1. Brent Mental Health User Group
Reflection on challenges in commissioning to address racial disparities at a local level
Brent Mental Health User Group

2. Addressing experiences of black and minority ethnic communities using services to deal with mental health issues
High percentage of African Caribbean men subject to the Mental Health Act - and in secure settings
Continuing stigma and discrimination resulting in lack of trust in services so less likely to access services at an early stage
More likely to be given particular diagnoses which have a long-term effect on their lives, including social exclusion
Focus on medication as the solution to mental health issues so lack of use of recovery approach
Experiences linked to social determinants of health not addressed

3. Addressing experiences of black and minority ethnic communities using services to deal with mental health issues
Continued use of the medical model which often does not resonate with individuals
Lack of access to more creative approaches such as self-directed support to meet social care needs
Therapeutic approaches which are not culturally appropriate
Use of systems that exclude those whose first language is not english and lack of interpreting
Effects of lack of attention to other aspects of individuals’ identities eg gender, sexuality, physical and or learning disability, age...

4. Challenges
Lack of use of wealth of data gathered locally eg about populations in Joint Strategic Needs Analysis
Lack of use of wealth of knowledge about the experiences of local black and minority ethnic communities held by community organisations – and user and carer groups
Lack of funding available to user, carer and community groups to engage with individuals and local communities
Focus of commissioners on service provision in the voluntary sector and not acknowledging our role in representing our communities

5. Challenges
Lack of engagement with community organisations by statutory specialist mental health services in relation to service provision
Individuals not consistently involved in co-production of design, redesign and evaluation of services
Key performance indicators negotiated in contracts focusing on quantitative data
Effects of monitoring being carried out by contracts rather than commissioning
Lack of strategic involvement of individuals using services locally

6. Challenges
Lack of organisational memory and consistent approach to engagement and good practice evidenced by ‘grey’ research produced by user and community groups
Lack of learning from and acting on individuals’ experience and what has been experienced as positive and helpful
Over-reliance of statutory specialist mental health services and commissioners on information purely from Friends and Family Test and national surveys to indicate satisfaction as don’t incorporate ideas for improvement

7. Opportunities
Involve individuals from diverse communities – and user, carer and community organisations in co-production in relation to the NHS Long-Term Plan to create appropriate models of care that directly address negative experiences of services – ensuring time and resources
Ensure that user, carer and community groups are funded and their different roles are acknowledged and acted on
Ensure that information and recommendations from ‘grey’ research is valued, incorporated in thinking about models of service provision – and acted on

8. Opportunities
Learn from approaches that have been successful and embed rather than replace them – giving them a profile and sharing knowledge across CCGs
Ensure that key performance indicators incorporate qualitative evaluation and information
Ensure that statutory service providers are incorporating meaningful qualitative information and utilise existing structures eg creating dashboards to measure attention to provision that is culturally appropriate and directly addresses racial disparity and other equalities

9. Opportunities
Create structures that facilitate strategic involvement of individuals from diverse communities and organisations that represent their experiences
Ensure organisational memory as opposed to successful approaches being dependent on particular staff members – continue to find ways of incorporating what has been successful

10. Produced by
Fiona Hill Brent Mental Health User Group