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Attempts to reduce the levels of ethnic inequalities in severe mental distress, both in terms of experience and outcome, have not been effective over many decades. One of the explanations is that interventions haven’t been applied to health systems, but operate in isolation from each other. This leads to resistance in other parts of the system, generating constraints on the flexibility and innovation of a health system.
Additionally, managers and commissioners often see concerns around equalities as a matter of legal compliance rather than quality and improved outcomes. Equalities’ issues can also be marginalised, when there are other apparently more urgent and dominant system metrics, which distort priorities.
For example, the harsh reality of providing care at a time of austerity and the neo-liberal emphasis on individuality and self-management and performance metrics to justify public spend, all of which work against innovation and creativity. Divergent narratives of the causes of, and solutions for inequalities have also been prominent, particularly when ethnic inequality is discussed.
This leads to pessimism, a lack of motivation and fragmentation of purpose and actions, with more systems energies spent on managing opposing narratives, ideologies and instincts rather than on solving the difficult issue of how to harmonise systemic efforts for wider system benefits and improved patient and public health.
What is Creative Spaces?
Creative Spaces aims to facilitate solution-focused dialogue and collaborations to enable health systems interventions to prevent or reduce ethnic inequalities and multiple disadvantages experienced by people with severe mental illnesses.
Ethnic inequalities in severe mental distress are longstanding and exceptionally large, disadvantaging those from Black Caribbean and Black African ethnic minority groups particularly, though not exclusively. Ethnic minority people have a higher risk for experiencing ‘symptoms’ of psychoses, an even higher risk for a diagnosis of psychoses, and once diagnosed are also much more likely to experience adverse pathways to and through care, including more coercive care, compulsory admissions and treatments, and comparatively less general practitioner care.
Creative Spaces brings together people from different constituencies within a space that facilitates honest and open exploration of the challenges and constraints, and to harmonise the purpose of future actions.
It works with the local legacy and experiences, and engages service user and carer organisations, NGOs, commissioners, academics, voluntary organisations, activists, community groups, public bodies and other interested parties. This includes informal and formal sectors, embracing social and cultural assests in the community. This helps to deliver identified solutions by electively sharing risk, but also keeping any actions close to the real experiences of the beneficiaries and their concerns.
Creative Spaces: Birmingham
Partners: Catalyst 4 Change, Dr Karen Newbigging (University of Birmingham), Health Services Management Centre, West Midlands Combined Authority and the Red Earth Collective.
Creative Spaces: Leeds
Partners: Leeds Health and Wellbeing Board, Leeds CCG, Leeds City Council, Leeds and York Partnership NHS Foundation Trust, Forum Central, Leeds Gate and Touchstone Housing.
Creative Spaces: Manchester
Partners: Greater Manchester Health & Social Care Partnership, Manchester Museum, Whitworth Gallery, Caribbean and African Health Network, African Caribbean Mental Health Services, LMCP, British Muslim Heritage Centre and Mind Manchester.
If you would like to know more, please email [email protected]