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Attempts to reduce the levels of ethnic inequalities in severe mental illness, 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 national dialogue and collaborations to enable health systems interventions to prevent or reduce ethnic inequalities and multiple disadvantages experienced by people with severe mental illnesses across the country.
As a safe space, it aims to bring together people from different constituencies with and without different types and levels of power and resources, to make possible an honest and open exploration of the challenges and constraints, and to harmonise the purpose of future actions.
Creative Spaces works with the local history 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.
First launched by Synergi in London in January 2018, the second phase is taking place in Birmingham in collaboration with Catalyst 4 Change, West Midlands Mental Health Commission and Birmingham University and a third phase is planned in Manchester in the summer 2019 and Leeds thereafter.
The underlying focus is on health systems interventions that will be beneficial and lead to transformation, particularly for patients and carers. It is about testing these health systems and circulating what works. And it is about exploring the ideas, concepts and realities in creative ways and creative spaces.
If you would like to know more, please email [email protected]