Welcome to the UK’s first national pledge calling on senior leaders in NHS mental health trusts, public bodies and commissioning to declare their commitment to reduce ethnic inequalities in mental health care systems. The pledge also has supporters, largely from the NGO and BAME voluntary and community sector, community groups and mental health activitists who have the expertise to partner with senior leaders to help eradicate ethnic inequalities in health and social care. Join us and be part of the wider network.
Black, Asian and minority ethnic (BAME) communities are facing disproportionate risks in mental health services that require urgent action, intent, shared vision and collaboration.
The context is stark. Ethnic inequalities in mental health care are longstanding and exceptionally large, disadvantaging BAME people in access, care, treatment and outcomes.
BAME people have a higher risk of experiencing ‘symptoms’ of psychoses, an even higher risk for a diagnosis of a psychotic condition, are more likely to experience adverse pathways to and through care, are subject to coercion and restrictive care, compulsory admissions and treatments, and poorer outcomes and follow-up.
Undeniably, the cost of coercive care is great, financially, but also in terms of trust and confidence in mental health and social care systems. The Black Lives Matter movement, and the worldwide protests in response to the killing of George Floyd, have resulted in renewed calls to address institutional racism. This makes it even more urgent to achieve a fair and equitable mental health system. This is why it is now time for action.
We believe it is unacceptable that despite 30 years of research, inquiries and reviews into this issue, a staggering 80% of recommendations made to address this problem have not been implemented fully. It is unacceptable that despite longstanding and pervasive ethnic inequalities, there are no plans for meaningful and sustainable change.
This ‘Statement of Intent’ is a call for commitment from CEOs and medical and nursing directors of NHS mental health trusts, commissioners and public bodies.
As senior leaders of mental health services and commissioners of mental health care, we will:
Some of this work is already underway in different parts of the country. For example, South West London and St George’s Mental Health NHS Trust, in collaboration with Wandsworth Community Empowerment Network, is implementing an Ethnicity and Mental Health Improvement Project, in a co-produced partnership with local stakeholders, including a range of diverse and multicultural community and faith networks.
Leeds City Council, NHS Leeds Clinical Commissioning Group, Leeds and York Partnership NHS Foundation Trust and a local stakeholder group of NGOs, BAME voluntary organisations, community groups and activists, are collaborating with Synergi’s Creative Spaces model to tackle ethnic inequalities in the risk and consequences of severe mental illnesses among the city’s BAME population.
Greater Manchester Health & Social Care Partnership (made up of all NHS organisations and councils, emergency services, the voluntary sector, Healthwatch and others, including the Mayor of Greater Manchester) has been working to reduce the ethnic inequalities gap. As part of their Covid-19 response the Partnership has collaborated with local BAME organisations and provided significant funding for critical mental health services for ethnic minority communities in the county.
We note that making the necessary changes will be complex and will take time. However, the scale of the task should not deter us from making a start in true partnership with communities across the health care systems.
This ‘Statement of Intent’ is an opportunity to pursue systems change as part of a constructive, bold, transparent and collective voice.