5. Quality of care: ‘good practices’ developed to improve the matching of service provisions to the needs of migrants and minorities

Measures that have been taken by service providers to improve the effectiveness of care delivery (e.g. ‘migrant friendly’ or ‘culturally sensitive’ care, health promotion targeted at specific groups, use of cultural mediation, user involvement and community engagement etc.)

Overview

Over the last 20 years, the inability of existing services to meet the needs of migrants and minorities has been an important topic of discussion. The Dialogue for Change was proposed in 1994 by the government to promote better quality of care for migrants and minorities (Mental Health Task Force, 1994).

Having started in 2005, the Delivering Race Equality in Mental Health Care (DRE) action plan is a 5 year action plan to make mental health services more appropriate and responsive to migrants and minorities, to allow for more community engagement and to improve the information on good practice and effective services.

Unfortunately, so far, good practice studies that have been done are limited in scope and are not done in a systematic way. Rather, they focused on using certain services as positive examples to illustrate what could be considered good practice.

Common aspects of good practice that have been identified are:

The presence of staff from a wide range of ethnic backgrounds that are able to speak community languages.
Training of staff in intercultural communication and anti-discriminatory practice.
In mental health care, a less traditionally western form of counselling with more flexibility in time and where being late for an appointment is not necessary a problem.
The integration of a wide range of services on one site such as community centres providing both English classes, cookery classes, housing assistance, legal assistance and therapy.

Fernando S (2005). Multicultural Mental Health Services: Projects for Minority Ethnic Communities in England. Transcultural Psychiatry. 42(3). 420-436. Abstract

Resources

For an overview on attemps that have been made in England to improve the matching of mental health service provisions to the needs of ethnic minorities:

Fernando S (2005). Multicultural Mental Health Services: Projects for Minority Ethnic Communities in England. Transcultural Psychiatry. 42(3). 420-436. Abstract

The following resource is very useful for all practitioners working with migrants and minorities, whether in regular health care or mental health care. It provides an overview of history, cultural customs that can be relevant and general information on communicating between cultures. All in easy to understand language.

Collins, Bernie (2007). Cultural competency toolkit : good practice guide in ethnic minority mental healthcare. London : West London Mental Health NHS Trust Download

Celebrating our Cultures: Guidelines for mental health promotion with Black and minority communities by NIMHE (December 2004)

Download chapters for specific cultural groups