Race

We celebrated Black History Month 2020 throughout the Trust by shining a light on BAME NHS staff over GMMH's social media channels and promoting the opportunity to be a Committee member on the Trust’s proactive BAME staff network: BAME Network | Greater Manchester Mental Health NHS FT (gmmh.nhs.uk). Follow all the action from our BAME Network on Twitter #GMMHBAME (opens in a new window).

IAPT services have looked at the ethnicity of the current treatment population and compared it with the wider population of Bolton to help develop a service model that is accessible to BAME communities in the borough.

Click the following link to see evidence on how Bolton is working towards a more inclusive therapy service:  BAME Communities in Bolton.pptx [pptx] 10MB

Our IAPT services have developed a BAME work group to develop a culturally competent response to different communities.

Please click the following link to see our objectives for 2020/21:  IAPT BAME Group Objectives 2020-21.docx [docx] 24KB

How effective are drug treatment and recovery services at meeting the needs of black, Asian and minority ethnic (BAME) communities? 

NDTMS- Nationally and locally BAME communities are underrepresented in treatment. However, the reports online do not specify demographics to demonstrate. 

Public Health England have limited research- there are reports to suggest BAME services users are less likely to access MH services than white people. Reasons- culture, language barriers, accessibility etc.  

In 2019, GMMH SMS has 94% white and 6% BAME service users – 2011 census  North West 91% white 9% BAME- therefore under representation.  I am not aware of any methods to monitor effectiveness of drug treatment in BAME communities? 

The Public Sector Equality Duty requires public bodies to help make society fairer by tackling discrimination and providing equality of opportunity for all. How effectively do the commissioners and providers of drug prevention, treatment and recovery services do this and what improvements could be made? 

Responses can address any of the protected characters, specified in the duty, which are: race, religion or belief, sex, sexual orientation, age, disability, gender reassignment, pregnancy and maternity. 

GMMH /SMS produces annual equality reports which demonstrate demographics of age, race, disability, religion and sexual orientation.  There are no remarkable differences between the general population and those who access substance misuse services (bar race).  

Disability SMS adheres to the accessible information standard and provides information in accessible format/has hearing loops in reception areas/ access to interpretation services. Buildings have accessible toilets, and where flat level access is not possible, effort is made to offer appointments at suitable community venues; and in specific cases at home. Provision is made to include support workers and other professionals within recovery planning.

Gender Reassignment/sexual orientation/sex- SMS has strong links with the LGBT foundation and has rainbow material displayed in reception areas. SMS/GMMH has access to a Trans advocacy worker, and training is available to promote inclusion and understanding. Services are actively involved in local Prides, and many staff have pledged as equality champions, wearing their rainbow badges to demonstrate this overtly to service users and carers. 

Pregnancy SMS accessed by pregnant service users and clear pathways with antenatal/maternity services. Services promote awareness of FASD/FAD and host events e.g. Drymester.

Religion/Beliefs SMS Cumbria sites have chaplaincy provision. SMS advocate 12 step approach through AA/NA. SMS plan appointments with gender specific staff to support service user belief systems. Community Development work with community faith leaders to promote inclusion e.g. attend Jewish ETE events in synagogue.

Race BBST produced downloadable (from the Achieve website), and hardcopy information booklets containing representative images of people from diverse ethnic backgrounds, to support inclusion and identification. Achieve BBST host a calendar of events to educate and celebrate diversity e.g. Hate Crime Awareness weeks, Black History Month; we do this to support engagement of people who identify within BAME communities.

Age BBST work with sub-contracted partners to provide young people services, including the Holding Families provision, and in-reach to older age services to promote the service offer and harm minimisation advice.

Marriage and Civil Partnership SMS support and include partners within service delivery, backed by the Carers, Family and Friends Strategy.

SMS BBST have outreach workers who target the homeless population, to support engagement with drug and alcohol services. 

Fundamentally there are no commissioned funding streams to target or address accessibility of underrepresented groups- ideally improvements would be outreach workers to engage with BAME communities.  

