Improving mental healthcare access and experience for people from minority ethnic groups: an England-wide multisite experience-based codesign (EBCD) study.
COVID-19
PSYCHIATRY
Journal
BMJ mental health
ISSN: 2755-9734
Titre abrégé: BMJ Ment Health
Pays: England
ID NLM: 9918521385306676
Informations de publication
Date de publication:
Jul 2023
Jul 2023
Historique:
received:
17
03
2023
accepted:
27
06
2023
medline:
21
7
2023
pubmed:
19
7
2023
entrez:
18
7
2023
Statut:
ppublish
Résumé
Long-standing ethnic inequalities in access and mental healthcare were worsened by the COVID-19 pandemic. Stakeholders coproduced local and national implementation plans to improve mental healthcare for people from minority ethnic groups. Experience-based codesign conducted in four areas covered by National Health Service (NHS) mental health trusts: Coventry and Warwickshire, Greater Manchester, East London and Sheffield. Data were analysed using an interpretivist-constructivist approach, seeking validation from participants on their priority actions and implementation plans. Service users (n=29), carers (n=9) and health professionals (n=33) took part in interviews; focus groups (service users, n=15; carers, n=8; health professionals, n=24); and codesign workshops (service users, n=15; carers, n=5; health professionals, n=21) from July 2021 to July 2022. Each study site identified 2-3 local priority actions. Three were consistent across areas: (1) reaching out to communities and collaborating with third sector organisations; (2) diversifying the mental healthcare offer to provide culturally appropriate therapeutic approaches and (3) enabling open discussions about ethnicity, culture and racism. National priority actions included: (1) co-ordination of a national hub to bring about system level change and (2) recognition of the centrality of service users and communities in the design and provision of services. Stakeholder-led implementation plans highlight that substantial change is needed to increase equity in mental healthcare in England. Working with people with lived experience in leadership roles, and collaborations between NHS and community organisations will be essential. Future research avenues include comparison of the benefits of culturally specific versus generic therapeutic interventions.
Sections du résumé
BACKGROUND
BACKGROUND
Long-standing ethnic inequalities in access and mental healthcare were worsened by the COVID-19 pandemic.
OBJECTIVES
OBJECTIVE
Stakeholders coproduced local and national implementation plans to improve mental healthcare for people from minority ethnic groups.
METHODS
METHODS
Experience-based codesign conducted in four areas covered by National Health Service (NHS) mental health trusts: Coventry and Warwickshire, Greater Manchester, East London and Sheffield. Data were analysed using an interpretivist-constructivist approach, seeking validation from participants on their priority actions and implementation plans. Service users (n=29), carers (n=9) and health professionals (n=33) took part in interviews; focus groups (service users, n=15; carers, n=8; health professionals, n=24); and codesign workshops (service users, n=15; carers, n=5; health professionals, n=21) from July 2021 to July 2022.
FINDINGS
RESULTS
Each study site identified 2-3 local priority actions. Three were consistent across areas: (1) reaching out to communities and collaborating with third sector organisations; (2) diversifying the mental healthcare offer to provide culturally appropriate therapeutic approaches and (3) enabling open discussions about ethnicity, culture and racism. National priority actions included: (1) co-ordination of a national hub to bring about system level change and (2) recognition of the centrality of service users and communities in the design and provision of services.
CONCLUSIONS
CONCLUSIONS
Stakeholder-led implementation plans highlight that substantial change is needed to increase equity in mental healthcare in England.
CLINICAL IMPLICATIONS
CONCLUSIONS
Working with people with lived experience in leadership roles, and collaborations between NHS and community organisations will be essential. Future research avenues include comparison of the benefits of culturally specific versus generic therapeutic interventions.
Identifiants
pubmed: 37463794
pii: bmjment-2023-300709
doi: 10.1136/bmjment-2023-300709
pmc: PMC10357761
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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