Case study E: positive impact engagement through partnerships

In October 2012 Lambeth Council’s Health and Adult Services Scrutiny

Committee recommended that Lambeth borough needed to do more to
address the issue of relatively poor mental health and outcomes amongst
black African and Caribbean residents.

Black Caribbean people make up 7 per cent of the population registered

with Lambeth GPs but account for 17 per cent of people with serious mental
illnesses. Whilst 26 per cent of people in Lambeth identify themselves as
Black African or Caribbean, 50 per cent of Lambeth residents in high secure
and 67 per cent in low and medium secure psychiatric detention are from
these groups.

There is no one single cause of mental illness but many contributing factors
including poverty and unemployment, poor housing or homelessness,
trauma, bullying or harassment.

The Lambeth Black Health and Wellbeing Commission was established in

October 2013. The 10 members comprise of service users and carers,
health service representatives and councillors from all three political parties
represented on Lambeth Council. It aimed “to improve the outcomes for
members of the black community experiencing mental health problems and
ensure that services in Lambeth are designed and delivered in a way that
meets their needs.”

The Commission agreed to focus on the black African and Caribbean

community and mental health specifically rather than Black and Minority
Ethnic (BME) populations generally, and asked three key questions:

1. How can we improve prevention and reduce stigma

2. How can we improve access to services
3. How can we improve the patient experience

The Commission concluded:

Improving prevention and reducing stigma

 There is a disconnection between what people want and what is available or offered – people want
prevention and early intervention but often end up in hospital
 The high eligibility criteria to Child and Adolescent Mental Health Services prevents access until problems
are extremely severe, despite general acknowledgement of the importance of early intervention
 Changes to mental health services have to be linked with changing the overall situation of black and other
minority ethnic groups
 More needs to be done by other sectors working collaboratively to reduce the causes of ill health and
address the environmental and economic factors that contribute to poor mental health by tackling poor
housing, unemployment and poverty
 The Health and Wellbeing Board should be asked to take a lead and ensure that public services individually
and collectively are addressing the contributory factors to mental wellbeing and working with residents,
providers and contractors to implement good practice, and leading by example with their own organisations
 A Lambeth Education Wellbeing Charter should be developed to promote social and emotional wellbeing.

Improving access to services

 Eligibility and access to Child and Adolescent Mental Health Services is uneven
 There are concerns regarding the Common Assessment Framework (CAF) used in primary care for
identifying the additional needs that a child may have
 Consideration should be given to rolling out the model of the Well Centre in Streatham to other
services/areas
 There is a need for better information about mental health services
 Mental health services need to be on par across GPs and help to reduce variation in outcomes
 Commissioning plans need to be refreshed, targeting at community support and trying to bridge the
fragmentation of commissioning.
Improving patient experience

 Notwithstanding the positive work which is underway via the Lambeth Living Well Collaborative, to date the
black African Caribbean experience of mental health services remains negative; outcomes are not yet
sufficiently changing and some people will not engage with services
 There is a need for earlier more effective community interventions targeted at Lambeth’s black populations
 Concern exists around regarding the experience of black mental health services/service users and the police
service, acknowledging the work the police force is doing in taking forward the recommendations of the
Adebowale Commission
 There is an awareness that physical restraint and restrictive (including chemical) interventions remain an
issue of significant concern for patients, public and professionals alike.

The Lambeth Living Well Collaborative

Lambeth CCG has commissioned a community partnership approach to mental health called the Lambeth Living
Well Collaborative (LLWC). The LLWC uses a community approach to support people experiencing mental health
issues.

Stories from staff, people who use services, families and carers are so
important to understanding the impact of the work happening in
Lambeth.

A collection of stories can be read on the Lambeth Living Well

Collaborative website. One of the stories is that of VB’s, a Jamaican
woman living in Brixton who joined Missing Link as a peer supporter,
working with people adjusting back into the community after having
dedicated support from the mental health team.

Peer support is all about having somebody walk by your side who isn’t
trying to fix you but just being there and empathising. The person helping you might have experienced similar
mental health issues and therefore have the insight into how you might be feeling.

VB praises Missing Link’s co-ordinator Lucas Teague, who has known her since she joined Vital Link and
encouraged her to keep believing in herself.

The encouragement has helped VB build on her skills and in 2012 she gained certificates in peer evaluation at
Southbank University. VB said: “I want to feel better and to help people who are recovering because I have those
feelings of mental health to support others.”

Forty recommendations were made in the Commissions report. The partners are currently drafting an action plan
on the recommendations, which will be shared on the Lambeth website when finalised.