Ethnic Inequalities in Mental Health Care

Established: April 2006, date of inception: 1 July 2006

Convenor (Chair): Professor Scott Weich, Professor of Psychiatry, University of Warwick. (e-mail: s.weich@warwick.ac.uk)

Members:
Professor S Weich, Professor of Psychiatry, University of Warwick; Professor D Bhugra, Professor, Mental Health & Cultural Diversity, Institute of Psych KCL; Professor K Bhui, Professor of Cultural Psychiatry & Epidemiology, St Bartholomews & Royal London School of Medicine & Dentistry; Professor M Birchwood, Professor of Mental Health, School of Psychology, University of Birmingham; Mr P Scott Blackman, Visual Arts, Education in Art and General Science, Arts Administration, London; Dr H Bradby, Department of Sociology, Warwick Medical school, University of Warwick; Dr M Commander, Consultant Psychiatrist/Hon Senior Lecturer, University of Warwick, Medical School; Professor T Craig, Professor of Social & Community Psychiatry, Health Services Research; Department, Institute of Psychiatry; Mr J Curran, NHS Modernisation Agency, Associate; Dr Paul Fearon, Senior Lecturer in Psychiatry, Division of Psychological Medicine, Institute of Psychiatry, London; Professor M Johnson, Professor of Diversity in Health and Social Care & Director, Mary Seacole Research Centre, De Montfort University Leicester; Dr F Keating, Senior Lecturer in Health and Social Care, Department of Health and Social Care, Royal Holloway University of London; Dr H Lester, Reader in Primary Care, Clinical Lead Foundation Practice Lansdowne Health Centre, Birmingham; Dr K McKenzie, Senior Lecturer in Psychiatry Royal Free and University College Medical School; Dr C Morgan, MRC Research Fellow and Honorary Lecturer, Institute of Psychiatry, London; Dr D Ndegwa, Consultant Forensic Psychiatrist and Clinical Director, Lambeth Forensic Services, London; Professor D Sallah, Director of Research, Ethics and Consultancy, School of Health, University of Wolverhampton; Professor SP Sashidharan, Hon. Professor Warwick Medical School, University of Warwick; Professor A Szczepura, Professor of Health Services Research, Warwick Medical School; Professor S Singh, Senior Lecturer in Community Psychiatry & Head of Social and Community Psychiatry, St George’s University of London; Dr J Tew, Senior Lecturer, Division of Social Work, University of Central England; Dr W Waheed, Academic Consultant Psychiatrist / Honorary Clinical Lecturer, University Department of Psychiatry, LANTERN Centre, Vicarage Lane, Fulwood, Preston.

Disciplines represented include psychiatry, social care, nursing, forensic mental health, primary care and social sciences including sociology and anthropology.

The project team includes individuals experienced in working strategically with stakeholders around implementing equality and diversity policies and will also work with other, local user involvement projects (such as UNTRAP at the University of Warwick, and SURESEARCH at the University of Birmingham).

Remit and Aims:
Ethnic inequalities persist in the delivery, experience and outcome of mental health care in the UK. Individuals from black and minority ethnic (BME) groups in the UK, particularly young Black and Caribbean men, have difficulty accessing mainstream services. They are more likely to be admitted to hospital (especially compulsorily) and perceive care as more coercive and less satisfactory than white counterparts. They are less likely to access social care interventions and psychological therapies. Recent policy initiatives are promising, but remain largely unsupported by empirical evidence. It is also increasingly clear that focusing on the failings of mental health services alone may not be sufficient to reduce existing inequalities. This is perhaps the most seriously under-funded area of health outcomes research in Britain.

The group will develop cutting-edge, multi-method research proposals designed to understand and therefore overcome ethnic inequalities in the experience and outcome of mental health care. There is currently much evidence of unmet need, but little about effective interventions. There have been promising recent developments, and users’ and carers’ voices are finally being heard.

This group will combine development and evaluation of complex interventions with epidemiological and aetiological research. This research will also seek to understand the relationship between ethnic and socio-economic inequalities, and will incorporate sociological and anthropological as well as biomedical perspectives.

Current Status & Future Plans:
The key focus is research that will contribute to improved outcomes for those with severe and enduring mental illnesses.
The following are key research areas:
• developing and evaluating training for mental health staff in the delivery of racially and culturally appropriate care
• improving communication and understanding in user-professional interactions
• comparing different models for delivering acceptable and accessible mental health and social care services for BME users
• looking beyond statutory services to the role of NGOs.

Specific proposals for large-scale studies are:
1. Development and evaluation of interventions to train mental health professionals in racial and cultural competency.
2. Cluster randomised trials of the cost-effectiveness of cultural formulation, consultancy and mediation across psychiatric settings.
3. Evaluation, including both comparative qualitative and quantitative components, of ethnically specific services (statutory and voluntary sectors) as against mainstream services.

All three proposed studies are eminently suitable for the MHRN, given the clustered distribution of BME populations in the UK and the widespread population coverage of MHRN hubs

Progress report (June 06): First meeting of this group to be held Oct 06.