The aim of this project is to improve access for people from black and ethnic minority (BME) communities to the Coventry and Warwickshire IAPT service by tailoring interventions to the needs of the population and working in active partnership with local communities, charities and third sector providers to make the service accessible for all, increase awareness of psychological therapies and reduce the stigma of mental health.
Co-Production
From start: No
During process: Yes
In evaluation: No
Evaluation
Peer: No
Academic: No
PP Collaborative: Yes
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Dr Michelle Webster - IAPT Clinical Lead Coventry and Warwickshire Partnership Trust
The aim of this project is to improve access for people from black and ethnic minority (BME) communities to the Coventry and Warwickshire IAPT service by tailoring interventions to the needs of the population and working in active partnership with local communities, charities and third sector providers to make the service accessible for all, increase awareness of psychological therapies and reduce the stigma of mental health.
Coventry and Warwickshire Partnership Trust (CWPT) IAPT service receives over 20,000 referrals a year and covers a wide geographical area from the inner city areas of Coventry, to the affluent suburbs of Solihull, rural North Warwickshire and the popular tourist destinations of Warwick and Stratford upon Avon in South Warwickshire. Recognising the diversity of this population and yet the disproportionate number of referrals from BME communities, the IAPT service set up a working group with the aim to improve access for people from black and ethnic minority communities and tailor interventions to any particular needs. The group was set up in collaboration with Coventry and Warwickshire MIND, who have a unique and extremely successful working partnership with CWPT in offering one of the leading IAPT services in England. It is chaired by the Director of MIND and attended by the IAPT Clinical Lead, the CWPT Diversity and Equality Lead, the CWPT Communications Officer and therapists (BME Champions) from each locality who all volunteered to join the group being passionate about enhancing services for BME communities.
The working group set the objective of “increasing access rates to the BME population” and was vociferously determined to improve pathways for the different community groups to enable people to get help as soon as possible and in a manner that engaged them and was sensitive to their particular cultural needs. The BME champions, all being therapists working in front-line services, identified issues in the access process and the way the service was delivering its interventions which led to a number of service changes to benefit the different needs of local BME communities. An action tracker was developed with a number of action points which were then reviewed at each subsequent meeting. Successfully completed actions included:
1. To use social media to promote the IAPT service to a variety of languages. One example of this has been to have regular postings in Polish on the CWPT IAPT Twitter and Facebook page and having a polish speaking therapist available for scheduled consultation/to answer questions/queries in Polish. Screensavers have also been developed in different languages to promote the service and the work of the working party throughout CWPT. Promotion through other forms of media is also featured on the action tracker, including using radio and articles in news publications.
2. To translate IAPT self-help materials into different languages. The pro-active PWP workforce in the IAPT service has developed a range of self-help leaflets about common mental health disorders (i.e. anxiety and depression) which are available for those accessing the service. The working party arranged for the translation of these leaflets into 6 languages and these have been circulated to community groups, primary care services, GP and third sector organisations. Hard copies of these leaflets are also available and similarly translated posters have been developed.
3. To use community venues and retail outlets to promote the service. Translated posters and leaflets are distributed by our IAPT therapists and BME champions who regularly visit community centres, food-outlets and shops to promote the IAPT service. These regular visits are improving our relationship with community groups and helping to raise the profile of our service in these populations.
4. To tailor and deliver IAPT interventions to the needs of specific community groups. The BME champions have worked tirelessly to tailor interventions that meet the needs of the local communities. One (Polish speaking) therapist and BME champion has personally translated self-help material into polish and made audio recordings, whilst another has delivered stress workshops in Hindi to local South Asian Women at a community centre in Coventry. The aim is to offer this workshop on a regular basis to increase awareness and reduce stigma of mental health in Asian women.
5. To promote IAPT at BME specific events and festivals. The IAPT service has an active communications and promotions plan aimed at raising awareness of the service across the Coventry, Warwickshire and Solihull areas. The working party has developed a specific plan to identify and target specific local BME events and festivals. For instance in April 2017 staff from the Coventry service held a promotional stand at Vaisakhi Mela to raise the profile of IAPT and encourage self-referral to the service.
6. To train all our IAPT staff in working better with BME communities. The working group acknowledged that there is very little core training on using IAPT interventions with BME communities. The PWP workforce receive a module on delivering CBT to different cultures but there was very little training to Level 3 practitioners. The group is now working with the CPD coordinator for CWPT IAPT to look at specific training provision for the service.
