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Equality and diversity
Target
a) The CRT can access interpreters to attend in person/video conference within 24 hours and by phone within 4 hours for at least 90% of service users for whom this is needed.
b) The CRT monitors service accessibility.
c) The CRT team broadly reflects the demographics of the local population.
d) The CRT can demonstrate at least one active attempt during the last 12 months relevant to the local population to make the CRT service more appropriate for a minority group.
e) There is all-source agreement that the CRT provides a service which is sensitive to diversity and responds to service users' and families' needs regarding disability, race, gender, ethnicity or sexuality.
Why this is important
It is important that CRT teams are able to communicate and meet the needs of all service users. Diversity within the CRT staff team can help the team provide a culturally sensitive service. Priorities for achieving equality in service provision will vary between teams, so active attempts to meet local needs are important.
Ways of doing this well
- Monitoring service users' demographics is an effective way of ensuring that teams recognise if there is a need to address any issues regarding equality and diversity. As West Berkshire's Crisis team monitored the demographics of their service users they were able to see that the service they were providing was not accessible for a specific minority group. Read their case study below:
West Berkshire Case Study: Improving Access to Mental Health Services for South Asian Community
The acute inpatient service and CRHTT conducted a joint audit in January 2013 to identify admission trends of BME groups to Inpatient and CRHTT services. The audit identified that South Asian groups were represented significantly higher within the inpatient service in comparison to CRHTT. An in depth analysis of cases identified that there is a reluctance to seek help from secondary mental health services at the early stages of mental health crises for the following reasons:-
• Interpretation of cultural factors by assessing clinicians
• Cultural stigma
• Lack of understanding and awareness relating to mental health conditions
• Lack of awareness of services available and accessing services
To address the above findings, CRHTT in collaboration with Inpatient services designed and delivered a training day to develop competencies and skills required to minimise cultural barriers and enhancing clinician's awareness of cultural characteristics of the South Asian community.
The day included activities in developing clinician's skills to reduce the stigma and cultural barriers associated with mental health and associated services so that the clinician's develop a clear understanding of the types of strategies which they can utilise. The workshop also focused on the importance of protecting and involving the service users' family members in achieving better mental health outcomes.
The overall feedback received by the clinicians who took part highlighted that the workshop was highly useful and they all achieved a greater understanding of cultural and religious beliefs related to the South Asian community.
Berkshire Healthcare organisation has now extended this workshop to both mental health and primary care clinicians as part of improving South Asian cultural awareness to enhance the care delivered by the organisation to this identified population.
North West Sussex CRHT wrote a case study documenting the way in which support was made appropriate a service user, respecting their cultural beliefs:
A number of Crisis teams use the easily accessible Language Line for translation purposes if they need quick access to an interpreter. Click on the link below to visit the website for more information:
Examples of good practice
In our fidelity review survey of 75 crisis teams in 2014, the following teams achieved excellent model fidelity, and can be contacted for advice about how they achieved this:
- Maidstone CRT, Kent and Medway NHS and Social Care Partnership Trust
- South Tyneside Initial Response Team, Northumberland, Tyne and Wear NHS Foundation Trust
- Adur, Arundle & Worthing CRHTT, Sussex Partnership NHS Foundation Trust
- Mendip CRHTT, Somerset Partnership NHS Foundation Trust
- Taunton and Bridgewater CRHTT, Somerset Partnership NHS Foundation Trust
Relevant reading
Healthcare Commission 2008
'Support for people from black and minority ethnic groups Higher proportions of people from black and minority ethnic groups are admitted to mental health hospitals and detained under the Mental Health Act.10 National policy recommendations for BME service users include: • Recording and monitoring ethnicity data. • Providing access to interpreters where needed, to ensure that care is assessed, planned, delivered and evaluated effectively. • Ensuring that information is available in different languages and formats. • Ensuring that inpatients are able to have their spiritual and religious needs met. • Access to worship space, faith leaders, and religious and faith groups.34' (p.31)