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 experiences of those from Black communities as well as LGBTQ+ and other ‘minority’ communities.
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 more difficult for these communities to access and receive support when they do ask for it. If people do not get support early then they are more likely to have a ‘crisis’ which may lead them to requiring much more restrictive support, such as admission to a hospital bed or even a secure (locked) facility.
The chart shows that nearly half (47%) of our adult mental health hospital beds were taken by those from Black communities (up from 43% the previous year) whereas those Black communities only make up 1 in 5 (19%) of Lambeth’s working age population. We are working hard to understand why this is the case and how we can 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.
What we offer
We are working hard to become more culturally sensitive. We have launched a ground-breaking service known as Culturally Appropriate Peer Support and Advocacy (CAPSA). This service employs people from Lambeth’s Black communities with lived experience of mental health issues to work with and advocate (speak up) for those we support. They will work and train with staff in our 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.
Race Equality Framework
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 Equality Framework) which aims to eliminate differences in access, experience and outcomes in mental health for those from Black and Minority Ethnic communities.
Listening those we support
We are increasing engagement with those we support and their carers, including more co-production and regular feedback from service users on their experience.
We are increasingly using data to identify issues and direct resources where they are most needed.
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.