Commissioning and providing mental health advocacy for African and Caribbean men
Background: Mental health policy
Mental Health National Service Framework
The Mental Health National Service Framework (MHNSF) recognised that mental health services were not meeting the needs of people from black and minority ethnic (BME) communities, with explicit reference to African and Caribbean communities. It established the principle that mental health services must be planned and implemented in partnership with local communities, and must involve service users and carers. Department of Health policy on BME mental health had been further developed through the reports 'Engaging and changing' (4), 'Inside outside' (5) and most recently 'Delivering race equality in mental health care' (6).
Delivering race equality
Delivering race equality in mental health care (DRE) is an action plan to achieve equality and tackle discrimination in mental health services for black and minority ethnic (BME) communities. The plan:
- identifies three building blocks: action to improve services; action for better community engagement; and action for better information. The community engagement element includes investment in a new role of community development worker (CDW).
- outlines 12 characteristics for improved services as a consequence of the DRE action plan. The action plan identifies development of culturally appropriate independent advocacy as a new area of action for primary care trusts and service providers.
Welsh mental health policy relating to services for adults was outlined in 2001 by the publication of The Adult Mental Health Services for Wales Strategy (7), which states that ‘advocacy services must be available throughout Wales for all patients who require them’ (p37). This commitment was picked up in the revised Adult Mental Health Services National Service Framework for Wales (8), wherein Standard 2, Key Action 6 stresses the need for relevant, independent, trained advocacy services to be promoted and available across Wales. The National Assembly for Wales Mental Health Strategy Implementation Group has also produced guidelines for advocacy. Further, the revised NSF commits the Assembly to producing a Race Equality Action Plan for Adult Mental Health Services in Wales. This has been produced and local action plans have been produced in response. The action plan requires that advocacy services are made routinely available.
The Bamford Review into mental health and learning disability services (9) in Northern Ireland considered the provision of advocacy in the context of protecting the rights of people with mental health problem or learning disability. This proposed a statutory right to independent advocacy for people using mental health or learning disability services and made it clear that this should embrace a range of models. The review also calls for a coherent strategic approach to the development of advocacy. The Department for Social Development has recently published a strategy for the delivery of community and voluntary advice services, including advocacy and representation (10).
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