Minority voices: Research into the access and acceptability of ... - MMC

More documents

Recommendations

Info

The way that some voluntary sector projects ‘networked’ at the community level, sharinginformation about what they offered through avenues used by young people such as localclubs, was also thought to be important in giving young people the confidence to use them.! Staff skills, training and confidence to deliver services to young peoplefrom Black and minority ethnic groupsThere were mixed views with regard to whether staff had sufficient knowledge and skills toaddress the mental health needs of young people from Black and minority ethnic groups.Some services, where they had managed to attract staff from different ethnic backgrounds andwhere they were able to offer support in a range of different languages, felt reasonablyconfident but highlighted that:“Individual teams are at different stages in their capacity to meet the needs of minority ethnicgroups.” (CAMHS respondent)This imbalance could make referring young people on to other services or teams problematic.Where staff did not feel that they had adequate skills, limitations in existing training werenoted, in particular that professional mental health training remains very Eurocentric and doesnot sufficiently address cross-cultural contexts. What little that is offered was described as‘very basic’ and was not offered on a regular basis. Other staff said they had received notraining specific to the needs of Black and minority ethnic groups and one reason for this was alack of relevant organisations with the appropriate knowledge that could provide training. Itwas also pointed out that attending conferences and workshops is:“not the same as being immersed in a culture. The more distant the client’s culture from theclinician’s the more difficult it becomes to understand the client’s needs and provide effectiveinterventions. This is why it is so important to have minority ethnic group staff…” (CAMHSrespondent)A common theme in the responses to questions exploring what training staff had received wasthat they had learnt ‘on the job’ or were ‘doing their best’ in an area that is not given priorityor sufficient time. A number described acquiring their knowledge through their own initiative,by talking to colleagues or staff in other services:“Most learning comes from this informal route, by discussing with other colleagues in the samesituation and sharing ideas and concerns…” (CAMHS respondent)Another important point raised by a number of respondents was that it is difficult tobenchmark what is ‘sufficient’ in terms of skills and training. There is also a danger in staffassuming they have become ‘experts’ in an area where there needs to be ongoing learning indeveloping relevant knowledge and skills, including in understanding the subtleties of crossculturalcommunication and inter-generational variations in views towards mental health. Itwas also emphasised that staff attitudes and approach to working with young people fromBlack and minority ethnic groups are at least as important as acquiring relevant knowledgeand skills and that there is a difficult balance between acquiring the latter while refraining fromcreating or applying stereotypes.Training needs of staff in voluntary sector projectsAlongside the many comments about deficits in CAMH staff skills and training in understandingcultural and religious diversity, another important area of concern emerged in the datagathered. This related to the knowledge and understanding of mental health amongst staffworking in voluntary sector projects with young people. A number of respondents from thissector highlighted that they needed more training so that they would be able to identify mentalhealth difficulties in the young people they were working with, and thus would be able tosupport them appropriately, including where necessary, referring them on to specialist CAMHS.Staff support in working with young people from Black and minority ethnic groupsAgain, there were mixed views about this issue that highlighted the different levels of capacityfor working with this client group amongst CAMHS across the country. Some staff stated thatMinority Voices Research Report35
