Advancing Equity & Inclusivity For Healthcare
Racial & ethnic groups the wider disparities
Anyone working in healthcare will know among racial and ethnic groups there are always wider disparities……
Black mothers experience postpartum depression more than any other group and Black women are 4x more likely to die in childbirth than other groups.
The release of the Patient and Carer Race Equality Framework for Mental Health Trusts and Providers (PCREF)
Is designed to address disparities in healthcare outcomes, access, and experiences.
Like all frameworks, they aim to promote equality, eliminate discrimination, and improve the quality of care provided by healthcare organisations.
But in reality, guidelines, strategies and goals are only relevant if we also implement changes to improve the experiences of the people who are most impacted.
Particularly, in settings where staff are often under-resourced and work under immense pressure.
6 Ways to advance equity & inclusivity for healthcare
For a framework specific to mental health trusts and providers, here are some components you may want to include and consider if you are doing this important work;
- Data Collection and Monitoring: Gathering and analysing data on patient and carer experiences, outcomes, and access to mental health services, broken down by racial and ethnic categories. This helps identify disparities and areas for improvement. It is also important to be aware of the racial/ ethnic demographic of the staff team delivering services, including management teams who are often responsible for wider organisational and systemic changes which will leave a legacy impact.
- Cultural Competence Training: Providing training for mental health professionals to enhance their cultural competence is a learning opportunity. This includes understanding and respecting diverse cultural backgrounds, beliefs, and practices to ensure culturally sensitive care. However, understanding the experiences of racialised staff working across the organisation and taking action towards creating better allyship is a growth opportunity for all colleagues to ease the mental load of black and brown colleagues.
- Patient and Carer Involvement: Actively involving patients and their carers in the development, implementation, and evaluation of mental health services is co-production. If you have taken this step and embedded patient and carer involvement you are doing a good job, but a further step is to devolve their care or service delivery to grassroots community providers who are embedded within these communities. This will also support broader patient or carer involvement, as often we are at risk of involving the same group of people who often participate and who may not be representative of the communities co-designing for.
- Equal Access to Services: Ensuring that mental health services are accessible and responsive to the needs of specific communities, particularly communities over-represented in acute inpatient treatment may involve addressing barriers to access and providing tailored interventions earlier in the care pathways or before acute crisis. This should ideally be extended beyond mental health providers and more embedded within grassroots or non-traditional models of community care. Grassroots providers are usually much closer to local communities and have greater experience and often better relationships or knowledge of the local populations whom they serve.
- Leadership and Workforce Diversity: Encouraging diversity in leadership positions across the mental health workforce, particularly in health populations with diverse demographics will directly impact the population’s experience of healthcare. What is the experience for racialised staff in the organisation who are promoted? What are the barriers faced by racialised staff when applying for leadership roles? How are you creating opportunities for them to get promoted? If the workforce is not diverse why are racialised staff not applying for these roles? What does the organisation do to address this?
- Addressing Disparities: Implementing targeted strategies to address identified disparities in mental health outcomes among different racial and ethnic groups can significantly reduce health inequalities and improve patient experiences. This is a win-win for both patients and providers. However, it does require the interventions delivered to be relevant or culturally nuanced and aligned to the needs of the population. For example, black maternal health black women are more likely to be dismissed when reporting symptoms.
To ensure that all mental health services are delivered in a culturally competent and inclusive manner we need to provide more support to racialised staff, who are often the victims of violent or racist incidences in their workplace.
I recommend visiting the official NHS England website to download the detailed documentation and resources related to this framework, including its goals, strategies and outcomes.
Benchmarking against these recommendations could be a helpful place to begin to see what good may look like for your team or services. If you are a black woman moving into leadership or you are already in a leadership role within healthcare.