Overview of Delivering Race Equality Commissioned for BME Research
Evaluation of Community Engagement in Black and Minority Ethnic Mental Health
Dr Helen Killaspy, Ms Nika Fuchkan, Dr Kwame McKenzie*,
Start Date - April 2005
Final Report received October 2006
This project has examined the experiences and progress made by 11 Community Engagement pilot projects within voluntary sector organisations across England. The study aimed to describe and assess the process of using the Community Engagement model devised by the University of Central Lancashire and to compare mental health needs assessments carried out as part of the Community Engagement model with a standardised mental health need assessment tool. The project had three phases: 1) initial detailed description of each project, their target population and their aims; 2) quantitative comparison of each pilot project's own mental health needs assessment with a standardised mental health needs assessment of their target population; 3) in-depth qualitative interviews with project managers and volunteers from each pilot project regarding their experiences and telephone interviews with local mental health commissioners regarding their views and commissioning intentions subsequent to receipt of a final report from each pilot project.
Evaluation of the Focused Implementation Site Programme
Scott Weich & Kamaldeep Bhui
Start Date - October 2006
End Date - April 2009
This project will undertake an analysis of the Focused Implementation Site (FIS) Programme. The FIS sites are an endeavour to organise systematic work across a geographical area to improve mental health care for BME communities. This research will examine the experiences of those involved in undertaking this work and the impact of the FIS sites on improving care. The aim is to collate the learning points from FIS developments. There are 3 phases to the work:
1) Describing early set up - interviews with lead individuals and questionnaires to other stakeholders in 8 FIS sites, plus 2 non-FIS. Identified factors enabling/hindering progress, learning points and examples of good practice.
2) Phase II - evaluation of national datasets to identify developments in care, e.g. Count Me In and other Health Care Commission data.
3) Evaluating organisational change - in-depth case studies of 4 sites, sampled from a typology developed from phase 1. Seeking to assess awareness of and engagement in developments of various stakeholders, and evidence for change.
Ethnic Pathways Improving Centres (EPIC) project
Kwame McKenzie & Kamaldeep Bhui
Start Date - March 2005
Final Report received August 2007
More adverse pathways to mental health care are experienced by BME groups. This is seen in the lower levels of satisfaction, the poorer outcomes and increased use of sections in this group. Improving pathways to care for this group would be expected to improve outcomes. This project aims to improve pathways to care for BME groups in four DRE Focussed Implementation Sites in England. A systematic review of methods of ways to enhance pathways to and through care has been undertaken. Findings included a reflective use of team strengths, engagement of stakeholders from boardroom to clinical teams, transformational leadership, transmission of leadership to more appropriate leaders for different stages of the project, a reflective learning style that permits obstacles to be embraced and managed, and managing cycles of movement in projects between ‘ideological' and ‘operational' phases of the project.
EPIC II .
Kamaldeep Bhui
Start date - September 2008
End date - September 2009
This project is following up on the sites in the first EPIC project to review progress and lessons to be learnt.
Review of BME mental health research projects on the National Research Register
Neil Moreland
Start Date - April 2005
Final report received September 2006
This was a review of BME mental health research projects registered on the National Research Register (NRR). The aim was to provide a strategic overview of the research in this area and key gaps. The NRR was the system used to collate a national overview of all research in health care in England, but it is no longer used.
BME Suicide Prevention Project
Kam Bhui & Kwame McKenzie
Reported March 2007.
There were three components to the work:
1) Assessing the evidence - reviews of the evidence on comparative risk and preventive factors for suicide and Deliberate Self Harm (DSH) amongst BME groups in England and Wales.
2) Secondary analysis of other data sets, such as from the EMPIRIC and UK700 research projects and national data sets.
3) Expert panel - the findings of parts 1 and 2 were presented to an expert panel for views about implications and possibilities for ways forward to address suicide and DSH amongst BME groups.
Some of the findings were:
1) Various issues, such as variable quality of data collection, mean there are poor data sets in this area, with specific gaps in child and adolescent studies and potentially high risk groups such as refugees and prisoners.
2) Consistent findings in the literature include south Asian women, especially young women, have higher rates of suicide; south Asian women under 35 at higher risk of DSH, south Asian men have lower; men born in East Africa have higher rates; some age groups of people born in Scotland and Ireland have higher rates; "the literature does not offer a picture of comparative suicide risk and rates that is comprehensive enough to form the basis for suicide prevention"
Evaluation of Community Development Workers (CDWs)
Ian McGonagle, Lincoln University
This work examines the development and impact of CDWs. A draft report has been prepared with a view to a launch in the spring.
Community Development Workers for BME mental health: Embedding Sustainable Change
Dr. Reg Walker, Professor Gary Craig
The report presents the findings into the national picture on recruitment to CDW posts. It examines experiences of how the role is being implemented in practice and the issues affecting its sustainability. The research was jointly commissioned by the DRE Programme the NIMHE National Workforce Programme. An interim Report was submitted in January 2009 with a view to a final report in March 2009.
