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Health

Tackling Inequalities and Discrimination Experiences in health Services (TIDES)

The Tackling Inequalities and Discrimination Experiences in health services (TIDES) study aims to understand how discrimination witnessed and experienced by healthcare practitioners is related to work and health outcomes, and how this may contribute to inequalities in health service use. TIDES phase 1 is funded by the Wellcome Trust.

TIDES phase 2 is funded by the ESRC as part of UK Research and Innovation’s rapid response to COVID-19 and aims to understand how discrimination contributes to inequalities in health and health services, and aims to continue this work by examining the impact of COVID-19 on inequalities experience by ethnic minority people working in health and social care.

TIDES Phase 1 involves four interrelated projects:

  • Project 1 uses survey data and electronic health records to investigate inequalities in health service use.
  • Project 2 uses the findings from Project 1 to inform a quantitative survey and facilitate qualitative interviews with healthcare practitioners about both experiencing and witnessing discrimination to see what impact these experiences have on inequalities in health service use.
  • Project 3 builds on the findings from the first two projects to look at how healthcare practitioners interact with patients in virtual reality environments.
  • Project 4 involves talking to a range of stakeholders including carers, service users, healthcare practitioners, community members and policy makers about the findings from Projects 1-3. Stakeholders will review evidence, set priorities and develop guidance for an intervention framework to tackle discrimination experiences and inequalities in health service use.

TIDES Phase 2 aims to:

  • Identify ethnic inequalities in mental health and occupational outcomes amongst NHS health and social care workers, how COVID-19 exacerbates such inequalities, and the processes through which inequalities are produced, maintained and resisted.
  • Develop a Race Equality Assessment toolkit, to help ensure ethnic minority perspectives are prioritised in research and education for all NHS staff.
  • Develop education and training resources targeted at improving ethnic minority health and social care worker experiences, job retention and relevant NHS policies.

An ethnicity module will be incorporated into an ongoing national longitudinal study of NHS staff (NHS CHECK, www.nhscheck.org) to assess health and work outcomes by ethnicity over an 18-month period. The survey will capture existing and emerging ethnic inequalities in mental and occupational outcomes between White British and ethnic minority staff during and after COVID-19.

Interviews (telephone/online) will also be carried out with ethnic minority staff with three samples:

  1. NHS CHECK sample of ethnic minority health and social care staff recruited from NHS CHECK Trusts across the UK.
  2. Pre/post COVID-19 TIDES sample of London-based nurses and healthcare assistants who have previously completed interviews as part of the TIDES Phase 1.
  3. TIDES senior management sample.

The interviews will explore how COVID-19 has affected mental and physical health and occupational outcomes, the impact of COVID-19 on experiences of discrimination, bullying and harassment during and post COVID-19, and the structural factors underpinning elevated adversity for ethnic minority staff during COVID-19.

For more information, please visit tidesstudy.com

TIDES Team

Professor Stephani Hatch

Principal Investigator

Stephani is a Professor of Sociology and Epidemiology in the Department of Psychological Medicine, King’s College London and is the Principal Investigator of the TIDES study. Stephani is also the founder of the Health Inequalities Research Network, which promotes integrated approaches to participatory research and public engagement in the community.

Dr Rebecca Rhead

Research Associate and Co-investigator

Rebecca is a Research Associate in the Department of Psychological Medicine, Kings College London and has a PhD in Social Statistics. In her previous work she has used quantitative research methods to study HIV (particularly barriers to care and treatment adherence) as well as military mental health and treatment needs. Rebecca’s current work with TIDES focuses on harassment and discrimination in the NHS and taking an intersectional approach to patient healthcare inequalities.

Dr Charlotte Woodhead

Lecturer and Co-Investigator

Charlotte is a Lecturer in Society & Mental Health at the ESRC funded Centre for Society and Mental Health at King's College London. Using insights from psychiatric and social epidemiology, and applied health research, her mixed methods research and public engagement activities focus on social/structural determinants of mental health inequalities. Specific interests include evaluation of complex social interventions to reduce inequalities in mental health and healthcare, including those led by communities affects; the role of the voluntary and community sector in mental health provision and equity of access; and, young adult mental health. As a Lead Co-ordinator of the HERON leadership team, Charlotte works across several HERON activities.

Dr Cerisse Gunasinghe

Research Associate and Counselling Psychologist and Co-investigator

Cerisse is a Postdoctoral Researcher and Counselling Psychologist in the Department of Psychological Medicine, IoPPN at King's College London. Cerisse is one of the lead coordinators of the Tackling Inequalities and Discrimination Experiences in health Services (TIDES) Study, the Hype (improving the Health of Young PeoplE) Project and the Health Inequalities Research Network (HERON). As a member of the HERON leadship team, Cerisse is Lead Co-ordindator for UP&RUNNING and works on RISE (Research methods in School Education) and the Biomedical Research Centre (BRC) Youth Awards. Cerisse has worked to understand the experiences of, and advocate for vulnerable and marginalised groups through service-user involvement in her projects. She recognises the importance sharing this acquired knowledge with colleagues through training. Her research interests focus on reducing barriers to social and psychological support and educating community populations to help early identification and treatment of mental and physical health difficulties. Cerisse is also committed to the mentoring and peer-support of local students, early career Black, Asian and minority ethnic women as well as allied healthcare professional in their pursuit of academic careers.

