Welcome to the initiatives and news page of the Equalities and Diversity section. There are three main areas on this page and below is a quick link to each are, please click on the title that interests you and you will be directed to the relevant area.

Equality and Diversity Good Practice Examples

Equalities and Diversity ‘Good Practice’ examples

The Trust recognises the importance of highlighting, encouraging and communicating examples of ‘Good practice’. The following are a few such examples evidenced in the work of the Trust.

Faith Training in Brent

Rehabilitation & Supporting People (RASPS), part of Brent Mental Health Service, has held its first faith training session. 17 staff attended the training on the Muslim Faith. The training was jointly facilitated with Brent Primary Care Trust with the session designed for front line mental health staff working within RASPS. The aim was to enable staff to be better informed and equipped to support service users from the Muslim faith community.

Yvonne Hines (Community Mental Health Worker and Faith & Spirituality Lead for RASPS) organised the event and delivered a presentation about the importance of recognising and supporting an individual’s religious/spiritual need(s). Aisha Khan (Community Health Development Manager –Brent Primary Care Trust and Vice Chair for the Brent Multi Faith Forum) delivered training on the Muslim faith.

The participants had the opportunity to look at stereotypes, the important practices and observances that are important to an individual from the Muslim faith and how the Muslim faith informs an individual’s lifestyle. Staff had ample time to ask questions. The areas that were found to be most helpful for workers, as identified by feedback, were: definition of Islam, 5 pillars of Islam, similarities with Christian religion, fasting and prayers.

South Kensington & Chelsea English Group

Noted within South Kensington & Chelsea Adult Mental Health Services was the sudden rise in referrals of service users with English as a second language. In particular, detained patients on wards were unable to engage in the majority of the Occupational Therapy group programme offered as their inability to communicate was seen as a barrier to engagement. This difficulty was also reflected in the community where it was noted that service users with English as a second language were being excluded from their local community. A majority of service users had been observed to lack confidence and the ability to access mainstream English courses at their local colleges therefore they remained unable to learn or develop any English language skills and became socially isolated in turn having a detrimental effect upon their mental state.

In meeting service demand, government and local initiatives combined with service users/carers needs funding was gained and the English Group started within the SK&C MHU in February 2007. It is currently open to all service users within SK&C inclusive of those who may be detained on the ward. Its main objectives include:

To acquire the skill of reading, writing and speaking the English language within a safe and supported environment
To promote the benefits of learning the English language.
To enable service users to gain the necessary skills in order for them to engage in a local community college course and further their learning within a mainstream resource.
To increase confidence in being able to communicate effectively.
To provide structured activity as part of a weekly routine.
Enable mental health monitoring in a non-threatening environment.
To promote social inclusion.

Since the running of the group the outcomes have been overwhelmingly positive with service users indicating how beneficial they have found the group in enabling them to function at a more optimum level.

Preparing for Ramadan

The Brent Mental Health Service Faith Links project have devised a checklist and posters, in conjunction with the Brent Multi - Faith Forum, to help ward staff support Muslim Service Users who wish to observe Ramadan through fasting. Whilst Muslim service users are aware that they may be exempt from fasting, many people try to participate actively.

Training in Deaf Awareness for PALS Workers

‘Link workers from the Trust’s Patient Advice and Liaison Service have recently begun receiving Deaf Awareness training. Two pilot one-day courses were run at Latimer House by Deafworks in May and June. The facilitators on both courses were Deaf, and the courses were very much about improving our communication skills in practice. “It was absolutely brilliant”, says Leslie Bennett, from Hillingdon’s Rehabilitation and OT Services. “The Deaf facilitator made us feel very comfortable. It was very interesting and definitely worth going to”.

Given the success of the pilot, we are now planning a series of half-day courses for PALS link workers, beginning in October 2007.’ Peter Barr, PALS Manager.

