Welcome to a brief update of my ethnic mental health carers forum for January 2025.

Quick recap

The meeting focused on discussing the Patient Care Race Quality Framework (PCREF) and sharing experiences and ideas among participants. The importance of incorporating equity and inclusion into organizational operations, particularly in relation to patient care, was emphasized, along with the need for better community engagement and the importance of making Personalised Care Framework more meaningful and reflective of people’s lived experiences. The meeting also highlighted the importance of education in addressing and understanding bias in mental health care, and the need for culturally competent care.

Patient Care Race Quality Framework

Matthew McKenzie, the host of the meeting, welcomed everyone and introduced the purpose of the meeting, which is to discuss the impact of mental health minority carers, along with the new NHS England’s Patient Care Race Quality Framework (PCREF) and to share experiences and ideas among participants.

The group was well attended with participants from Kent Community Health Trust, the lead for PCREF and carer governors and involved Service Users in Health Inequalities at Oxleas, also introduced themselves. The meeting also included introductions from other participants, including a carer from Lancashire, and Kelvin, a carer consultant for dementia and older adults. The conversation ended with PCREF leads presenting updates from Kent and Medway NHS and Social Care Partnership Trust.

Improving Data Collection for Carers

KMPT provided an update on the trust’s efforts to improve data collection for carers, including simplifying how protected characteristic records are captured. Matthew McKenzie offered to support and emphasizes the importance of honesty in organizational updates. He suggested organizing a launch event to engage community groups and carers, sharing examples from other trusts. Matthew also mentioned his involvement in PCREF at different levels and offered to share ideas for KMPT PCREF launch event.

Incorporating Equity in Patient Care

KMPT also discussed the importance of incorporating equity and inclusion into the organization’s operations, particularly in relation to patient care. They expressed interest in learning from other organizations with more mature equity frameworks and proposed a peer review process. Matthew agreed to assist KMPT if a peer review was needed due to his involvement with KMPT NHS Trust. Matthew also suggested KMPT attend a national Triangle of Care community group.

Kelvin raised concerns about the organization’s support for older adults, particularly those from diverse backgrounds, and KMPT responded by highlighting their dementia program and memory assessment service. The conversation ended with Kelvin expressing appreciation for KMPT’s NHS honesty and openness.

Addressing Cultural Competency in Mental Health

Matthew then presented a framework for addressing cultural competency and reducing disparities in mental health services. He emphasized the importance of leadership buy-in and the need for data collection to measure the success of initiatives. He also highlighted the need for continuing engagement with communities and the importance of co-production. Matthew suggested that carers and patients could hold organizations accountable for their leadership and accountability for PCREF. He also mentioned the need for culturally sensitive pathways and policies that reflect the feedback and measures of service effectiveness. Matthew then mentioned the importance of training staff in cultural awareness and addressing complaints related to race discrimination.

Improving Access to Services Pathway

Matthew discussed the development of a pathway for improving access to services, which is a continuous feedback mechanism to measure success. He also mentioned the importance of training staff to recognize and address biases and racism. A carer involved in Oxford PCREF requested access to the slides Matthew had shared, which Matthew agreed to provide. Tan expressed interest in conducting similar training within their trust in Oxford. Simone, the staff PCREF lead for Lewisham, shared a new framework in an easy-to-read format that she will send to Matthew for distribution.

Personalised Care Framework Development

Matthew then led a discussion about the development and implementation of the Patient Carer Race Equality Framework (PCREF) at South West London & St. George’s. The PCREF Project Lead, shared updates on the organization’s progress, highlighting their focus on three national organizational competencies: workforce, cultural awareness, and partnership working. They also mentioned the development of a cultural capability training for staff, co-produced with external providers and lived experience colleagues. The discussion also touched on the need for better community engagement and the importance of making PCREF meaningful and reflective of people’s lived experiences. Questions were raised about the promotion of PCREF to the community, particularly in languages other than English, and the impact of PCREF on unpaid carers.

Advanced Statements for Black Africans

Jonathan Simpson, a research assistant, presented on the Advanced Statements for Black African and Caribbean People project, which was run by King’s College, London, in collaboration with South London and Maudsley NHS Trust and funded by Maudsley Charity. The researcher concluded that launch for 2023 and aimed to develop resources for creating Advanced Choice Documents (ACDs) for Black service users.

The resources included an ACD template, a facilitator manual, and training for stakeholders. The project involved a workshop phase, a co-production phase, and a resource testing phase. The ACDs were created through meetings led by an independent facilitator, and the most frequent requests were for hospital alternatives, treatment preferences, and strategies for deescalation. The project also highlighted the need for a different approach to include carers and supporters in the ACD creation process. The project’s findings and resources are now being used to inform the rollout of ACDs across South London and Maudsley NHS Trust services.

Carers’ Role in Advanced Care Directives

Jonathan clarified that the decision to involve carers in the creation of Advanced Care Directives (ACDs) was left to the service users. He also mentioned that he would consult the facilitator to understand why carers were not included in the ACD creation process. Kelvin raised concerns about the lack of information on end-of-life considerations for dementia patients, particularly in relation to faith and spiritual issues for black people. Jonathan confirmed that dementia was not a focus of the project and that end-of-life considerations were not included in the ACDs. He also mentioned that he would revise a workshop paper to include the carers’ input.

Involving Family and Carers in Care

Matthew then moved on to discuss the importance of involving family and carers in the care process to ensure a smoother recovery for patients. A patient involved with PCREF raised a question about the terminology used for carers, suggesting the term ‘trusted person’ might be more appropriate. Jonathan clarified that the ACD form allows for both formal and informal supporters to be listed. Another carer expressed concerns about the independence of the independent facilitator, questioning whether they should be part of the trust or not. Kelvin suggested that the presentation should be shared with South London Moralsey to promote co-production and partnership. Matthew then presented on the importance of education in countering biases, though the specifics of the presentation were not detailed in the transcript.

Addressing Bias in Mental Health

Matthew discussed the importance of education in addressing and understanding bias in mental health care. He highlighted the need to recognize different forms of bias, including systemic, implicit, and cultural bias. He emphasized that education is one of the key strategies in countering these biases, but acknowledged that there would be challenges. Matthew also mentioned the need to increase awareness and tools for success among mental health professionals, patients, and carers. He concluded by encouraging the group to consider the different forms of bias and their implications in mental health care.

Addressing Mental Health and Biases

Matthew then discussed the importance of education in addressing mental health issues and reducing implicit biases. He highlighted that education can reduce implicit biases by increasing self-awareness and encouraging introspection from professionals. He also emphasized the need for culturally competent care, which involves understanding diverse cultural beliefs, values, and practices related to mental health. Matthew stressed the importance of collaboration with minority groups and marginalized communities to understand their needs and develop training programs. He also acknowledged the challenges of resistance to change, limited funding, and measuring the effectiveness of bias reduction efforts. Matthew concluded by emphasizing the need for sustained commitment and systematic change to create a more inclusive and just healthcare system.

This concludes the brief summary for January.