7. To review the way we currently receive data to see if there is an easier method for mapping prevalence for BME communities and to determine whether our current and future actions have an impact on raising the profile of IAPT in specific communities. This is an ongoing piece of work however we are already starting to use data to help plan and map the work we need to do to ensure we provide a service which is accessible to all.
Wider Active Support
Coventry and Warwickshire Partnership Trust and Coventry and Warwickshire MIND have worked collaboratively with local community groups, places of worship, schools and retail outlets to drive improvements in service access and provision to ensure people from all backgrounds and cultures can benefit from IAPT services. The work of the BME champions in building good working relationships across this range of stakeholders has been integral to the success of the project so far. The working group chair and IAPT Clinical Lead are also passionate about turning objectives into actions and supporting delivery of change across the IAPT service. They represent the working group in management meetings and provide feedback and updates on the progress of the work.
Co-Production
The working group has actively promoted the importance of engaging and involving service users and has taken every opportunity for feedback and consultation at promotional events and festivals and during visits to community groups, schools, GP surgeries, places of worship and retail outlets. This work has been integral to understanding the needs of the different BME populations and has helped to shape the project and the action plan. Further work is planned to enable a process for feedback from community groups, including the translation of the Patient Experience Questionnaire (PEQ) into different languages.
Looking Back/Challenges Faced
Working within an IAPT service is a challenging environment and with national and local access and recovery targets to meet, (which are increasing year on year) both therapists and service/clinical leads are left spinning a number of different plates. Attending a regular meeting and making a commitment to deliver on the actions agreed has therefore been a challenge, particularly for therapists who have regular clinics and patients to see. We have therefore had to engage with locality team managers to release staff to attend meetings and with their help, have luckily have recruited a group of BME champions who are committed to improving access for BME communities. It is still not easy for them though and much of their BME group work has to be somehow cleverly fit around their busy diaries. For the Clinical and Service Leads, some of which work part-time and who also sit within the other working groups (i.e. older adults, learning disabilities, veterans, communications) prioritising time for BME work has also been difficult and some actions have taken longer to complete than hoped. Looking back, it would have been better to allocate Leads to different working groups so allow them to focus on one or two of the target population groups.
A further challenge has been to find appropriate training for therapists working with BME communities. Diversity and Equality training is offered through the NHS Trust and however access and resources to “buy-in” more specific training (for example using CBT with different cultural groups) would enhance practice and understanding. The working group is still working on this as an action however looking back it maybe should have been higher on the agenda in the early days of the group.
Sustainability
The working group and the enthusiasm and commitment of its members will ensure that the project is maintained and continue to work in improving access for BME communities to IAPT services. The working group and IAPT service has invested in the production of translated service leaflets, posters and translated social media posts and therefore has laid the foundations for this work to just become integral to the way the wider service is delivered. It has also made good links with local community groups and leaders who are also committed to ensuring the project continues to grow and succeed.
Evaluation (Peer or Academic)
IAPT is renowned for its data collection and using this data to evaluate the work we have been doing as part of the working group is now underway. We are starting by looking at the numbers of referrals received for the different ethnic groups across our 5 locality areas (Coventry, Rugby, North Warwickshire, South Warwickshire and Solihull) since the group was formed 2 years ago and will use this to benchmark the success of our engagement work in improving access to our service. Anecdotal evidence is positive and feedback from our groups has shown good outcomes and is encouraging.
Outcomes
As stated above, we are just starting to formally evaluate our project however qualitative feedback has been very positive and we are getting good reports and outcomes from the work that is being done. For those working in the service, they have welcomed the work the BME project has been doing and it is making it much easier for everyone now have much better links and relationships with local communities groups and leaders. The translated leaflets, posters, therapy groups and social media postings are also demonstrating how we have improved our ability to engage with BME communities and increased our accessibility and service provision.
Sharing
The IAPT Clinical lead has been invited to write a case study of the work of the BME group as part of a wider publication about working groups in the CWPT IAPT service. This will be published on the National IAPT Yammer page as a model of good practice in an IAPT service. Working group updates and outcomes are also shared to the Trust board and commissioner as part of the IAPT annual reports, as well as being shared more informally through team meetings and the service newsletter.
Is there any other information you would like to add?
I would just like to thank the work of all working group members and in particular the BME champions who fit all this work around their clinical caseloads, and the CWPT comms officer who brings our ideas to life!
