Health Minister, Rosie Winterton, today launched the consultation paper: Delivering Race Equality: A Framework for Action. This will inform a period of three months consultation on how best to improve mental health services for Black and minority ethnic communities. People from Black and minority ethnic communities express lower satisfaction rates than the general population within the health service. Rosie Winterton said: "To achieve race equality and better community relations, whether in central government, local government, health services, voluntary groups or local communities, all of us need to work together to deliver better services for people from Black and minority ethnic communities. Services that are informed about their needs, and appropriate and responsive to those needs."

Currently:

• Black people constitute 30% of the patient group in medium secure services and 16% of high secure services.
• Black people are over six times more likely than the majority population to be detained under the Mental Health Act.
• Women born in India and East Africa have a 40% higher suicide rate than those born in England and Wales.

The Department of Health has been researching these issues to provide the framework and will work with the health service, voluntary groups and local communities to consult properly on how best to:

• improve the provision of services to Black and minority ethniccommunities
• ensure that those communities are informed about and consulted on services
• ensure they are willing and able to work in partnership with services.

The Department has set a clear target for improvements in services for people from Black and minority ethnic communities including the employment of 500 Community Development Workers by 2006. These workers will play an important part in helping services implement the framework for action.

To help services achieve improvements, the National Institute for Mental Health England (NIMHE) is establishing a major implementation programme headed by Professor Kamlesh Patel OBE. This will start with high profile consultation events in all NIMHE regions. The programme will include

• Ambitious series of community based projects to identify the recruitment pool for the 500 new Workers and increase communities' engagement with services
• Major national project to improve the quality of data on ethnicity, in partnership with the inspectorates
• Creation of 9 new senior regional posts within NIMHE to lead on Race Equality.

Kamlesh Patel OBE, Chair of the Mental Health Act Commission and the Director of the Centre for Ethnicity and Health at the University of Central Lancashire, said:

"This is a long-term, whole-system approach designed to gain commitment and ownership from stakeholders, instill knowledge and confidence in the workforce and build mutual trust between services and the communities they serve. I am confident that this holistic, multi-layered approach will succeed."

The consultation paper : Delivering Race Equality: A Framework for Action is available online. A free print copy can also be found by ringing the Department of Health response line on 08701 555 455.

The consultation will run from 17 October 2003 to 23 Jan 2004. This is a long-term commitment. A full review of implementation will take place in 2007. A reassessment of the impact of mental health services on Black and minority ethnic communities, including public consultation, will be carried out in 2010. The results of both reviews will be published.

KARMA NIRVANA

A good example improved services can be found in Derby. Karma Nirvana is an Asian women's project in Derby funded by the National Lottery and others including the local PCT and Social Services. Its objectives are to support and promote the physical and emotional health of Asian women, provide a befriending/support service, empower Asian women to become active participants in promoting their own health and well-being and liaise with voluntary and statutory bodies to ensure the needs of Asian women are heard and met. It held a conference in 2000 on South Asian women self-harm and suicide that highlighted the significance of the GP role in early diagnosis and prevention, and the need for training/awareness raising on the risk factors leading to emotional distress in young Asian women.

Karma Nirvana is conducting with Derby Mental Health Research Unit a local research project looking at factors of subordination, shame and entrapment and how these can affect the mental health of Asian women, particularly depression, and the implications for service delivery. It has identified the four main reasons for Asian women not accessing mental health services to be: 'Izzat' (a learnt complex set of rules an individual has to follow to protect the family honour and keep his/her position in the community); confidentiality; fear of being misunderstood; and unawareness of the available services.

Tel Karma Nirvana on 01332 604098/299166.

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