Dr Jessica Jones Nielsen

Senior Lecturer and Counselling Psychologist and Co-investigator

Jessica is a Senior Lecturer and Counselling Psychologist in the Department of Psychology at City, University of London, and Associate Dean of People and Culture for the School of Arts and Social Sciences. She has a background in community-based participatory action research and examines the intersection between physical and mental health and promoting engagement in positive health behaviours with particular emphasis on the experiences of ethnic minority community groups.

Dr Juliana Onwumere

Senior Lecturer and Consultant Clinical Psychologist and Co-investigator

Juliana is a Senior Lecturer in the Department of Psychology, King's College London, and a Consultant Clinical Psychologist in the South London and Maudsley NHS Foundation Trust in London. Her research and clinical interests are focused on the experiences of mental health problems, their impact on families, and improving the development and access to evidence-based psycho-social interventions, particularly in under-represented groups.

Dr Ioannis Bakolis

Statistician

Ioannis is a Lecturer in Biostatistics at the Department of Biostatistics and Department of Health Services and Population Research. His research interests are focused on quasi experimental designs, causal inference, hierarchical models, multivariate and variable selection techniques and their applications in policy evaluation, life-course, environmental and mental health epidemiology.

Nathan Stanley 

Research Assistant

Nathan is a Research Assistant in the Department of Psychological Medicine, King's College London and his primary responsibility is qualitative data collection and analysis for the TIDES study. He has a BSc in Biology and an MSc in Medicine, Health and Public Policy; and has previously worked in public health to help carry out research into sexual health.

Zoe Chui

ESRC Funded PhD Candidate and Research Assistant

Zoe is a part time Research Assistant and PhD Candidate. Her thesis title is; Ethnicity and exposure to workplace violence for hospital-based and community nurses. This project, funded by an ESRC LISS DTP Collaborative (CASE) Studentship, and supervised by Professor Stephani Hatch, Dr Gerry Lee and Dr Habib Naqvi, aims to understand the nature and impact of workplace violence on the mental and physical health of hospital-based and community nurses across ethnic groups, and the barriers to reporting these incidents. The project partners with NHS England and builds on the TIDES study. For more information on the study please visit www.even-study.com.

Amy Morgan

Research Assistant

Amy is a Research Assistant in the Marginalised Communities programme at the ESRC Centre for Society and Mental Health, King's College London. She has a BSc in Psychology and a MSc in Mental Health Studies and supports with qualitative analysis for the TIDES study.

Lucy Ensum

Research Facilitator

Lucy is the Research Facilitator for the TIDES study, and the Programme Co-ordinator for the HERON Network, in the Department of Psychological Medicine at the IoPPN, King’s College London. Lucy is an experienced administrator and project co-ordinator, working for leading London universities since 2010. She brings over 15 years of event management skills to help with the smooth running of the HERON Network engagement activities.

Monalisa Bora-White

NHS Peer Researcher

Monalisa is a Research Coordinator in the Avon and Wiltshire Mental Health NHS Partnership Trust and works on a portfolio of observational and interventional mental health research. Mona is a NHS Peer Researcher for the TIDES study. 

Naomi Clifford

NHS Peer Researcher

Naomi is a Research Assistant in the NHS and has worked in acute mental health services for 17 years, alongside gaining a Joint Honours BA in Education Studies and Early Years. Naomi is a NHS Peer Researcher for the TIDES study. 

Paula Meriez

NHS Peer Researcher

Paula works for Cambridgeshire and Peterborough NHS Foundation Trust as a Senior Clinical Mental Health Nurse. Paula is a NHS Peer Researcher for the TIDES study. 

Phase 2 Co-investigators and Collaborators

Professor Tarani Chandola – Co-investigator

Professor of Medical Sociology, University of Manchester

Dr Sharon StevelinkCo-investigator

Senior Lecturer in Epidemiology, King’s College London and NHS CHECK Co-Chief Investigator

Dr Ghazala Mir – Co-investigator

Associate Professor, University of Leeds

Professor Anne Marie Rafferty – Co-investigator

Professor of Nursing Policy, KCL; President of The Royal College of Nursing; Co-Director of NIHR/DHSC Health and Social Care Workforce Policy Research Unit, KCL

Professor Richard Morriss – Co-investigator

Professor of Psychiatry and Community Mental Health, University of Nottingham; Honorary Consultant Psychiatrist, Nottinghamshire Healthcare NHS Trust; Mental Health and Well-being Lead for ARC East Midlands; Co-Lead, NIHR Cross-ARC Health and Social Care Workforce Group

Professor Kamlesh Khunti – Co-investigator

Professor of Primary Care Diabetes and Vascular Medicine, University of Leicester; Director of NIHR ARC East Midlands; Director of Centre for Black Minority Ethnic Health; General Practitioner, Leicester

Dr Lucia Valmaggia – Co-investigator

Reader in Clinical Psychology and Digital Mental Health, King’s College London

Yvonne Coghill and Dr Habib Naqvi - Collaborators

Director, NHS Workforce Race Equality Standard

Dr Jacqui Dyer - Collaborator

Mental Health Equalities Advisor, NHS England and NHS Improvement

Joan Saddler - Collaborator

Associate Director of Patients and Communities NHS Confederation

Natalie Creary - Collaborator

Director, Black Thrive Global

Femi Otitoju - Collaborator

Managing Director, Challenge Consultancy

Dr Sean Cross - Collaborator

Managing Director, Maudsley Learning

Wendy Irwin

Equalities Lead, Royal College of Nursing