Suggestions for improving service provision for mental health

Many people made suggestions for what professionals, policymakers, mental health trusts and researchers could do to improve the situation for people with mental health problems.

Suggested improvements regarding service provision

The people we interviewed had a number of ideas about what was missing from mental health services and how they could be improved.

a. Service provision, access and quality

Many people thought that there should be more support and services for people with mental health problems, including support in the community and more support groups. One woman described her fears about growing older and highlighted the need for support for vulnerable people without family support. People with mental health problems might also be vulnerable in other ways, for example, they might find it difficult to get care for their physical health problems.

Mae says there should be more support for lonely or elderly people with mental health problems…

Age at interview 62

Gender Female

Age at diagnosis 45

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People with mental health problems should be considered vulnerable in terms of their physical…

Age at interview 49

Gender Male

Age at diagnosis 15

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Many people also thought that services should be easier to access. Some had experienced difficulty accessing services, including one man who found it difficult to get his GP to refer him to a psychologist and another who would have liked some form of respite care while he went through a period of depression. Some mentioned the importance of speeding up the assessment and diagnosis process. Others wanted specific treatments, including counselling, group therapy, talking therapy, and more intervention in hospital. A few thought that group activities and opportunities for social interaction were important. One man wanted the opportunity to do music and drama – but not music or drama therapy. He went on to set up a music project for people with mental health problems.

One woman, who had been arrested several times, highlighted a need for the provision of more help in police stations [see Mae above].

Shaukat says it would help his social anxiety if he had more opportunity to practice being in…

Age at interview 36

Gender Male

Age at diagnosis 30

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Some people thought that more funding should be made available for Black health care organisations, proactive mental health care strategies (including more talking therapy, reduced waiting times for assessments), and child psychiatry. Many said they would be in favour of professionals campaigning for more investment in the mental health sector, which they felt was often not given enough priority within the NHS. One man emphasised the importance of initiatives and interventions being sustainable. Another man thought it was important to evaluate services.

One man thought that the quality of services would be improved if the mental health trusts introduced compulsory drug testing for all patients, staff and visitors and if staff were prepared to ‘blow the whistle’ on bad practice. He also suggested that Serious Untoward Incident enquiries – currently used to investigate deaths from suicide – should be expanded to include enquiries into the deaths from all causes of inpatients and patients who have been recently discharged.

b. Gender and culturally sensitive services

Some people referred to the need for gender and culturally sensitive services. One woman, who had a history of sexual abuse, thought that there should be more services for women in the community, including counselling and support groups, and single sex wards in hospital.

Ugo says there should be more services for women and minority ethnic groups.

Age at interview 38

Gender Female

Age at diagnosis 31

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People also described the need for services specifically for people from Black and minority ethnic backgrounds. They suggested that services should be culturally sensitive: they thought they should take people’s ethnicity and religion into consideration and make provision for it and provide culturally appropriate food. One woman emphasised that such provision should be fully integrated into services. One man reflected on the under-representation of Black doctors in the mental health system and the failure of the system to understand Black culture. Several people for whom English was not their first language mentioned the need for interpreters.

Jay says services should cater for people from different backgrounds as part of their normal…

Age at interview 42

Gender Female

Age at diagnosis 34

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Some people thought that professionals could continue to learn and made suggestions for health professionals training, including training GPs to recognise symptoms. They recommended that professionals involve people with mental health problems and from Black and minority ethnic communities to contribute to teaching (See Dolly’s story below) and policymaking.

Niabingi says there should be more funding for Black health organisations, more consultation and…

Age at interview 42

Gender Female

Age at diagnosis 25

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Dolly says she thinks the mental health system “stinks” and suggests that people with mental…

Age at interview 36

Gender Female

Age at diagnosis 21

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Suggestions for research

Many people had ideas for further research into their condition and its consequences for their long term health, and the effects of medication. Some mentioned needing to know more about the causes of mental health problems, including the role of ethnicity and psycho-stimulant drugs (‘uppers’ such as caffeine, nicotine and amphetamines). Others had specific questions they would like to see answered about where voices came from, and the nature of the chemical make up of the cells in the brain.

Edward would like to see more research into the nature of the chemical make up of cells in the…

Age at interview 59

Gender Male

Age at diagnosis 20

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A few thought there should be more investigation into the relationship between spirituality and mental health, and the effectiveness of faith-based interventions, complementary and alternative medicines and meditation. One man thought there should be more research into the way in which people from different cultures, especially migrants, treat mental health problems. One woman wanted to find out more about why the number of Black people in the mental health system being diagnosed with schizophrenia has increased and not reduced, despite the research that has been conducted [see Niabingi above].

Hanif says he thinks there has not been enough research in the UK into the effectiveness of faith…

Age at interview 49

Gender Male

Age at diagnosis 23

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One woman, however, thought money should be invested in therapy, and not research.

There are organisations that provide information and help for members of the public who would like to get involved in doing as well as participating in research. Find out more about patient and public involvement in research.

3. Suggestions to reduce stigma around mental health

A few people highlighted the need to reduce the stigma of mental health problems. Some saw a clear role for professionals in doing so: they thought professionals should produce and disseminate culturally sensitive information about mental health and promote positive images of mental health/challenge use of mental health terms in society.

Hanif says professionals should campaign to reduce the stigma associated with mental health…

Age at interview 49

Gender Male

Age at diagnosis 23

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Imani says professionals should make themselves available in the community to reduce the fear and…

Age at interview 48

Gender Female

Age at diagnosis 47

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It is hoped that new government programmes for mental health will improve access to services for minority ethnic communities, but the approach is questioned by many BME mental health campaigners and it is too early to tell whether it will be effective.