Developing Organisational Frameworks to Build System Capacity for implementing CDWS' Role
Dr. Reg Walker, Professor Gary Craig
Based on the emerging findings in the CDW implementation report, an extension report was commissioned to identify approaches aimed at supporting the development of organizational frameworks for CDWs. This is with a view to enabling organizations to better work with and through CDWs. The final report is expected to be published in April 2009.
Overview of the Community Engagement projects
Jez Buffin, University of Central Lancashire
Report to be submitted June/July 2009, with possible earlier publication of some sections
This work takes an overview of all the community evaluation projects and the lessons to be learnt. Community engagement projects employed the model led by the University of Central Lancashire (UCLan) in which local community groups are supported by a researcher from UCLan to undertake local audits, evaluations or research to better understand issues affecting their local communities. Following analysis of the data the community groups develop an action plan to address problems to seek to improve conditions. It draws together each of the reports from the community engagement
Audit of prescribing
Anne Connolly, SLAM
The aim of the project is to determine if ethnicity of patients affects total dose of antipsychotic used (high dose (> 100% of dose) antipsychotic use, total numbers of antipsychotics prescribed and type of antipsychotic used)
after controlling for more than 20 factors affecting dose e.g. age, weight etc. 10 sites were approached to provide data with only 2 not being able to participate. Data on over 1000 patients has been collected, with its entry for analysis being about 50% complete at this point, ready for the statistician in March 2009. We expect a preliminary report in April 2009.
Early Intervention (EI) in Psychosis Economic Modelling
Paul McCrone (IOP) & Martin Knapp (LSE)
DRE and NIMHE/DH have co-funded an extension to the first economic modelling project for EI. The first project modelled a comparison of EI service against usual care and used research and service data to calculate the economic cost of each approach, showing a very significant saving with the EI approach. The model has had a very significant impact on policy, commissioning and practice developments in EI since reported.
In this second phase of work (begun in April 2008) the model is being refined, with each data, including more quality of life outcomes in addition to service costs. The model is also being adapted to specifically examine the impact of EI services on the BME populations. Preliminary findings presented at the steering group are very positive. A seminar to discuss an interim report back is being held on March 11, with a plan for a final report in June 2009.
SPEKTRA Project
David Ndegwa
Experiences of Acute Mental Health Services among Black and Minority Ethnic Groups
Scott Weich and Sashi Sashidharan
Start Date - September 2005
End Date - February 2009
This project was not commissioned, nor funded, by the DRE programme but has been adopted into its research portfolio.
This project will explore from new perspectives the issues around the overrepresentation in mental health in-patient services of people from BME communities. A multi-disciplinary and in-depth, qualitative analysis of the experiences of people from BME communities with regard to mental health in-patient care will explore the interaction between individual factors and experiences and community and socio-geographical factors. The research team is now in place and the parameters of the research have been agreed with the steering group. The project is based in central Birmingham, an ethnically and socio-economically diverse locale served by a single Mental Health Trust. All ethical and research governance approvals have been secured. Work has begun to map statutory and voluntary services, and to recruit participants (including service users, carers and mental health professionals).
This report is based upon an analysis of the NRR in April 2006. It concerns solely with projects dealing with mental health and Black and Minority Ethnic communities. This is a more focused and specific mental health brief than the general overview undertaken in 2001 and reported in 2002 (Kai et al., 2002).
Dr. Neil Moreland
Dementiaplus West Midlands
April 2006
Joanne Moffat, Bernd Sass, Kwame McKenzie and Kamaldeep Bhui
Royal Free & UCL School of Medicine, UCL.
This paper synthesises existing knowledge from the grey literature on how to improve pathways to mental health care for ethnic minorities. A ‘pathway' was defined as ‘the flow of patients, service users or help seekers with mental distress into services or between services or professionals'. As previous reviews of care pathways for mental health have excluded nonstatutory services (1, 7), this review aimed to include broader ‘pathways' as a focus of intervention, including routes into, through and out of care across statutory and non-statutory sectors.
The Recovery Star model and culturally competency
Author and Project/Research Manager: Onyemaechi Imonioro
Researcher: Natasha Okonkwo
Date: June 2009
The Recovery Star is a key-working and outcomes measurement tool designed to map an individual's journey towards recovery. It uses a ‘ladder of change' as a framework for service user's, supported by their key-worker, to explore key themes in working towards recovery; Managing mental health, Self-care, Living skills, Social networks, Work, Relationships, Addictive behaviour, Responsibilities, Identity and self-esteem, Trust and Hope.
This Pilot study examines the effectiveness of the Recovery Star for people from BAME backgrounds; looking at the model's components through the lens of race and culture. It also examins whether the Recovery Star's generic models of mental ill health and recovery adequately pick up on and address the role of race and culture on people's lived experience.