Held on 31 March and attended by more than 100 participants, the webinar was the last in a series hosted by the NIHR Mental Health Implementation Network (MHIN) to share insights, research results and resources developed under the MHIN programme.
The PCREF framework aims to improve mental health services for racialised communities by promoting culturally appropriate services, improving care experiences, and tackling the disproportionate detention of minority ethnic individuals under the Mental Health Act.
The webinar was chaired by Jason Grant-Rowles, lived experience advisor and researcher at the MHIN. Jason opened the event, explaining the background to the MHIN. He shared his experience of mental healthcare which has inspired him to work for various organisations as an expert by experience, training over 500 colleagues across southeast London to better understand experiences of mental health.
When I first had a mental health crisis, I didn’t know how to access services or recognise that I had mental health problems. I experienced very poor treatment but since then, I’ve been lucky enough to receive the support I needed and the time to understand my condition. The work I do now is about making sure the system can support people with severe mental illness to be able to make a meaningful contribution using their experience. Mental illness does not have to be a burden. It can be an experience that people can flourish from afterwards.
Husnara Malick, national lead for advancing mental health equalities at NHS England responsible for implementing the PCREF, gave an overview of how the PCREF fits in with the NHS Advancing Mental Health Equalities Strategy, which aims to identify what needs to be done to improve access, experience and outcomes of mental healthcare. They emphasised that the PCREF is a key intervention to help NHS England achieve the aims of the strategy.
Dr Jacqui Dyer, MBE, Mental Health Equalities Advisor and chair of Advancing Mental Health Equalities Taskforce, gave the background to the development of the PCREF and where the initial idea came from.
My experience of mental health provision has been very traumatic. It hasn’t supported the needs of our family and I was concerned that if this is what was happening in my family then what is happening for other people? I aimed to understand the system problem and what needs to be done to serve my family better and serve communities when they’re at their most vulnerable.
Jacqui explained that systemic racism is entrenched in policies in mental health care leading to persistent disparities in access and treatment for racialised communities. The consequences of dehumanisation in mental health services has an impact on patient trust, cultural misunderstandings and a long-term psychological impact. There needs to be a commitment to the importance of cultural humility and ongoing learning and development to address structural racism.
We have embedded PCREF in every part of the system and policies so that there is a collective impact, collective ambition and collective accountability that is visible to the constituents that are being served. So it becomes a reality in our lifetime.
The Care Quality Commission (CQC) have a key role in assessing PCREF-related development and performance. Ciara Hayne, senior equity and rights officer and Ewan Mearns, senior policy officer at the CQC gave an overview of how they are supporting the implementation of PCREF, providing training, guidance and resources. From 1 April this year, PCREF findings will inform CQC formal judgements of services, reporting and action.
Following this presentation, the MHIN project leads Cath Prescott and Juiliana Morimoto, Applied Research Collaboration (ARC) Greater Manchester and Donna Franklin, ARC Yorkshire and Humber shared insights from their work with system partners including NHS England Advancing Mental Health Equalities Programme to understand practices that strengthen or hinder implementation of PCREF. Their research focused on learning from community and voluntary engagement systems to support racially diverse community partners in co-creating solutions. They are developing tools and resources for Integrated Care Boards (ICBs) and NHS trusts to support them with implementing PCREF.
Finally, Dr Kate Allsopp shared findings from the StaffTIME study, an NIHR-funded national study which explored the experiences of staff from racialised communities and other minoritised groups working on acute mental health inpatient wards. Their study found that unacceptable racist behaviour was often not acknowledged by colleagues, there were mixed experiences of support from managers and overall organisations were not doing enough to support staff. Recommendations for managers and NHS trusts included supporting staff post-incident, carrying out investigations and contributing to staff wellbeing by creating supportive environments, training for staff and acknowledging the impact of discrimination.