Inequalities in mental health support are a real challenge. We have long-term evidence that Black people in Lambeth are less likely to seek support but in 2018 were nearly five times more likely than White British people to be detained in hospital under the Mental Health Act
Context and key challenges
More work needs to be done to better understand the needs and experiences of those from black communities as well as LGBTQ+ and other minority groups.
However, our current belief is that there may be more reluctance from these communities to seek mental health support early, and the system itself may be making it harder for them to access and receive support when they do ask for it. If people don’t get support early then they’re much more likely to have a ‘crisis’ which may lead them to needing more intensive help, such as hospital admission or even a secure (locked) facility.
In 2022-23, just over half of the people sectioned under the Mental Health Act (forced to stay in hospital for either your safety or the safety of others) were from our Black communities, even though those Black communities only make up 1 in 5 (19%) of Lambeth’s working age population.
What we offer
We have several initiatives in place to help us to better understand why those from our African and Caribbean communities are over-represented in mental health services, especially on the acute end, and to do something about this. We want to make sure that anyone from any background feels comfortable asking for support as soon as they need it, and that support is easy to access, sensitive to their individual needs and effective.
Culturally Appropriate Peer Support and Advocacy (CAPSA)
Our award winning Culturally Appropriate Peer Support and Advocacy (CAPSA) service was co-created by Lambeth’s Black communities with lived experience of mental health issues and employs people with these backgrounds to work with and advocate (speak up) for those we support. They work with staff in our acute wards, Living Well Centres and other Alliance teams to improve our support for people from Black communities. Improving our cultural awareness will also help to improve our support to all those from ‘minority’ communities by ensuring we see the person in front of us, not just assume everyone is the same.
Patient and Carer Race Equity Framework (PCREF) pilot
The South London and Maudsley NHS Trust, a core member of the Alliance, is one of four national pilots for PCREF (the Patient and Carer Race Equity Framework). The aim of this pilot is to make the experience of using mental health services easier, better and fairer for those from Black and Minority Ethnic communities and by doing this, build more trust in our services. The project is a collaboration between the Black community, Black Thrive and the South London and Maudlsley Trust. They will be developing a strategy around six priorities to make this change happen: cultural awareness, staff knowledge and awareness, partnership working, coproduction, workforce and co-learning.
Coproduction and engagement
We’re increasing engagement with those we support and their carers, to include making sure we do more co-production and get regular feedback from service users on their experience. We will continue to work closely with the Lambeth Collaborative who were the driving force behind our Alliance being formed. We meet with the Collaborative monthly to get feedback on how we’re doing, along with suggestions and ideas for improvement.
We’re increasingly using more data to identify issues and direct resources where they are most needed. For example, using natural language processing to analyse doctors’ notes to identify where certain medications have been prescribed so that medication management support can be focused in those areas.
We have championed the collection, analysis and reporting of ethnicity data in Lambeth – improving the quality and amount of that data. For example, when we started reporting the ethnicity of those introduced to our Single Point of Access in the summer of 2020 we had ethnicity data for less than half of those referred (48%) we now have that data for more than 4 out of 5 (81%) and this is growing all the time. By reporting this and other data we will be able to see any changes over time.
Our CAPSA service has just started, but in its first month the service made 37 contacts with patients across 4 wards and held 16 one to ones. We will report fuller data over the coming months.
Our next steps
We will continue to embed and develop our CAPSA service, sharing learning across the Alliance system and beyond.
We will implement changes as part of the PCREF programme to improve the access, experience and outcomes of the people we support from our Black, LGBTQ+ and other ‘minority’ communities.
We will also implement our new workforce strategy, which includes plans to ensure staff from these communities have the confidence, support and opportunities to develop themselves and their careers to their maximum potential.
Case study: CAPSA & the Professional Footballer’s Association
Can you help us?
We have a short survey that anyone who use our services is invited to complete. It will take less than three minutes and will tell us how well we are doing and what we need to improve.