Culturally appropriate advocacy, improving access, experience and outcomes for racialised people in mental health services
Independent Mental Health Advocacy (IMHA) is a type of statutory advocacy. Its aim is to protect and promote the rights of people who are detained in hospital under the Mental Health Act (MHA).
For example, a patient detained under MHA section on a ward could be supported to request leave to visit home; or in their request to be discharged from the section, and then be treated in the community.
More ethnic minorities are detained in mental healthcare than we should expect. Research also shows they do not have a positive experience, such as not getting the treatment they may need, and very often they experience racial discrimination.
IMHA has been identified as a measure to reduce these poor experiences. However, research shows ethnic minorities do not always experience IMHA positively.
The UK government is funding research to test if culturally appropriate advocacy (CAA) can make improvements by protecting the rights of ethnic minorities. CAA means that a patient would have their cultural perspectives, or factors relating to their experiences of racial discrimination taken into consideration in the support offered.
For dissemination we will: produce three resources for advocacy organisations on developing CAA, co-produce a strategy with advocacy organisations to optimise impact; and share findings through a workshop and reports with our clinical, academic and policy networks.
Aims
To understand if, and how, CAA can meet the needs of ethnic minorities. The focus will be on CAA projects that are being tested by the Department of Health and Social Care.
Design and methods
- Look carefully at research to develop quality performance indicators to help evaluate CAA and how it supports ethnic minority people.
- Look in detail at published literature to understand the rights-issues affecting ethnic minorities in mental healthcare. This will be used to develop a rights framework to categorise how advocacy organisations can protect or promote the rights of patients, and an organisational typology to better understand different models to offering CAA.
- We will bring together experts, including people with lived experience of mental health challenges and racism, to decide which quality indicators are most relevant to CAA.
- We will carry out interviews with patients who have used CAA, and mental health professionals, to understand if CAA is protecting and promoting rights of ethnic minorities.
- We will gather information about the different CAA models being tested, including number of ethnic minorities receiving support, to understand what makes a successful model.
Patient and public involvement is embedded throughout the project. Three people with lived experience will be recruited as service user researchers, and six people with lived experience will be members of the lived experience advisory panel, directly shaping each aspect of the project.
