Time to Change Wales Stigma Symposium 2021 was held today September 15th, 2021, and Alfred Oyekoya, Director BAME Mental Health Support-BMHS, was invited to take questions from Audience and to deliver a speech on “Ensuring Mental Health Care is culturally competent and appropriate to ethnic minority needs in Wales”.
Alfred told the Audience “There is an urgent need to address the disparities in how the Mental Health Act affects people from black, Asian and minority ethnic minority (BAME) backgrounds. The Mental Health Act 1983 Code of Practice for Wales (the Code) was issued under section 118 of the Mental Health Act 1983.
The Code promotes considerations of a person's dignity and independence, as well as a requirement not to restrict people more than is absolutely necessary. It is true, however, that the act has not kept pace with developments in public attitudes, how we understand and treat mental health, or how we should support people with a learning disability or autistic people and also ethnic minorities.
We want to ensure that ethnic minorities who need to be detained under the act should have every right to expect that their voice and views will be central to decisions made about their care, as with any other NHS service.
People from Black, Asian and minority ethnic minority (BAME) backgrounds should be able to express their views and to collaborate with professionals to agree care and treatment plans that work for them, with clear therapeutic benefit and are focused from the outset on discharge and recovery.
Wales has made distinctive choices for its health strategy, but “Devolution” at its core is pure politics and service users should not get caught up with services below their expectations of excellence. Therefore, when it comes to delivery of mental health services., we need thriving social models of community-based care which cut across traditional organisation and service boundaries, working in partnership with integrated Local Health Boards and statutory Regional Partnership Boards
"Wales has made distinctive choices for its health strategy, but “Devolution” at its core is pure politics and service users should not get caught up with services below their expectations of excellence. Therefore, when it comes to delivery of mental health services., we need thriving social models of community-based care which cut across traditional organisation and service boundaries, working in partnership with integrated Local Health Boards and statutory Regional Partnership Boards "
Below are the specifics that we can do:
• Removing Barriers to Mental Health Service Recruitment: Wales is a country of diverse and inspiring communities. The NHS is one of the largest employers in Wales. To make the most of these benefits, health boards will need to work together with local providers to establish joint campaigns, make best use of resources and recruit the best people. In doing so they will need to identify shared recruitment and staffing needs which can help entice BAME individuals and families to train, work and live in Welsh communities.
• Engage on a more holistic basis which is continuous and integrated, so that conversations about changes to services are more clearly linked to how they will be delivered. The government should listen to all voices, to build mutual understanding, especially with organisations that provides mental health support specifically for ethnic minorities in Wales for example, Diverse Cymru and BMHS.
· Implement the outcomes of the consultations on Mental Health Act Reforms in Wales Such as:
Decisions about medication should, wherever possible, be in line with the patient's choice. Hopefully the government will amend part 4 of the act to create a new framework for consent and refusal of medical treatment, which will enable patients to have a greater say in their treatment and ensure that their wishes and preferences are upheld as far as possible and are more difficult to overrule.
The Government should implement the recommendation for patients to be able to choose a nominated person (NP) replacing the current Nearest Relative provisions.
Patients should be able to identify their NP in their advance choice document or at the point of detention.
We also proposed that there should be a process in place for when the patient lacks the relevant capacity to choose an NP.
Also, care and treatment plans should be made a mandatory requirement of detention. The Plan should however be subject to internal scrutiny and approval by the Medical or Clinical Director or equivalent within the first 14 days of detention.
This is not a challenge which the Welsh Government, NHS Wales, or local government can meet on their own. We will need broader and deeper partnerships, new skills, and ways of working and we will need people to take more responsibility for their own health and wellbeing. We would need a seamless whole system approach that will be equitable. Efficient Services and support that will deliver the same high quality of care, and achieve more equal health outcomes, for everyone in Wales.
Indeed, an approach that will improve the physical and mental well-being of all, throughout their lives, from birth to a dignified end, because our real test as a team, will be in the delivery of services and improved outcomes across Wales.