Our priority outcome: To improve mental health outcomes for people from Black communities in Lambeth.
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
We continue to improve our understanding of the experiences of those from Black communities as well as LGBTQ+ and other ‘minority’ communities.
We believe 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.
Although there is a small reduction, for the last three years, around half of the people sectioned under the Mental Health Act (forced to stay in hospital for either their 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 continue to work hard to understand why those from our African and Caribbean communities are over-represented in mental health services, especially 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 for these communities 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, was 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. PCREF has now been rolled out as a national requirement for mental health trusts (and all those that use public money to provide mental health services), and we are ensuring that it is integrated into Alliance plans and performance management.
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.
Smarter resourcing
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.
Our impact
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.
In 2023/24 our CAPSA service has worked with 69 individuals for an average of 14 weeks each, visited inpatient wards more than twice every week, engaging with 77 people, and held 29 group advocacy sessions. It has provided advice and support on more than 1,000 occasions.
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.
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.