Commissioning and providing mental health advocacy for African and Caribbean men

Commissioning for best practice

From the SCIE Knowledge Review 15, the following approach to commissioning advocacy is recommended:

Reflecting local needs

Funding and commissioning of advocacy provision needs to be demonstrably linked to assessed need and reflect local demography and ethnic diversity. The organisational arrangements for the provision of mental health advocacy with African and Caribbean communites will therefore differ, for example between city, urban and rural areas, as the population of African and Caribbean communities varies.

This implies:

In arriving at a decision, commissioners will need to map provision to need and available resources. They will need to demonstrate a clear relationship between demographic profile, needs and the service provided. However, a focus solely on numbers must be avoided and whatever the population size, arrangements will need to be in place to ensure culturally appropriate provision for African and Caribbean men. This is particularly pertinent to secure services, where African and Caribbean men in general might be over-represented but will find themselves in the minority.

The diversity of needs, demand on mental health services, and the over-representation of African and Caribbean men and women (and indeed under-representation of other groups) within mental health services and pathways into services also need to be considered. The engagement of communities and mental health service users in this process is essential.

A strategic approach

This will involve viewing advocacy provision as a whole system and moving away from an approach driven by the availability of current services. It means:

Equality of access

Equality of access to effective mental health advocacy for African and Caribbean men requires:

Valuing diverse models for provision

It is evident that the organic development of advocacy within BCVS has preserved a holistic and collective model of advocacy. It is important that this model is not disadvantaged or dismissed in any future moves to formalise advocacy in the context of the new statutory duties and the development of more systematic commissioning arrangements.

Sustainable funding

The capacity of advocacy organisations to enhance capacity and sustain themselves is currently severely limited by insecurities around long-term funding. In line with current policy and recognised good practice (12), contracts need to be established on a three year basis. See the Social Perspectives Network website for further information on money and commitment.

As well as direct service provision, contracts need to include funding for:

Alongside this, the service specifications for mental health services should include the requirement that staff receive training to understand the legislative and policy context for advocacy, its contribution, and their role in facilitating access and supporting its development.

Service user and community engagement

The engagement of service users and communities will facilitate the development of more appropriate and better-quality services that are more likely to achieve the identified outcomes. This needs to be underpinned by transparency and clarity about decision-making. African and Caribbean service users and their communities have a particular contribution to make in:

Link: Community Engagement Project, Centre for Ethnicity & Health, University of Central Lancashire.