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

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Tier 1 servicesAt Tier 1, essentially, are allservices that work withchildren and their families.How effective they are inpromoting the mental healthof children and young peoplewill depend upon the extentto which these services areaccessible to BME familiesand have an understanding oftheir needs and the skills towork with them.Two projectsare given as examples: theMarlborough RoadProject and the NevilleStreet Project, both run byBarnardo’s.Good practice examples 4 & 5 - Barnardo’s projects in CardiffMarlborough Road offers a variety of projects,including supported housing for single young peopleand for young families; this includes specific projectswith Black and minority ethnic young people. TheCaterpillar Project is a mental health project for 16-25year-olds, who can self-refer or be referred by aparent or another agency. One-to-one work can becarried out as needed by any young person, and theproject will also work alongside statutory mentalhealth services to provide support. A PresentationGroup campaigns to help reduce stigma associatedwith mental health and to develop positive solutionsfor the care of young people with mental healthproblems. The group gets together regularly to writepresentations and to attend conferences and events.A CD has been produced for the Open University.Young people are given opportunities to expresstheir views and to feel listened to, which helpstheir confidence and self- esteem. Confidence, selfesteemand well-being are also promoted in agentler Girls’ Group. Staff from the Caterpillar Projectalso run a group for young people in the localTier 4 CAMHS unit.The Neville Street Project offers a range ofservices including an advocacy service for Black andminority ethnic children in education, including those atrisk of school exclusion or experiencing problems withracial teasing or attacks. Other activities include aBoys and a Girls Group, each for 11 to 16 year-olds,meeting once a week on different evenings. Boys’activities include: photography sessions, football andcricket, attending community based events and trips;girls’ activities include art and craft, eg. tie-dye, batik,games, trips and visits to places of interest withinthe community. (continued on next page)Elements of good practice1Projects and services atTier 1 include universalservices such as maternityand early years and youthservices, as well as thosethat offer help tovulnerable groups such asthe homeless and youngpeople leaving care. Inboth types of situation,mental health needs canbe identified by staff withthe appropriate skills andexperience in a nonstigmatisingmanner.Staff in these services ‘pickup’ on problems in aflexible and informalmanner and canthemselves carry out workin meeting mental healthneeds that are not severeor complex.They are wellplaced to advise andsupport young people infinding more specialisthelp as indicated.2 A key element in goodpractice by Tier 1 servicesis to foster a trustingrelationship and to engageclients with helpingservices. For young peopleand their families, servicesoften achieve this bypresenting a voluntarysector ‘shop window’, so asnot to be seen as offputtinglyofficial andformal.The service may belocated where local youngpeople generally hang out,and open as a drop-in athours that are likely to beconvenient for them.Theseservices are well used ifthey operate as a ‘OneStop Shop’, providing avariety of services underone roof, including socialand recreational facilities.Access to the service isnot limited to theduration of a ‘problem’,allowing time for needs tobe identified andacknowledged and for theestablishment of a securebasis for therapeuticintervention. In addition,access is not rigidly limitedby age so that youngpeople older than thecut-off ages for provisionby mainstream services,can find support otherthan in services for adultswhich may not be suitable.3 In promoting mentalhealth and earlyintervention, good practicein planning and provision oflocal services requiresmultiagency collaboration,including with BMEcommunity groups.Thismay require sensitiveproactive and painstakinggroundwork.4For BME young people,good practice in Tier 1depends upon widespreadcultural awareness amongstaff and close andrespectful workingrelationships with localBME groups and agencies.Wherever possible,provision should be by staffwho come from the localBME communities andBME voluntary sectoragencies. Otherwise,interpreters can breakdown the language barriersand empower families tochallenge issues that affectthem. Receiving help fromstaff who are interestedand aware of religious andcultural differences andneeds and who do notmake assumptions about ayoung person’s situation ishighly valued.A staffgroup that reflects thelocal communitygives a welcoming ‘feel’to the service.5 Tier 1 services shoulddevelop, in collaborationwith parents and youngpeople from the local(including BME)communities, written andother types of informationraising awareness of mentalhealth issues and explainingwhat services can do.10