Gay Men's Therapy Group

A weekly Gay Men's Therapy Group, referred to as ‘The Men’s Group’, is run at the Soho Alcohol Team in Westminster. Co-facilitated by CNWL staff and a staff member from a local non-statutory agency, the Alcohol Resource Centre (ARC). The group allows gay and bisexual men to explore common issues within an accepting, non-judgemental and confidential environment. Abstinence and returning to employment are common outcomes. Referrals are primarily from Hammersmith and Fulham, Kensington and Chelsea, and Westminster although it is open to referrals from other sectors.
The group is primarily an alcohol group with other secondary substance use i.e.: cocaine, ecstasy and ketamine plus other drugs. Dialogue in the group is not restricted to only substance use but is open to other issues. Members are also encouraged to bring social and personal or other pressing matters. Motivational Interview (MI) and Solution Based Practice interventions are used.
One of the co-facilitators of the group writes that ‘Gay culture is disproportionately involved in substance use, alcohol and drugs (1), whether it's in pubs, clubs, saunas or in other personal situations. A common theme in the group is how to socialise and meet others without the use of alcohol or drugs. Issues of self-esteem and relationships are also frequent.’ He makes the important point that ‘the wonderful thing about groups are their ability to question and encourage behaviour change via peer pressure. We have had instances where members have admitted the desire to use or behave chaotically but haven't "because I didn't want to come back to the group this week and let everyone else down by using".’
The group is open to referrals and staff are invited to send client referrals to the service.
(1) Bloomfield, K. (1993) A comparison of alcohol consumption between lesbians and heterosexual women in an urban population. Drug and Alcohol Dependence, 33, (3), pp 257-269.

Work With Community Organisations
The Asian and Arab Families Counselling Service at The Marlborough Centre has developed close working relationships with a number of community organisations. This has involved developing and establishing trusting relationships over time through joint work and has facilitated a two way learning process.

An example of this is the joint work with An Nisa women's group. An Nisa is a voluntary Muslim women's organisation based in Brent. They have organised a number of conferences and workshops on Mental Health and Islamic Counselling, which Rabia Malik from the Asian and Arab Families Counselling Service has presented at, as well as conferences on Muslim fatherhood and workshops encouraging Muslim women to work. Through presenting our work at such conferences we have been able to build up a dialogue with the community and community organisations about the needs of Muslim clients and to illustrate our approach to working with mental health issues in a culturally and religiously competent way. This has resulted in a significant number of referrals to the service either through An Nisa or self referrals from Muslim clients who have trusted that they will receive a service in which they would be understood.

Arabic Families Service –North Kensington and Chelsea
Funding for a small multi-disciplinary ‘Arabic Families’ team was agreed by the PCT in July 2004, to continue until March 2006: additional funding from the local authority allowed a half time Arabic social work post to be added to the service. The Arabic Families Service is a Child and Adolescent Mental Health Service, operating at Tiers 2 and 3.

The main objective of the service has been to achieve equality of access to Child and Adolescent Mental Health Services for children from Arabic families, who were previously under-represented in our clinic population. We began this process by considering different aspects of what it meant to be an ‘Arabic’ family, and came to the conclusion that this could refer to having Arabic as a mother tongue, to coming from an Arabic culture, or to being a Muslim.

The service welcomed people who could be defined as ‘Arabic’ according to any of these definitions, and a number of adaptations were made to the service to take account of the linguistic, cultural, and religious preferences of this group of potential clients.

a) In terms of language, anyone coming to the service who preferred to have a therapeutic service in Arabic could be offered this
b) In terms of culture, we found that an aspect of Arabic culture was that in certain circumstances a less formal approach might be preferred. Particular emphasis was placed on offering a welcome and taking time to hear the concerns as presented by the parents
c) In order to reach out to those who felt a ‘clinic’ to be an alien environment in which to discuss sensitive family issues, aspects of the service were offered without appointments and in a community setting
d) An Islamic approach was adopted, which ranged from employing Islamic Counsellors who could offer this intervention as a treatment option, to raising awareness of Islamic beliefs in the team as a whole

Targets were set, information and activity was monitored. It was found that in 2002/3 prior to the establishing of the service, 5% of clients accessing CAMHS were from Arabic Families, whilst in 2004/5 once the service had been established the figure was 20%. The highest proportion of clients were from North Africa.

Interestingly, records kept by the education service show that in some primary schools in North Kensington, more than 50% are from an Arabic background –they either speak Arabic at home, belong to the Islamic faith, and/or come from the Middle East or North Africa. Clearly there is scope for the Asian/Arabic Counselling Service to develop further.

Refugee and Asylum Seeker Training Day
Harrow Mental Health Service Diversity Group has recently hosted a very successful training workshop on the topic of working with Refugees and Asylum Seekers. As well as having staff from Harrow Mental Health Service in the Diversity group we have actively encouraged partnership working with other statutory providers and the voluntary sector. This latest partnership with the refugee worker from MIND in Harrow, the specialist health visitor working with Asylum seekers from Harrow PCT, a CPN from one of our local CMHTs and the Director of REAP (Refugees Effective Active Partnership) in Hillingdon spawned the idea that developed into the workshop.

Using existing contacts from members of our group we invited Paul Warburton from the Legal Team of the Immigration Advisory Service, Dr Mariwan Husni, Consultant Psychiatrist Harrow Mental Health Service, Jane Cook, Nurse Advisor for Asylum Seekers, Hillingdon PCT, Dick Blackwell, Psychotherapist at the Medical Foundation for Victims of Torture and Mark Hall-Pearson, our lead social worker, to speak to us on their specialist areas of expertise.

