Blueprint to eradicate discrimination in the Mental Health Services, UK

Main Category: Mental Health
Article Date: 13 Jan 2005 - 11:00 PDT

email to a friend   printer friendly   view / write opinions   rate article

UK Government response to the David Bennett Inquiry - Black and minority ethnic people with mental health problems will benefit from better care from the NHS and social services, thanks to a new blueprint for reform launched today by Health Minister Rosie Winterton.

Delivering Race Equality in Mental Health Care, an action plan for reform both inside and outside NHS mental health services over the next five years, is being published together with the Government's response to the independent inquiry into the death of David Bennett who died in 1998 whilst being restrained in a psychiatric ward.

Rosie Winterton said:

"We know what the problems are. There are significant and unacceptable inequalities in the access to mental health services that black and minority ethnic patients have, in their experience of those services, and in the outcome of those services.

"Rates of compulsory admission are significantly higher for black and minority ethnic groups. Average lengths of stay in hospital are longer. BME patients are more likely than white people to be prescribed drugs or ECT rather than psychotherapy or counselling. All this fuels the "circle of fear" that can deter BME patients from seeking early treatment for their illness.

"We've made some progress, but not enough. Now we have a clear and comprehensive action plan for making sure that progress continues and accelerates.

"I'm very grateful to Sir John Blofeld and the other members of the inquiry team for their thorough and helpful report into David Bennett's death. It has been invaluable in informing our thinking over the last year, and today we are publishing our positive response to its recommendations. Together, DRE and the response form a coherent and comprehensive action plan for eliminating discriminatory practice."

Main elements of the action plan include:

-- PCTS providing more responsive services based on the needs of the local population, helped by local demographic data;

-- NHS trusts being assessed by the Healthcare Commission on their performance in challenging discrimination and providing equality of access;

-- a new commitment to reduce the disproportionate rates of compulsory detention of black and ethnic minority mental health patients and preventing deaths in mental health services following physical intervention;

-- new focused implementation sites where SHAs and organisations will work together, on a local level, to drive change in mental health services for black and ethnic minority people and develop best practice;

-- creating a workforce that has the knowledge and skills to deliver equitable care to black and minority ethnic populations with support from the Royal College of Psychiatrists and better race equality training;

-- an important role for the independent sector, supported by a £2 million national community engagement scheme to help PCTs identify black and minority ethnic voluntary and community organisations that can advise them, and, in some cases act as partners in delivering services. PCTs will be supported by 500 new community development workers;

-- NHS Direct providing a national interpretation and translation service and PCTs providing directories of NHS and social services targeted at BME people; and

-- working with the Home Office and police to improve local liaison and the National Patient Safety Agency (NPSA) to reform the process of independent inquiries and issue guidance on creating safer environments on acute psychiatric wards.

Rosie Winterton added:

"We expect by 2010 that we will see a service characterised by a reduction in the disproportionate rates of admission and compulsory detention of BME patients, a more balanced range of effective therapies, increased patient satisfaction and less fear of services among BME communities.

"Equality is not an optional extra. Priorities may vary locally, but the Healthcare Commission will be assessing trusts' performance against the core standards of challenging discrimination and promoting equality. We will be able to measure progress through the new annual census of mental health patients that will record ethnicity and data on things like the sort of treatment that patients are receiving.

"Racism, discrimination, or inequalities have no place in modern society, and they certainly have no place in the modern NHS. David Bennett's death stands as a tragic reminder of what can happen if the service fails to meet the needs of its black and minority ethnic patients. Change might not come overnight, but we are offering a way forward to equity for all in mental health care."

Professor Kamlesh Patel OBE, Director of the Department of Health's Mental Health Black and Minority Ethnic Programme, said:

"This action plan will develop and change over time, and has the potential to transform the care that black and ethnic minority patients receive from mental health services in this country. It is not about separate mental health services - it is not possible to adequately address improvements in access, experience and outcomes for BME mental health patients without taking a mainstream approach.

"We are making the first big step in a very challenging five year programme of work. I will stay deeply involved in leading this work, and I wouldn't have agreed to take on the job unless I was optimistic about the outcome. Implementing this blueprint and the response to the independent inquiry is in everyone's interest for all sorts of powerful reasons, and I know that we have the strong support of Ministers and NHS top management."

"This action plan will develop and change over time, and has the potential to transform the care that black and ethnic minority patients receive from mental health services in this country. It is not about separate mental health services - it is not possible to adequately address improvements in access, experience and outcomes for BME mental health patients without taking a mainstream approach."

Notes to editor

1. Copies of Delivering Race Equality in Mental Health Care can be seen at http://www.dh.gov.uk/publications

2. David 'Rocky'Bennett, a 38 year old African-Caribbean patient, died on 30 October 1998 in a medium secure psychiatric unit after being restrained by staff. The report of the independent inquiry into his death was published on 12 February 2004. The Government's response properly addresses the recommendations of the Inquiry Report, follows consultation on the framework in the Report Delivering Race Equality and is set alongside its wider programme of action to improve mental health care for black and minority ethnic communities. The report can be seen in full at http://www.nscha.nhs.uk/scripts/default.asp?site_id=117&id=11516

3. Young black men are six times more likely to be compulsorily detained than the national average.

4. Kamlesh Patel has agreed to continue leading the work through the Department's BME Mental Health Programme Board, which is part of a wider programme promoting race equality in the NHS. Sir Nigel Crisp, Surinder Sharma, the first national director for equality and human rights in the NHS, and Louis Appleby, the national director for mental health will be deeply involved in driving that forward.

5. David Sallah is the new director of the National Institute for Mental Health in England's black and minority ethnic mental health programme. This is NIMHE's largest programme, reflecting the importance of the issues. The programme is made up of 16 sub-projects working with policy makers, local planners, commissioners, providers, voluntary organisations and communities to address adverse impacts in all aspects of services for BME groups and individuals.NIMHE will support the national programme of work to improve services for black and minority ethnic mental health patients and implementation sites. Further details can be found at: http://www.nimhe.org.uk/priorities/black.asp

6. For further media queries please contact the Department of Health media centre on 020 7210 5724/5229/5239/4984

7. For all other queries, please contact the Department of Health public enquiry line 020 7210 4850.

This is a press release from the UK Dept of Health