Mental healthcare services must adopt new models of care to reduce ethnic inequalities
The experiences of people from ethnic minority groups with NHS mental healthcare are being 'seriously undermined' by failures to consider the everyday realities of people’s lives in services in the UK, reports a new study led by researchers at the University of Bristol and Keele University.
The lack of progress in tackling ethnic inequalities in the UK is attributed to failure to ensure authentic community co-production of services, and a reluctance to fully implement community recommendations within statutory services.
The research team reviewed previous research to understand the under-use of primary care mental health services by people in ethnic minority groups and their over-use of crisis care pathways and involuntary admissions to hospital.
The research sets out to explain why these inequalities continue to persist despite over five decades of established evidence and government initiatives in this area.
The study calls for clear strategies and plans to address individual, systemic, and structural obstacles to authentic and meaningful co-production and implementation of existing community recommendations in mental health services.
Keele's Professor Carolyn Chew-Graham, Professor of General Practice Research, said: "This is an important study, conducted by a multi-disciplinary team, with implications for all clinicians who work in primary care and mental health services. We have described the continued inequalities in access to mental health services and highlighted the often tokenistic inclusion of under-served groups in the design and delivery of services. There are important messages in our findings for commissioners and providers of care."
Dr Narinder Bansal, the study’s lead author and Honorary Research Fellow at Bristol's Centre for Academic Mental Health, said: "The delivery of safe and equitable person-centred care requires a model of mental healthcare that is better aligned with social and anti-racist models of care. Assessment and treatment should always consider the intersections between experiences of racism, migration, complex trauma, and religion.
"We found that addressing the overlapping experiences of oppression, such as those related to racism, migration, complex trauma, and English language literacy, is more relevant than approaches based on crude ethnic group classifications in understanding and reducing ethnic inequalities in access, experiences, and outcomes of mental healthcare.
"Data has highlighted ethnic inequalities in mental healthcare in the UK over the past 50 years, the reasons behind these inequalities continue to be under dispute. We found that community voices are not listened to and community recommendations for reducing the adverse experiences are rarely implemented as they are seen as too radical for services. Although service providers recognise the importance of co-production, we found that attempts at co-production are experienced widely as superficial, tokenistic and the failure to implement it authentically creates more frustration and further disengagement."
The National Institute for Health and Care Research (NIHR) funded study has been published in PLOS Medicine.
An animation summarising key findings is available to view at: https://vimeo.com/776884875
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