trust and engage with carers in a way that statutory services find difficult.
Carers Connect is making services more appropriate by ensuring BME carers have a say in the local provision of mental health and carers' services. A steering group has been set up enabling representatives from the local authority, the mental health trust and the voluntary sector to meet carers in quarterly meetings. Sharing best practice plays a vital role in improving services for carers and identifying gaps. FWA is producing a training video highlighting the needs of carers, featuring interviews with carers and professionals plus a variety of FWA activities. Once completed, it will be translated into minority languages and distributed widely among professionals and community groups.
- Case Study
- James Wiltshire Trust befriending scheme:
- Hampshire
- James Wiltshire Trust befriending scheme:
The James Wiltshire Trust's Community Engagement Project runs a befriending scheme for BME patients in psychiatric in-patient care units in Southampton and Hampshire.
The scheme uses the unusual approach of working directly with inpatient communities, and draws on the skills of service users, ex-service users, carers and mental health care volunteers. These individuals work to relieve the isolation felt by BME inpatients, and then to help them develop local connections and reintegrate with society. These 'befrienders' play a crucial role in helping patients rebuild their lives, pointing them in the direction of part-time work, hobbies or exercise and sport.
The part-time befriending scheme workers are a vital component in the drive to achieve equality in mental health care for black and minority ethnic clients and carers. Through feedback from workers and patients, insights can be gained into how to look after the spiritual needs and motivations of inpatients on the wards.
Ideas for action > Community engagement
Better community engagement in mental health care is taking many forms. Communities are being consulted and engaged in the drive towards equal and non-discriminatory mental health care in a range of ways - from healthcare teams working with Imams in Bradford to supporting the Jewish community in Manchester.
- Case Study
- Kids Emotional Wellbeing
- (KEW-5): Plymouth
- Kids Emotional Wellbeing
KEW-5 is a community Child and Adolescent Mental Health Services (CAMHS) initiative that links with health visitors, Sure Start, the Ethnic Minority Achievement Service (EMAS) and other voluntary sector players in Plymouth. It has cultivated strong links with the BME voluntary sector in the city and is now regularly approached for support in helping vulnerable people, particularly asylum-seeking and refugee families. Kew-5's work is led by the needs of these groups, and while it offers tailored individual support for families and children experiencing difficulties, it is keen to tap into existing social networks to support them as much as possible.
Faith groups form a strong part of this approach:
Having developed a relationship with a local Muslim community group, KEW-5 has 'joined' the women's group and developed a drop-in session on Sunday mornings where the women can discuss parenting issues with KEW-5's educational psychologist. This has led to individual parents requesting support on various issues - particularly related to teenage children.
The Plymouth Islamic Education Trust, PIETY, offers a number of services to Plymouth's Muslim community, including Arabic and Quaranic lessons, spiritual guidance and counselling services. In partnership with PIETY leaders, KEW-5 has produced a range of literature to promote their work to isolated families, and to promote access to local mental health services. KEW-5 has also developed a relationship with the Christian Refugee Community Group, which provides holistic emotional support for around 200 (largely French/Portuguese speaking) West African individuals and families.
- Case Study
- Dementia carers' support group: Manchester
- Focus
- Dementia carers' support group: Manchester
Focus is run jointly by Manchester Mental Health and Social Care Trust and the Manchester Jewish Federation. It is a group for Jewish Carers of people who have dementia. The sessions provide an opportunity for carers to obtain a greater understanding of dementia and how it affects the person who has this condition and to receive objective advice from professionals regarding such things as medication, progression of the illness and accessing services for themselves and those they care for. In a confidential environment carers share problems and ideas about coping, give and receive emotional support and are able to befriend people in a similar situation.
FOCUS is the only carers' group run by both NHS and Voluntary sector staff which is designed to meet the cultural, spiritual, social and healthcare of a specific ethnic group. Its venue allows access to a kosher dairy kitchen where food is stored and prepared in accordance with the requirements of the Jewish faith. The dates of meetings are organized around the religious Jewish calendar so as to avoid festival and fast days. By meeting the needs of Jewish carers' in this way FOCUS has been able to attract attendance where other groups have not.
FOCUS is regularly advertised in Manchester Jewish Federations' Time For You Carers' Project newsletter and from time to time in the local and national Jewish press. Carers are invited to informally evaluate the sessions and are encouraged by staff to identify topics for future exploration or discussion. The support to carers offered by FOCUS enables them to continue in their caring role for longer and to improve the quality of the care they provide. Additionally this support potentially increases the likelihood of carers returning to or remaining in work as well as reestablishing social links.
Ideas for action > Better Information
As is stated in the Delivering Race Equality Action Plan, "Better services depend on better monitoring of ethnicity, better dissemination of information and improved knowledge about effective services."
Across England, new initiatives are improving the flow of information between service providers and carers and users. Through websites, newsletters, forums and focus-group research, BME carers and users are finding out more about what services are available to them. Providers, meanwhile, are finding out more about what BME communities need and want from their services.
In May 2006, Dorset and Somerset NHS launched a groundbreaking new website called E-Quality 4 Mental Health.
[www.e-quality4mh-dorsetandsomerset.nhs.uk] The website was created in partnership with BME community representatives, and provides accessible information about mental health services both for BME users and carers, and for staff in mental health services.
Topics covered on the website include:
Mental health and illness
How to promote good mental health
Available local and national services
Culture and faith
Legal rights and mental health law
There's also a jargon buster to help users understand mental health terms.
The E-quality4mh project was funded through the Value Added Grant and has been supported by Dorset HealthCare NHS Trust, Dorset Race Equality Council, North Dorset Primary Care Trust, Somerset Partnership NHS and Social Care Trust, Somerset Black Development Agency and the Somerset Race Equality Council. This alliance intends not only to deliver an informative and community 'owned' website, but also to raise levels of engagement and shared confidence on the part of BME communities and staff in mental health services.
Ideas for action > Six steps to E-quality
Setting up a DRE website:
- Step 1: identify contributors from BME communities and staff in NHS trusts
- Step 2: agree content and style of website for users and others in BME communities
- Step 3: determine staff information needs and operational access requirements
- Step 4: provide relevant translations of the content of the site
- Step 5: produce and test prototype; make modifications; obtain approval for the system from all contributors
- Step 6: system live - launch and promote through local media and road shows