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Delivering race equality in mental health care: An action plan for reform inside and outside services and the Government's response to the Independent inquiry into the death of David Bennett

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    Department of Health
  • Published date:
    11 January 2005
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This document combines (a) a five-year action plan for reducing inequalities in Black and minority ethnic patients' access to, experience of, and outcomes from mental health services; and (b) the Government response to the recommendations made by the inquiry into the death of David Bennett.

Executive summary

Delivering Race Equality in Mental Health Care (DRE) is an action plan for achieving equality and tackling discrimination in mental health services in Englandfor all people of Black and minority ethnic (BME) status, including those of Irish or Mediterraneanorigin and east European migrants.

It draws on three key recent publications in particular:

  • Inside Outside: Improving Mental Health Services for Black and Minority Ethnic Communities in England;
  • Delivering Race Equality: A Framework for Action; and
  • the independent inquiry into the death of David Bennett (although DRE itself is not a direct response to the inquiry's report).

David Bennett was a 38-year-old African-Caribbean patient who died on 30 October 1998in a medium secure psychiatric unit after being restrained by staff. As well as DRE, this document contains the Government's formal response to all the recommendations made in the report of the inquiry into David Bennett's death. The responses are overwhelmingly positive and, taken together with the action plan in DRE, comprise a coherent programme of work for achieving equality of access, experience and outcomes for BME mental health service users.

The programme is based on three 'building blocks', first proposed in the consultation version of DRE:

  •  more appropriate and responsive services - achieved through action to develop organisations and the workforce, to improve clinical services and to improve services for specific groups, such as older people, asylum seekers and refugees, and children;
  •  community engagement - delivered through healthier communities and by action to engage communities in planning services, supported by 500 new Community Development Workers; and
  •  better information - from improved monitoring of ethnicity, better dissemination of information and good practice, and improved knowledge about effective services. This will include a new regular census of mental health patients.

 DRE itself is just one component of a wider programme of action bringing about equality in health and social care. For example, National Standards, Local Action is the Department's current care standards and planning framework. Among the core standards that it sets out are:

  • that healthcare organisations must challenge discrimination, promote equality and respect human rights (C7(e)); and
  •  that organisations must enable all members of the population to access services equally (C18).

 DRE will support the implementation of Sir Nigel Crisp's 10-point race equality action plan in the NHS, and will also help NHS trusts to fulfil their obligations under the Race Relations (Amendment) Act 2000.

The vision for DRE is that by 2010 there will be a service characterised by:

  • less fear of mental health services among BME communities and service users;
  • increased satisfaction with services;
  • a reduction in the rate of admission of people from BME communities to psychiatric inpatient units;
  • a reduction in the disproportionate rates of compulsory detention of BME service users in inpatient units;
  • fewer violent incidents that are secondary to inadequate treatment of mental illness;
  • a reduction in the use of seclusion in BME groups;
  • the prevention of deaths in mental health services following physical intervention;
  • more BME service users reaching self-reported states of recovery;
  • a reduction in the ethnic disparities found in prison populations;
  • a more balanced range of effective therapies, such as peer support services and psychotherapeutic and counselling treatments, as well as pharmacological interventions that are culturally appropriate and effective;
  • a more active role for BME communities and BME service users in the training of professionals, in the development of mental health policy, and in the planning and provision of services; and
  • a workforce and organisation capable of delivering appropriate and responsive mental health services to BME communities.

A new BME Mental Health Programme Board, directly accountable to Ministers, has been set up at the Department of Health to oversee this action plan and the wider BME mental health programme. It will be informed by the BME National Steering Group, which is jointly chaired by the Minister of State for Health and Lord Victor Adebowale (Chief Executive of Turning Point).

Implementation of DRE should be a matter for everyone involved in planning, managing or delivering mental health care. Focused implementation sites will be established to help identify and spread best practice.

Delivering Race Equality in Mental Health Care: a review

Published: 7 December 2009

Gateway reference: 13108

This review looks back at the work of the Delivering Race Equality (DRE) programme as its 5 years comes to an end. This review describes some of the key challenges, successes and learnings. It also outlines how DRE's work will be taken forward under New Horizons.

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