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

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Good practice example 10 -Family Resource Project inNorth Kensington South Asian community – staff decided toconcentrate on the South Asian community asthe bilingual workers spoke the languages of thatcommunity. Did not attend first/second appointment – ofthe referrals received by the service, manychildren, adolescents and their families did notturn up for a first appointment, or if they didattend, they would be confused about why theywere referred or simply feel that the servicecould not offer them what they wanted.Therefore, they would not attend for secondappointment and would drop out of the service.There were examples of families not knowingthat they had been referred by their GP,or thinking they were coming for anothermedical opinion. Telephone contact – the bilingual workersbegan to contact families by phone as soon asthe service received a referral of a South Asianchild or adolescent. The purpose of thetelephone contact was to: ask if parents wereaware their child had been referred; explain therole of CAMHS; offer to provide interpreting ifit is required; find out where would be mostappropriate to meet for a first appointment, forexample, home, health centre or CAMHS, and ifthey wanted to attend CAMHS, to make surethey knew how to get there.Increase in attendance – every family that hadbeen contacted and had also agreed to attend,attended their first appointment. Furthermore,there was an 80% increase in families attendingfollow-up appointments. Since the developmentof these posts, the workers have gone on totrain in more complex work, for example, familytherapy and occupational therapy.A similar service has been developed for thelargely African Caribbean community by the localauthority Family Resource Project, which worksintegrally with the Tier 3 CAMHS in NorthKensington. This service works closely with thelocal primary care teams, schools and voluntarysector agencies. A range of community-specificwork has been developed, including a Girls’Group on the Travellers’ site and an ArabicFamilies Project, across Tier 2 and Tier 3, toprovide Arabic speaking families with a servicedelivered in Arabic which is sensitive to theircultural and religious needs. The work with BMEgroups is planned and carried out by workersfrom the relevant BME communities, who alsowork as integral members of the CAMHS team.Issues of concernElements of good practiceThe bilingual support inthe Bradford CAMHSenables the followingelements of goodpractice essential to theeffective delivery of aspecialist mental healthservice for BME youngpeople:1 The ability to build atrusted relationshipwith the young personand their family,based on understoodboundaries ofconfidentiality.2 Staff and a serviceenvironment thatshows understandingand sensitivity todiverse cultures.3Work with familymembers.4Work with otheragencies such aseducation, schools andcolleges to support theyoung person in theimportant domains oftheir lives.5 The capacity tooffer flexible timesand venues forappointments.6 An appropriateinterpreter serviceand specialist stafftrained to work withan interpreter.7 The ability to give timeto explain and answerquestions, with writteninformation in therelevant languages andwith a text thatappropriately meetsthe needs of particularcommunities.8Development bybilingual supportworkers of mentalhealth skills andtrained expertise, thusincreasing knowledgeabout mental healthamong the localcommunity.9Good practice isshown by servicedevelopment inresponse to theassessed needs of thelocal BME community.10 Proactive provisionof information toyoung people andparents andpreparation for theirfirst appointmentwith the CAMHS.1 A Tier 3 specialist CAMHS israrely found that has responded tothe needs of its local communitiesin a comprehensive way.2 There are considerable challengesfor Tier 3 CAMHS in working withlocal BME communities to explainwhat they do and develop mutualunderstanding of the mentalhealth needs of children andyoung people and the kinds ofhelp available.3 BME young people frequentlygain access to specialist CAMHSat a late stage in their problemsor in crisis.4 There is a shortage of CAMHSstaff from local communities and alack of funding for appropriatetraining programmes for all staff.5 Staff from BME communities aretoo often seen as the BMEspecialist, so that other staffremain uninformed and unskilledin work with BME young people.BME staff are often poorlysupported within the serviceswhere they work.14
Services targeted on 1) particular communities, 2) BME young peopleat particular risk and 3) particular mental health problemsMany projects have developedin response to the needs ofyoung people in particularcommunities such as theChinese community, to BMEyoung people at particularrisk, such as Asian girls andrefugees and asylum seekers,and to particular mentalhealth problems, such as highrisk of being sectionedunder the Mental Health Actand suicide.Good practice example 13 -Zindaagi (Newham AsianWomen’s Project)Newham Asian Women’s Project encompasses awide range of departments and is aimed atmeeting the needs of South Asian women andchildren fleeing domestic violence and/orexperiencing mental health difficulties. Theproject has four refuges, a counselling service, atraining department, a youth project calledTeens@NAWP, a general and legal advice serviceand a