Deeds not words

Deeds not words

It has been just over a year since Saiqa Naz was elected chair of BABCP’s Equality and Culture Special Interest Group. Here she takes this opportunity to reflect upon her learning with CBT Today readers.

I often say to people that I was a bit naive about what I initially thought the focus of my role would be. One of my plans was to trawl through the resources used by IAPT services to work with BAME communities across England and prepare a resource pack to share with everyone. But that has proved to be difficult and I have had to remove my rose-tinted glasses as often therapists have looked to me to develop and provide them with resources.

Other therapists lack confidence in working with people from different cultural backgrounds to themselves and do not feel supported by their services. It has got me wondering that with IAPT celebrating it's tenth anniversary this year having received substantial amounts of funding over the past decade, why are therapists expected to work with diverse communities without adequate support and resources? By adequate I mean basic therapy worksheets translated into other languages...grrr!

Some services may argue that their figures show their services are performing well with BAME communities, for example. If this was the case, then why are BAME communities still typically underrepresented in primary care and overrepresented in secondary care? The trend should surely be the opposite? Who is monitoring the number of men, or people with hearing or visual impairments receiving therapy? What concerns me most is that nobody in a position of authority i.e. in the government do not seem to be asking these important questions around inclusion and pushing for solutions, as the status quo is not working. This leads me on to what is now the focus of the Equality and Culture SIG work. It really is a shame to have to do this, but we are reminding therapists and mental health services of their duty of care to all communities. It is all of our responsibility to ensure we have adequate training, resources and ongoing support to work with all diverse communities whether that be men, the BAME community, LGBT community, working class people, elderly or those who require other adjustments.

There would be an uproar if medical professionals were expected to operate on patients without the correct tools. Why should mental health be any different? We are, after all, advocating for parity of esteem between physical and mental health. It is the responsibility of service managers to develop good working relationships and work more collaboratively with commissioners to ensure their services receive adequate funding to meet the needs of all service users that are representative of the local population and provide high quality care for all. I will take this opportunity to remind us all that we have a legal obligation to help all those covered under the protected characteristics of the Equalities Act 2010.

Members of the Equality and Culture SIG are delivering workshops to give therapists confidence in developing cultural competency and updating the IAPT Positive Practice Guide. Services need to develop resources. Commissioners need to either allocate more funding or ring-fence existing funding to be

used towards working with other communities. It is frustrating when those in charge of policies and funding talk about the importance of doing more for BAME mental health and other underrepresented groups without having serious conversations around the resources required to do the work. Emmeline Pankhurst’s motto ‘Deeds not words’ comes to mind!

My fear is that with IAPT expanding into physical health conditions, the inequalities of core IAPT will be overlooked and unresolved, and yet again underrepresented groups will further be disadvantaged in the new integrated pathways. The more IAPT expands and the longer the agenda of inclusion is overlooked, the more ingrained inequality will be in mental health services and the harder it will become to redress these inequalities.

We cannot use stigma as an excuse and lay the blame on diverse communities for being underrepresented in primary care mental health services and overrepresented in secondary care. Stigma also exists is White British communities. We need to broaden our minds and question what other factors are contributing to mental health inequalities. Perhaps we need to take a closer look at ourselves first. I believe that is where the answers lie.

Saiqa Naz, Chair BABCP Equality & Culture Special Interest Group

You can follow Saiqa on Twitter @saiqa_naz To join the Equality & Culture SIG please email equality-sig@babcp.com

28 December 2018