The day was made all the more successful by the choice of venue for the workshop at the Sangat Centre a community resource in Harrow belonging to the local Anglo-Indian Society which provided excellent hospitality including a wonderful lunch! Forty-five people attended the workshop from across Harrow and the Trust, from a range of statutory and voluntary organisations. The consensus from the feedback forms was that the attendees would like us to host further events on this very important subject. We are starting to plan a programme for the spring and summer and this time will be inviting local refugee groups to join us in a more interactive day’s training.

This report of the training workshop has been published in ‘Inbrief’, the Trust'’s quarterley newsletter to all staff, thereby widening awareness of this kind of initiative and therefore encouraging others to consider similar training for their team/partner agencies.

Multi-cultural Faith Initiative in Brent
Brent Mental Health Service has taken a pioneering initiative to provide spiritual help to Brent users. A 75% response rate to an in-patient survey at Park Royal in 2003 showed a high interest in faith support being available and how it could best be used. The survey showed clear differences between the seven faith groups represented in how they would like faith support. In response to the survey a number of actions have been initiated:

Service users on admission are individually asked whether they have a prayer/faith/mediation practice that helps them
Users and are given information about faith support available
A Faith Room: is available throughout the day, with time set aside for specific faiths during festivals
Faith visitors are also available for a range of different faiths, including Muslim, Sikh, and Jewish
Users can attend services and group prayers, Christian Holy Communion and RC Mass, as well as fortnightly Pentecostal praise services. Muslim users can attend Juma’a Friday Prayers weekly on site
Major faith festivals are marked in in-patient, day and rehabilitation services across the year e.g. Ramadan, Diwali, Rosh Hashanah, Easter, as reflected in the wider Brent community. Day treatment programmes focus on special events. We train staff to support users during fasting periods and requirements Transport is provided for inpatients to attend mosques and other local places of worship
Training of Faith Visitors in mental health awareness involving service users
Community links have been fostered with the Brent Multi-Faith Forum and other local faith leaders to identify potential visitors, who also advise us on specific faith needs
The Brent Black and Caribbean Mental Health Consortium is working in conjunction with Brent Mental Health Services to develop stronger community links with faith groups to support mental health users through community chaplaincy
Users’ feedback and evaluation. Users participate in the regular Faith Links group where we plan services and receive feedback and ‘Users quotes’, the local advocacy group, ensures users receive information about services.
Rehabilitation and supporting people services are likewise hoping to link users with their faith more actively in the community, while the Asian day care service has long-established practice of recognising users' faith as part of everyday contact.

The service has contributed to the wider mental health and spirituality debate through national surveys and involvement with other Councils and Trusts. A Brent-wide strategy is planned, to embrace minimum standards for faith support in mental health and increased funding is being identified for staff training in faith awareness and understanding of cultural/faith needs. It is hoped that a Spiritual Care Coordinator post can be funded with faith visiting becoming funded on a formally recognised basis.

Disabled access to Child and Adolescent Mental Health Services: an example of the helpfulness of consultation with parents
Parkside Clinic has had ‘disabled access’ for a number of years, but there had been complaints which included finding it difficult to use: it was not signposted, there was a gate to be negotiated as well as a door, it was dark and overgrown, it made people feel like second class citizens before they had even got to meet with a member of the clinic staff.

Two parents of disabled children we invited to help the Clinic staff think about how to make the disabled entrance more welcoming, and to advise us about what changes were needed inside the building to make it genuinely accessible to disabled children and their parents. One of the mothers had difficulties herself with hearing and balance, and advised the service about the needs of adults with these disabilities.

Both of the mothers spoke of feeling very uncomfortable at being in a clinical setting having had experience over many years of having to attend hospitals and clinics with their children for assessments and procedures, sometimes painful and often upsetting. They spoke of frequently having to negotiate environments that were not child friendly, and to deal not only with the emotions and behaviours of their children, but to manage their own distress.

Looking around the clinic with experienced eyes, they quickly pointed out a number of improvements that could be made. These included:

Detailed attention to the signage, not only so that people were able to find the disabled entrance on the way in, but also to clarify the way out –essential if a child is distressed
Changes to doors, so that disabled clients can open doors themselves, and manoeuvre wheelchairs through them
Improvement to the deécor. They spoke of the need for an atmosphere of calm, with not too many people and objects around, and pictures that were simple, colourful, and child-friendly
Changes to clinic leaflets, so that these clearly stated that the services offered were available to children with disabilities.

