Mental health services working with Minority Ethnic Populations in Toronto - a briefing on the Canadian experience on improving access for ethnic minorities
By David Truswell
Central and North West London NHS Foundation Trust and the Westminster and Kensington and Chelsea Black and Minority Ethnic Health Forum
Background to visit
As part of its participation in The Health Foundation's Leadership for Change (BME) programme, the Kensington, Chelsea & Westminster BME Health Forum made an educational visit to Toronto, Canada to explore and learn from their approaches to tackling race equality in health and social care. In the UK the BME Forum recently completed research on primary care access by Black and Minority Ethnic Communities, published in its research report, Primary Concern1 and has been awarded funding to conduct six pilot studies with BME communities and GP surgeries in Westminster and Kensington and Chelsea to improve access. Mental Health service access was identified as a key health issue for minority communities in the Primary Concern report.
The BME Health Forum obtained full funding for its Leadership for Change programme team to visit Toronto from the Health Foundation. I have been a BME Forum Steering Group member for three years and a member of the Leadership for Change team for almost two years, providing support and advice on mental health issues and BME communities, as part of my role as the Trust's Focused Implementation Site (FIS) Project Manager. CNWL has developed a number of local projects across the 5 London Boroughs in which it provides services as part of its FIS work to support the national Delivering Race Equality Action Plan. Raising awareness in BME communities about mental illness and understanding how to access services have been the focus of the CNWL FIS work in Westminster and Kensington and Chelsea.
This report is a short account of the mental health aspects of the Canadian visit prepared for the Westminster Briefing. The BME Health Forum is currently preparing a report on the full range of health access areas covered in the visit which included services for women, services for undocumented migrants and access to dentistry and non-medical circumcision.
What can we learn from the Canadian experience of working with ethno-racial communities in Delivering Race Equality in the UK?
- Working in partnership with the not-for-profit sector to research health needs.
- Working in partnership with the not-for-profit sector to deliver services.
- Substantially and reliably funding the not-for-profit sector allows them to develop their capacity to deliver services effectively.
- The importance of having an explicit anti-discrimination framework when working with BME communities
- The importance of a holistic approach to health based on wellbeing
- Working with staff who have direct experience of local communities
- ‘Walking the Walk' - advocacy/'buddy' support systems that stay with service users across agency and care team transfers
- The importance of mental health promotion that recognise diversity and cultural differences
- Willingness to acknowledge and deal with intra-group and multiple-discrimination issues - e.g. bullying within Black male groups, gay and lesbian issues in BME communities, dual heritage and identity
- An understanding of the need to build trust as the first step in the engagement with the care provider.
- Understanding the need to continuously and flexibly develop services as communities change.
- A focus on diverse communities as a resource rather than a problem.
You can find more on the Westminster and Kensington and Chelsea Black and Minority Ethnic Health Forum at: http://www.westminster-pct.nhs.uk/diversity/bmehealthforum.htm
You can find out more about the Central and North West NHS Foundation trust and its Equality and Diversity work at: http://www.cnwl.nhs.uk/equality_diversity.html