mental health project called Zindaagi.1) Particular communities -the Chinese communityGood practice example 11 -Kwan Wai Chinese MentalHealth ProjectKwan Wai Chinese Mental Health Project is oneof ten projects managed by the Wai Yin ChineseWomen’s Society in Manchester, which wasestablished over 16 years ago. Its originalpurpose was to offer support for womenexperiencing domestic violence and thosesuffering depression and anxiety. However,since then, Wai Yin has developed a range ofprojects serving children, young people, adultsand elderly people.Funded by a Family Support Grant,these include: A supplementary school, which aims to helpyoung Chinese people (aged 5-19) with theirEnglish, Maths, Mandarin and homework. The Youth Project offers activities for youngpeople under 30, help with benefits andeducation and health promotion; it worksclosely with the local Connexions service andthe drug and alcohol service. Through itsdifferent activities, the Youth Project workerswill often become aware of mental healthdifficulties and will assist in referring a youngperson on to Kwan Wai, a specialist mentalhealth project or to the CAMHS if the youngperson’s difficulties are too complex for theKwan Wai staff to deal with on their own.Whilst the service is not set up as a formalcounselling service, three Kwan Wai staffhave an Advanced Certificate in Counsellingand undertake a lot of ‘informal’ counselling.The team leader is a qualified psychiatricnurse and two other staff are qualified nurses.2a) BME young people atparticular risk – youngAsian womenGood practice example 12 -EACH: The PUKAAR projectThis project works across West London fromthree sites (Hounslow, Harrow and Brent),mainly with BME communities, and providesculturally sensitive counselling and supportservices for those affected by alcohol, drug andmental health problems.In 2004, EACH received new funds to developthe PUKAAR project. This offers specific supportfor young Asian women and girls aged between11 and 19 experiencing violence and abuse wholive or work in the boroughs of Hounslow,Hillingdon, Ealing, Richmond upon Thames, Brentand Harrow. The service offers free andconfidential counselling via one-to-one work andgroup work support. Satellite counselling servicesare run in a number of local colleges andschools. Self-referrals are welcomed as are thosefrom GPs and other professionals. The service isdelivered by fully qualified counsellors, from awide range of ethnic backgrounds who are fluentin Gujerati, Hindi and Punjabi.Teens @ NAWP is one part of the Zindaagiprogramme and is focused on young Asianwomen aged 10-19 years.A range of activities areoffered including: Work in schools – lunchtime drop-in sessionsallowing informal relaxed time for young Asiangirls to talk about any issues of concern to them. One-to-one support and counselling. Residential trips – once or twice yearly; smallgroups of girls taken away for a week, providingopportunities to try new activities and have fun. Summer programme – largely activity focused. Youth project – weekly drop-in on Tuesdayevenings, with transport home providedafterwards. The project provides a range ofactivities and issue-based workshops aimed atbuilding self-esteem and confidence, as well aspeer and professional support. The transportprovision seen to be key to the uptake/successof these sessions. As the recent project AnnualReport notes:“The services provided have helped break downisolation among many young Asian women in andout of school by providing them with theopportunity to make friends, seek support fromthe project and has provided them with a safeand confidential space to discuss the issuesaffecting them in their daily lives.”Other activities by Zindaagi include theproduction of a training pack and other resourcesfor professionals working with young Asianwomen (addressing issues of self-harm, suicideand domestic violence). Training is also offeredfor professionals on self-harm (demand for thisis noted to have increased considerably followingpublication of the National Institute for ClinicalExcellence (NICE) guidelines on self-harm).15
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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
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3. CONTEXT OF THE STUDYVarious area
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• A measure of general psychiatri
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Page 17 and 18: 4. METHODOLOGYThe study methodThe p
Page 19 and 20: Staff: The interview schedules for
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Page 25 and 26: 6. STUDY FINDINGS II: YOUNG PEOPLE
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Page 33 and 34: 7. STUDY FINDINGS III: INFORMATION
Page 35 and 36: • High DNA (Did Not Attend) rates
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Page 39 and 40: Table 4: Areas of unmet need/defici
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Page 47 and 48: Wide-ranging review of the issues c
Page 49 and 50: REFERENCES1 Silvera, M. & Kapasi, R
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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
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Page 65: Tier 3 CAMHSIn providing for local
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Page 73 and 74: APPENDIX IIAs set out in Delivering
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