This article originally appeared in the South London Press on 17/10/16.
In 2014 Lambeth’s Black Health and Wellbeing Commission uncovered shocking levels of mental health inequality for black African and Caribbean people living in the borough.
As part of the South London Press and London Weekly News Change Is Possible campaign, the commission’s co-chairwoman Jacqui Dyer – a local councillor and veteran mental health campaigner – explains the steps that are now being taken to bridge the gap.
Fighting the continuing stigma around mental health is vital to the prevention and early help that are a key part of the solution for people requiring support.
In Lambeth, by prioritising prevention and engaging with residents early, we have seen a really encouraging 60 per cent reduction in people requiring acute psychiatric care – in only two years. This has allowed us to spend further on prevention and improving crisis care.
But this progress masks a major blight on the system. Black African-Caribbean residents are, for a range of complex reasons, hugely over-represented in the mental health system, in Lambeth and elsewhere.
For instance, while 26 per cent of Lambeth’s population is black, nearly 70 per cent of the borough’s residents in secure psychiatric settings are of African or Caribbean heritage.
Until we fully address this, mental health services cannot claim to be succeeding. And we must never see a repeat of the circumstances that led to the death in 2008 of black musician Sean Rigg, who died in police custody after being restrained by officers during a mental health crisis.
In 2014, we launched the Black Health and Wellbeing Commission, which brought service users, carers, practitioners, community representatives and Lambeth residents together to face up to the problem and come up with practical ideas to improve the prevention and treatment of mental ill health within our black communities.
These were embodied in the commission’s report, Surviving to Thriving, which sought to understand how we have got here and point the way towards system improvements, which we published shortly afterwards.
Groups like Brixton Soup Kitchen and Block Workout, who work directly with vulnerable young people, all helped the commission understand the gap between those who need help and the formal services that should support them.
One of the key commission recommendations was to empower these kinds of groups with the skills and connections they need to help people earlier, which may not be in a formal mental health service.
The issue has many inter-related root causes: a low level of trust between black communities and the system, fuelled by historic, systematic discrimination and a common feeling that seeking help from the statutory system ‘isn’t what you do’; and a lack of awareness of the support on offer – a recent Healthwatch Lambeth survey revealed that a very low proportion of black people knew of the variety of mental health services available, and only six out of 10 would consult their GP in the first instance.
Indeed, black people suffering mental distress in London are more likely to be referred to hospital via the police and courts than by their GP, though the reverse is true of white British patients.
Black people are also under-represented in some services, such as the South London and Maudsley NHS Trust’s integrated psychological therapy.
There is a clear need to establish a more suitable pattern of service use among black communities.
We are now setting up the Black Wellbeing Partnership to continue the work of the commission, with a vision of enabling black communities in Lambeth to thrive and improve their health and wellbeing.
The partnership is bringing together the community and the ‘system’ to identify changes, establish actions, and monitor and learn from progress.
Together we will deliver improvements across the system and create an environment where people are well-informed and able to access high-quality services regardless of their race.
The partnership, which is receiving great buy-in from SLaM and the Lambeth Clinical Commissioning Group, as well as vital assistance from Healthwatch Lambeth, will build trust across the community through genuine shared ownership and action, together with a commitment to honest, open dialogue and transparency.
Using hard data, the Black Wellbeing Partnership will track overall progress on the issue and the commission’s recommendations. Measuring progress in language and data we all understand will also enable transparency, build confidence and provide a single route for reporting back to the Lambeth Health and Wellbeing Board.
The partnership will create collaboration across the range of people and organisations that are needed to achieve change.
If we can create the transformation in support and services for black communities that so many people need here in Lambeth – where we have historically had some of the highest rates of mental ill health in the UK – we can positively contribute to efforts to address this challenge.
We aim to share our progress with our communities on a regular basis as we continue this journey of collaborative change for the better.
Jacqui Dyer is currently the vice-chairwoman of England’s Mental Health Taskforce and a trustee of the Mental Health Foundation. She is an experienced counsellor, trainer, group facilitator and carer.
The Change Is Possible campaign aims to promote and protect good mental health for everyone in south London, helping to shape a community that makes sure people with experience of mental health problems are treated fairly, positively and with respect.
Along with South London Press and London Weekly News, we are committed to raising awareness about the complex mental health problems that many people in our community face, and working together to expand and improve the range of support available.
We aim to put a stop to the stigma around mental health – at home, at work and at school – and to break down the barriers that prevent people from seeking help.