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Call to redress racial disparity for BME staff at senior level

Mental health nurses from African-Caribbean backgrounds should have more career support, review states

Mental health nurses from African-Caribbean backgrounds should have more career support, review states


Picture: iStock

Black and minority ethnic (BME) nurses should be supported to rise to senior mental health positions to help address racial disparity in the field, according to independent reviewers.

The panel made 154 recommendations after examining the Mental Health Act 1983, which the government is planning to revise.


Catherine Gamble: ‘Nurses had 
hoped this report would empower
clinicians.’ Picture: Barney Newman

The review, chaired by Royal College of Psychiatrists former president Sir Simon Wessely, recommends that more is done to encourage people of African-Caribbean heritage to reach senior levels in mental health, particularly in nursing and management.

Most diverse professional group

RCN mental health professional lead Catherine Gamble said: ‘Nurses, the largest and most diverse professional group in the mental health workforce, must be tapped into to support, represent and advocate for BME patients who, as this report highlights, are the most likely to be detained under the act.’

However, Ms Gamble added: ‘Nurses had hoped this report would empower clinicians and allied health professionals to act more autonomously, reduce barriers to seamless service and prove to nurses they’re valued. It’s difficult to see how this report will enable that.’

Two recommendations

In its response to the review, the government said it was accepting two of its recommendations:

  • Allowing those detained under the act to nominate a person to be involved in their care; at present, the patient has no input in the decision.
  • Giving patients the right to express their preferences for care and treatment and have these listed in statutory ‘advance choice’ documents.

The government intends to respond to the review in the new year, before preparing a new Mental Health Bill.


Paul Jenkins: joint working needed
to 'close the gap in terms of
inequalities in access and outcomes’ 

Responding to the review

Referring to mental health services, Mental Health Network chair Paul Jenkins said: ‘The review rightly acknowledges that the experience of people from black African and Caribbean heritage of mental health services is too often one of exclusion or detention. Restricting someone’s liberty should always be a last resort. Putting this right requires all of us taking steps to ensure we close the gap in terms of inequalities in access and outcomes.'

Welcome focus

Care Quality Commission deputy chief inspector of hospitals (lead for mental health) Paul Lelliott said: ‘We have welcomed the focus from the outset on ensuring there is greater understanding of the specific needs of people from ethnic minority communities.

‘We are pleased to see the recommendation for the provision of culturally appropriate advocacy services to better support ethnic minority communities and reduce the level of disparities they face.’

Treatment rather than security

Meanwhile, Centre for Mental Health chief executive Sarah Hughes said: ‘The Mental Health Act we have today is in many ways outdated and paternalistic.


Sarah Hughes: ‘The Mental Health
Act we have today is in many ways
outdated and paternalistic’

‘The review’s recommendations should go a long way to bringing the act into the 21st century by ensuring people have more rights to say how they want to be treated, including by making advance decisions that professionals have to take more seriously.’

British Medical Association mental health policy lead Andrew Molodynski added: ‘As well as a significant legislative overhaul, there is a clear need for investment in mental health to ensure effective patient care, with a focus on treatment rather than security. Meaningful change can only endure if underpinned by properly staffed and fully resourced services.’

‘Not a time for timid changes’


Akiko Hart: 'failure to address
widespread and institutional abuse’
cannot be ignored

English National Hearing Voices Network Akiko Hart said: ‘While we recognise the good intentions, dedication and heart of those who contributed to this review, we cannot ignore its failure to address widespread and institutional abuse and the ongoing erosion of people’s human rights.

‘This is not the time for timid changes or placating promises; it is a time for action and an opportunity to revise the support we offer to those in most distress’.

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