A number of inequalities around access to mental health services have been identified showing that black people are over four times more likely to be detained than white British people and over ten times more likely to be subject to a Community Treatment Order (CTO) under the Mental Health Act 1983 (the Act).
In addition, the White Paper notes that back British people experience poorer outcomes and that, during detention, black patients may be subject to a level of restraint that is three times higher than that of white British people. Under the heading of “the degree of inequality” the White Paper sets out plans to overhaul the mental health system with the aim of addressing disparity in outcomes and detentions by enhancing the patient voice, supporting advocacy, having a greater reliance on evidence, scrutinising decisions more and improving the right to challenge.
The Government’s recent White Paper highlights a series of reforms underway to tackle those disparities identified to ensure that the next piece of mental health legislation (as the current Act is almost forty years old) is brought into the 21st century to reflect how modern society thinks about mental illness.
The reforms will see:
- The introduction of a practical tool called the Patient and Carer Race Equality Framework (PCREF) which will be used to understand what steps the NHS mental healthcare providers and local authorities need to take to improve access and engagement with the communities they serve. It specifically states that monitoring data at Board level is crucial to facilitate appropriate action.
- The piloting of ‘culturally appropriate’ advocacy for people of all ethnic backgrounds who can be better supported to voice their individual needs. However there are two provisos in terms of implementation: successful learning from the pilots and appropriate funding.
- Research priorities to identify and explain the issues that lead to mental health problems and develop early interventions within BAME communities.
- Improvement to diversity of the workplace, in professions such as clinical psychology and occupational therapy, to tackle the significant under representation of people of black African and Caribbean descent across mental health professionals.
- A reduction in the number of CTOs by achieving reductions in future CTOs and increased scrutiny of CTOs, so that if they are used they do not last for extensive periods.
- Plans to introduce mental health transport vehicles to reduce inappropriate, distressing conveyance by police to hospital.
- Progression and support towards discharge from detention more quickly and ensuring people’s views and choices are heard and respected regarding their care and treatment.
Dealing with mental health can be a traumatic experience for any person but a lack of cultural understanding of an individual’s needs can reinforce barriers when trying to access or use mental health services. There is a clear need for reform and improvement to address the inequalities and variation in care and with the proposed reforms, there is hope that specific targeted interventions for BAME communities will help to combat the stigma and inequalities identified within mental health services. Only time will tell whether the above reforms will go far enough to achieve the person-centred plan for individuals and whether an already under-resourced and over stretched service can meet the requirements and improvements identified above.
On balance, the reforms are a positive step in acknowledging the problems and deficiencies within the current legislation and we look forward to seeing the output of the consultation and the level of funding that the Government commits.
Have your say about the proposals in the consultation which closes on 21 April 2021.
You can read our earlier blogs on the MHA reforms: Reforming the Mental Health Act, Five big changes to the Mental Health Act and The new look Mental Health Tribunal.