they felt sufficiently supported and that they enjoyed good access to interpreters, bilinguallinkworkers, open discussion and support from their team colleagues, regular supervision frommanagement and that the service they worked in regularly reviewed its provision to ensurethat it was relevant to its local client base. Others quite clearly lack all of these things andsupport came about only through their own efforts.! ‘Structural’ problems impeding effective support to young people fromBlack and minority ethnic communitiesA variety of problems were identified by staff respondents, of which probably the one causingthe greatest concern was the lack of staff from Black and minority ethnic backgroundswithin CAMHS and serious difficulties with recruitment. Not only is the inability toprovide a diverse staff group recognised to be a problem, in terms of helping CAMHS to betterreflect the communities they are serving and to enhance understanding of cultural diversity,this deficit can mean that services struggle to provide support in different minority languages.This, in turn, fuels the worry that to promote or target the service is inappropriate.Other problems identified by staff included:• A lack of interpreters including a lack of funds for such support, but also, the needfor both training for interpreters in mental health (strictly ‘technical’ interpreting seenas unhelpful in understanding the subtleties of mental health problems and adequatelycommunicating them to the clinician) and training of mental health staff in working withinterpreters. Several respondents had experienced interpreting services at what theydescribed as an ‘unsatisfactory’ standard, and some also noted the lack of continuitythat results when different interpreters are used for sessions with the same family.• A lack of space in CAMHS venues which can make it difficult to accommodatemembers of the extended family at appointments, also the lack of different venues andflexibility in hours of operation, in order to provide a range that better matches thedifferent needs of young people (for example, that addresses worries about visibility ofservices located too near to a young person’s community or allows attendance at timesthat do not interfere with education).• Restricted referral pathways, notably the need to be referred to CAMHS viatheir GP or another health professional, was recognised as a significant barrier forsome young people. Some staff indicated that they thought there was a big gapbetween asking for help from a GP and then coming to CAMHS and that thisexacerbates the tendency for young people to use the voluntary sector as a first port ofcall - who in turn may end up ‘holding’ cases due to an inability to refer on or a lack ofknowledge of local services.• The limited availability of translated materials especially in the languages ofsmaller minority groups and service ansaphones being only in English. Even whereservices could offer a good range of translated information, some had encounteredproblems reaching family members who are illiterate.• A lack of involvement of young people in the planning of services was widelyreported, including only very limited gathering of feedback data. Where young peoplehad been involved or consulted, several respondents indicated that there had been noconsideration of issues specific to Black and minority ethnic groups.Minority Voices Research Report36
Page 1 and 2: Minority VoicesResearch into the ac
Page 3 and 4: ACKNOWLEDGEMENTSThis eighteen-month
Page 5 and 6: factors that study participants ide
Page 7 and 8: Study recommendations• The lack o
Page 9 and 10: ! Concerns about the provision of m
Page 11 and 12: 3. CONTEXT OF THE STUDYVarious area
Page 13 and 14: • A measure of general psychiatri
Page 15 and 16: and some minority groups have poore
Page 17 and 18: 4. METHODOLOGYThe study methodThe p
Page 19 and 20: Staff: The interview schedules for
Page 21 and 22: 5. STUDY FINDINGS I: MAPPING OF ACT
Page 23 and 24: In a number of areas attempts to im
Page 25 and 26: 6. STUDY FINDINGS II: YOUNG PEOPLE
Page 27 and 28: ! Awareness of mental health and me
Page 29 and 30: “The therapist I was seeing was A
Page 31 and 32: Suggestions from young people for i
Page 33 and 34: 7. STUDY FINDINGS III: INFORMATION
Page 35: • High DNA (Did Not Attend) rates
Page 39 and 40: Table 4: Areas of unmet need/defici
Page 41 and 42: • The breakdown of whether some B
Page 43 and 44: 8. CONCLUSIONS AND RECOMMENDATIONST
Page 45 and 46: The study recommendations are:• T
Page 47 and 48: Wide-ranging review of the issues c
Page 49 and 50: REFERENCES1 Silvera, M. & Kapasi, R
Page 51 and 52: 69 German, G. (2002). Antiracist st
Page 53 and 54: Minority VoicesA GUIDE TO GOODPRACT
Page 55 and 56: ContentsIntroduction04 The basis f
Page 57 and 58: Meeting NeedsThe level and typeof s
Page 59 and 60: Good practice example 1 - Sharing V
Page 61 and 62: Elements of good practiceThese thre
Page 63 and 64: Neville Street also offers provisio
Page 65 and 66: Tier 3 CAMHSIn providing for local
Page 67 and 68: Services targeted on 1) particular
Page 69 and 70: 3) Particular mental health problem
Page 71 and 72: 3.Good practice in service planning
Page 73 and 74: APPENDIX IIAs set out in Delivering
Page 75: This guide to good practice is base

Minority voices: Research into the access and acceptability of ... - MMC

Create successful ePaper yourself

Delete template?

Save as template?