This project aims to implement and evaluate community engagement systems for people from ethnic minority communities to improve access to mental health care.
There is a much higher prevalence of psychosis spectrum disorders in ethnic minority populations, specifically in Black Caribbean and Black African populations in England: the 2014 prevalence report found >4xs greater prevalence of psychosis in Black men (3.2%). This elevated prevalence is particularly pronounced in people of Black Caribbean descent. Unmet treatment needs are 7xs higher in people with psychosis compared with the rest of the population; mental health care pathways are fraught for Black populations, and disproportionately involve the police.
To select the key interventions in each topic area, a co-produced prioritisation exercise with local ARCs, Academic Health Science Networks (AHSNs), patient groups, and provider organisations was conducted. The 2018 Mental Health Act Review highlighted that Black and minority ethnic groups were more likely to experience coercive treatment and involuntary admissions and are much less likely to get good care. The Patient and Carer Race Equality Framework (PCREF) is an ambitious framework that came from that review. Following our call for expressions of interest, where we sought partnerships with organisations working in this area we appointed two ARC partners to work with us to evaluate how the PCREF was working in their sites. We appointed Greater Manchester and Yorkshire and Humber who were already piloting the PCREF framework.
Researchers used a number of clinical and implementation outcome measures to measure the impact of the project:
• Number of people from ethnic minority communities accessing mental health services
• Extent to which champions from ethnic minority communities are involved in the community engagement system
• Acceptability of the intervention for service users and service providers
• Number of staff trained in delivering culturally acceptable psychological services.
• Number of linkages from mental health trusts to community centres and charities.
An evaluation of the PCREF in Sheffield was carried out by Sheffield University in partnership with lived experience experts and colleagues leading the PCREF locally. They identified some of the resources and activities needed for effective sustainable implementation of PCREF including: Embedding of a Race Equity Officer role, improved recording of protected characteristics, cultural advocacy on inpatient wards and authentic leadership and involvement.
Implementation of the PCREF at the Greater Manchester Mental Health Trust was also evaluated and focused on governance and leadership, organisational competencies and feedback mechanisms for implementation of PCREF. They also focused on community engagement with voluntary and community sector organisations and highlighted inclusive communications as an important feature needed for implementing PCREF. In March 2024, the MHIN team held a webinar on findings from the first phase of this project: Find out more and watch a recording
In March 2025 another webinar was held focusing on the role of system partners to implement the PCREF. Applied Research Collaboration (ARC) Greater Manchester and 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. Find out more and watch a recording.
Download a copy of the Theory of Change (Project 1) developed by Sheffield Health and Social Care PCREF which details the elements needed to improve data collection of racialised protected characteristics data.