After the improvements had been carried out, they both indicated that the improvements had been carried out to a high standard, and were particularly pleased both to have been consulted in the first place, and also that their recommendations had been acted on so quickly and efficiently.

Women in Management
Places for BME staff are ring-fenced within the Women in Management Programme. Since 2000, 25 people have been seconded to this programme. The ethnic breakdown was as follows:

White/Eng/Scot/Welsh	13
Black Caribbean	3
White Irish	1
Asian	1
Black African	2
Black Other	1
White Other	1
Mixed White/Black British	1
Other Ethnic Group	1
Not Stated	1

Evaluation feedback received from all participants included:

Better understanding of management roles, of how decisions are made, why people become managers and ‘better understanding of managerial role
’Motivation higher as everybody was supportive
support from senior managers to address career aspirations with ‘time and space to focus on career issues and the future
’An invaluable overview of Trust priorities’, an ‘opportunity to network with managers across the Trust
’Has given ‘confidence to apply for new jobs’ (usually as a promotion)

All participants were very positive about the scheme –‘brilliant idea’, ‘very useful’, ‘enjoyable’.

Sponsored Nurse Training Scheme
The Sponsored Nurse Training Scheme has been in operation since 2000. The training is to undertake a three year diploma in Registered Mental Health Nursing. It is funded by the Strategic Health Authority and staff are seconded from their work place on full salary. At the end of the 3 years if they complete the training they become registered nurses and we offer them substantive posts. It is a means of growing our own local workforce and allowing staff to meet their full potential. The Trust is pleased to report that of the 46 staff who have passed through or who are currently in training under the Scheme, 96% are from BME communities. In 2005, all 5 places have been taken up by black African nursing staff.

Trust Induction
The Trust offers a five day induction. Within this programme, time is given for a presentation on Equalities and Diversity. The presentation (and discussion as time allows) includes describing the Race Relations (Amendment) Act 2000 and the Race Equality Duties; the Disability Discrimination Acts 1995, 2005 and the Disability Equality Duties;The Equality Act 2006 and the Gender Duty; together with describing how the Equalities and Diversity agenda is taken forward within CNWL and how staff can become involved. Copies of the presentation are available on Trustnet for all staff to access, and the presentation is regularly updated.

Focused Implementation Site

The Delivering Race Equality Focused Implementation Site (FIS) is a 3-year project to implement specific outcomes from the Departments of Health's initiative 'Delivering Race Equality in Mental Health' within CNWL. The Project Manager taking this work forward is David Truswell, who can be contacted by telephone on 020 7612 1656 or 07812 031215 or by email on: david.truswell@nhs.net

The CNWL FIS Project is focusing on 5 specific areas:

Reduction in the disproportionate rate of admission of people from BME communities to Psychiatric Inpatient Units
Reduction in the disproportionate rates of compulsory detention of BME users in Inpatient Units
Reduction in the proportion of prisoners from BME communities
More active role for BME communities and BME Service Users in the training of professionals, in the development of mental health policy, and in the planning and provision of services
Workforce and organisation capable of delivering appropriate and responsive mental health services to BME communities.

Updates on progress and developments are to be found in the Trust’s FIS Newsletter (Which, since autumn 2006 has been incorporated into the Trust’s Equalities and Diversity Newsletter –Inclusion News).

FIS News Issue No 4, November 2006

FIS News Issue No 3, July 2006

FIS News Issue No 2, April 2006

FIS News Issue No 1, February 2006

Equalities and Diversity Posters, Factsheets and Newsletters

CNWL has produced a range of posters and accompanying factsheets to promote awareness of Equalities and Diversity legislation and in particular the general duties that it is required to fulfil under Equalities law.

Posters

1. Race Relations (Amendment) Act 2000 - Race Equality Duties

2. Disability Discrimination Act 2005 –Disability Equality Duties

3. Equality Act 2006 –Gender Equality Duty

The Trust has also produced a series of accompanying Factsheets.

Factsheets and Guidance

1. Race Relations (Amendment) Act 2000

2. Disability Discrimination Act 2005

3. Equality Act 2006

4. Deafness and the Deaf Community Guidance

Inclusion News

Additionally, in order to ensure staff can be kept up-to-date on Equalities and Diversity developments, a Trust Newsletter has been produced, ‘Inclusion News’, and issues of this can be accessed below.

Inclusion News Issue No 8 February 2008

Inclusion News Issue No 7 November 2007

Inclusion News Issue No 6 August 2007

Inclusion News Issue No 5 May 2007

Inclusion News Issue No 4 February 2007

Inclusion News Issue No 3 November 2006

Inclusion News Issue No 2 August 2006

Inclusion News Issue No 1 May 2006