COVID-19 Equality Impact Assessment

SMS elicited service user feedback, contacting them to assess their ability to access virtual interventions/groups using technology. We involved volunteers/peer mentors in decision making exercises. SMS led a campaign to ensure service users knew the services are still available, and what the adaptations were. This campaign used a range of demographics of service users /and used real service user feedback to ensure relatability. 

Communication during coronavirus has mainly been limited to electronic methods; however to ensure an inclusive approach information has also been shared by letters. This is on a presumption that older people may not access emails/SMS texts. Communication campaigns to promote service accessibility was shared on social media for younger generation accessibility.  For older service users who may be shielding, services have ensured medication is delivered and provided general support over the telephone. 

For those shielding with physical disabilities, services have provided extra support and services.  

There may be some disabilities whereby telephone contact is not suitable, all service users have been risk assessed and where face to face appointments were required, this has been facilitated. For those who are at high risk in regards to their mental health, increased support has been provided.  For some physical disabilities and for areas such as Cumbria, whereby geography is an issue, receiving over the phone telephone support has supported them to remain within the home as advised.  

For those who may be chaotic/disadvantaged mobile telephones have been procured and provided.  

For homeless service users, staff have provided in reach to hostels /ABEN facilities. 

Speakers of English as a second language were provided with translated safety guidance from PHE, or offered interpreter services. 

Bluesci have appointed two dedicated BAME Primary Care Mental Health Wellbeing Workers (PCMHWW) (one three days, one two days pw) for 6 months to provide direct Mental Health and Wellbeing support for BAME adults living in Trafford who are experiencing emotional and psychological distress. They work alongside our Bluesci team that includes their BAME Community Development Worker, who works closely with BAME community groups in Trafford through their small BAME wellbeing grants programme.

The role recognises the reported facts about Covid-19, which have impacted on BAME individuals and communities in a number of ways, not only are they having to be extra cautious and vigilant to protect their physical health. The impact on their mental health and wellbeing is also impacted; worrying about children and family members, stigma, racism, discrimination creating a climate of fear and mistrust. Taking this collaborative approach, drawing on the current resources, networks and local knowledge will ensure individuals receive culturally appropriate support and interventions and access vital prevention services for their physical, emotional / psychological health and wellbeing.

The dedicated PCMHWWs' have a full understanding of the impact of COVID-19 on this client group and consider a range of approaches to mitigate fears and provide relevant targeted information and awareness. It offers much needed support via a range of interventions that enable individuals to manage their mental health and wellbeing (physical health, emotional/ psychological health, Social wellbeing financial wellbeing). These culturally appropriate interventions supported by the dedicated worker understanding the stigma often associated with mental health that potentially means people suffer in silence.

These interventions include: (taking into consideration language, resources, interpreters, gender, barriers)

• Emotional Wellbeing – Psychological Interventions: Sleep, Behavioural Activation, Psycho-education, Guided Self-help, Problem Solving, Motivational interviewing support to access psychological therapies.
• Financial Wellbeing – Benefits advice/support, food / period poverty, work related concerns.
• Social Wellbeing – Housing, Practical Help, Social Network, community connections.
• Lifestyle Behaviour Change - (linked to the 5 ways to Wellbeing (www.nhs.uk); Stop Smoking, Be Active, maintain a routine, Reduce / manage alcohol & drug use, Healthy weight/healthy eating, exercise. The project will make a difference in the first instance by raising awareness of the individual support available. Knowing there is a dedicated worker (and wider service) as a point of contact to help navigate services, seek out opportunities and support individuals and families during this difficult time.

The impact of this work aims to improve:

• Health outcomes
• Wellbeing outcomes
• Navigation and support around services and agencies
• Feelings of connectivity into the community through social prescribing. (Social prescribing has been shown to produce positive outcomes, such as emotional, cognitive and social benefits).
• Giving confidence to BAME community groups knowing there is someone available to provide more specific advice and support for individuals in their community.

This is a targeted addition to an existing Trafford service provided by Bluesci. This role integrates into the existing Bluesci service and benefits from support from the PCMHWS team sharing skills and resources.

These posts are Big lottery funded through the Government targeted COVID-19 scheme and only for 6 months. It is hoped that GMMH will contribute the funding for the additional 6 months costs to make the posts 12 months.