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People from Black and minority ethnic backgrounds have poorer access to and outcomes from NHS mental health services such as counselling and cognitive behavioural therapy (CBT), according to an independent review.
Sean Duggan, chief executive of the mental health network at the NHS Confederation said the findings were “unacceptable” and eliminating inequalities is a “top priority for health leaders.”
Bangladeshi groups at particular risk of poor outcomes
The review, which was prepared by the Prepared by the National Collaborating Centre for Mental Health (NCCMH) on behalf of the NHS Race and Health Observatory, looked at 10 years of anonymised patient data on talking therapies.
It found that in comparison to White British people, with the exception of Chinese people, people from minoritised ethnic groups experienced worse outcomes, waited longer for assessments and were less like to receive a course of treatment.
The data also showed that poor outcomes were faced by people from South Asian communities, in particular Bangladeshi groups.
Whereas people of mixed ethnicity, mostly White and Black Caribbean, are the least likely to access these services.
Inequalities in outcome for people from minoritised ethnic groups are associated with:
- increased symptom severity at initial assessment
- living in areas with higher levels of deprivation, and higher unemployment
- waiting longer for assessment and waiting longer between treatment.
Therapists must be ethnically diverse and services must be targeted at underserved communities
In light of these findings, the report makes a number of recommendations to improve access to and outcomes from NHS Talking Therapies for anxiety and depression.
This includes ensuring Integrated Care Boards and those in leadership roles in mental health services respond to the inequalities highlighted in the report, and use local data to understand the needs of minoritised ethnic communities in specific locations across the country.
It also calls on commissioners of NHS services to develop training to improve understanding of mental health inequality, particularly how it impacts people from black and minoritised ethnic backgrounds.
In addition, mental health leaders should ensure that:
- therapists are ethnically diverse
- services are co-designed in partnership with different communities
- therapists offer additional sessions if they need time to understand cultural differences
- talking therapy services are promoted to underserved communities.
Positive steps but still a “long way to go”
Mr Duggan says while mental health service leaders will welcome some of the positive progress that has been made, he admits “there is still a very long way to go.”
“People from minoritised ethnic groups have poorer experiences and outcomes from across mental health services, which is unacceptable.
“Eliminating inequalities is a top priority for health leaders who are keen to deliver whole system transformation and cultural change; the implementation of the Patient and Carer Race Equality Framework (PCREF) will help enable this and be key in further reducing disparities.
“As well as the framework, reducing ethnic inequalities is one of the main drivers behind the reform of the Mental Health Act. Health leaders will hope that the government recognises the importance of this act and include the reforms that are so clearly needed in the upcoming King’s Speech,” he said.