Neville Street also offers provision for the pre-schoolage group. There are three Stay and Play sessions andone Family Workshop a week for the under 4s andtheir parents, with the aim of encouraging parents toplay with their children or to provide positive playingexperiences for their children. Both the Stay and Playsessions and the Family Workshops run in term-timeonly. During the holidays, Neville Street runs aplayscheme for 5 – 11 years olds, and offers activitiesfor some of the siblings of the under 4’s.Other resources offered by Neville Street include atoy library and individual case work support from twosocial workers based at the project. They may offeradvocacy, counselling, or support with housingissues/employment issues/childcare issues.Occasionally, they run parenting groups and fathers’groups. Direct work, including identity work, life-storywork, loss and bereavement, fostering and adoptionissues, and abuse or crisis in the family, is offered byseveral skilled staff at the project for children referredby social services, health or education.Issues of concern1 Funding for Tier 1 services that offerthe elements of good practice forBME families, as for many vulnerablefamilies is often difficult to raise andshort-term in nature.Thus, it isdifficult to build a local service systemin which BME young people haveconfidence and to sustain continuity.2 Staff with the necessary skills andexperience from BMEbackgrounds are in short supply.3 There is also a lack of trainingopportunities in racial andcultural awareness andcompetence, for thewide range of staff disciplinesworking in Tier 1 services.Tier 2 servicesSome Tier 2 services havebeen developed to provideearly intervention for mentalhealth problems in youngpeople from BMEbackgrounds, known to be atrisk.Three examples of quitedifferent approaches havebeen selected for inclusion inthis section: A project formed inpartnership between a localNHS Trust and a localCommunity Centre, toaddress an identified gap inprovision – the Peace ofMind/Xaloonida MaankaSomali mental healthoutreach project. A dedicated NHS clinicalpsychology service – theAfrican Caribbean FamilySupport Project (ACFSP)in Nottingham. A Black specific servicewithin mainstream statutoryservices – Antenna.Good practice example 6 -Peace of Mind/ XaloonidaMaanka Somali mental healthoutreach projectThe Peace of Mind project was developed under theauspices of the Tavistock and Portman NHS Trust inpartnership with the Somali Community Centre in late2002. Though housed in a Tier 3 provision, servicedelivery is primarily community-based, with a strongpresence in community venues such as schools.The project was set up following consultation with theSomali community when it was acknowledged thatthere was limited mental health service provision forSomali children and their families in Camden. Of thenearly 3700 refugee children in schools in Camden,26% are from Somalia where their experiences andongoing adjustment to a very different life in the UKmake them a vulnerable group. Twelve per cent ofCamden’s children are refugees and half of these areSomali. Cultural issues, such as severe stigma aroundmental health, prevent Somalis from seeking help anda lack of knowledge about the way services functionin the UK has resulted in misunderstandings and fearabout mental health professionals and services.The project aims to specifically target Somali childrenaged 5-13 and their families in Camden and willaccept self-referrals as well as referrals from schools,social services and community groups. Individual,group and family work is offered.The following services are offered: Parent training, including the RaceEquality Unit’s course Strengthening Parents,Strengthening Communities. Awareness days – on the UK education systemand the mental health needs of children. Capacity building – the training ofSomali community workers/teachers/parents in mental health. Consultation work in local schools around themental health needs of Somali children. Joint work with a variety of other local teamssuch as Sure Start and the Youth Offending Team. Joint consultation and case work with Tier 3 –where the pairing of a Somali outreach workerwith a specialist CAMHS worker has provedparticularly successful in demystifying the processof seeking and receiving help from mental healthservices in the UK, reducing the fear andmisunderstanding of CAMHS professionals,and in tackling the stigma surrounding mentalhealth in the Somali community. For workersthemselves, the model developed by thePeace of Mind project has allowed bothpersonal and professional development withregard to understanding of each other’sdifferent communities.11
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Minority VoicesResearch into the ac
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ACKNOWLEDGEMENTSThis eighteen-month
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factors that study participants ide
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Study recommendations• The lack o
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! Concerns about the provision of m
Page 11 and 12: 3. CONTEXT OF THE STUDYVarious area
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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
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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 and 36: • High DNA (Did Not Attend) rates
Page 37 and 38: they felt sufficiently supported an
Page 39 and 40: Table 4: Areas of unmet need/defici
Page 41 and 42: • The breakdown of whether some B
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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: Elements of good practiceThese thre
Page 65 and 66: Tier 3 CAMHSIn providing for local
Page 67 and 68: Services targeted on 1) particular
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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
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