principles into practice network

Respect for diversity

Topics covered in this article: Equality & diversity, Care groups, Care & treatment

Award Winner

Sanctuary

Contact Neil Quinn, Mental Health Improvement Lead, Positive Mental Attitudes, 6 Buchanan Street, Ballieston Glasgow G69 6DN

Neil.Quinn2@ggc.scot.nhs.uk

0141 342 3200

With Scotland hosting a significant sized population of asylum seekers and refugees, who have a high incidence of mental health problems , the mental health needs of this population has become an important issue to address. Glasgow Anti-Stigma Partnership, who has developed a number of programmes to address stigma and discrimination in Greater Glasgow and Clyde, decided to develop a programme of work with asylum seekers and refugees.

The Sanctuary programme brought together national, regional and local partners to undertake an action research project, seeking to identify patterns of stigma and discrimination experienced by asylum seekers and refugees in Glasgow and to explore how this may be addressed through community development approaches. Peer led research was undertaken with over 100 participants and identified how pre-migration trauma as well as poverty, racism and the stress of the asylum process was impacting negatively upon people's mental health. In addition, significant levels of stigma and discrimination towards mental health issues were found within communities, resulting in a reluctance to seek help.

Following the research, two programmes were developed: a programme of awareness workshops with community groups and staff training with accompanying DVD delivered to NHS staff and housing providers.

The awareness workshops were entitled 'community conversation' explored mental health and stigma in safe, supportive workshops. 10 peer educators drawn from asylum seeker and refugee community organisations were recruited to develop and deliver the workshops to ensure cultural sensitivity in terms of language, process and content. The rationale for the session was to improve awareness of mental health issues in order to reduce stigma, promote help seeking, peer support and recovery. 25 workshops were delivered to 328 asylum seekers and refugees in Glasgow at a range of community venues.

The other programme was staff training. The research had identified the need to address

the lack of awareness amongst key service providers, including NHS staff and housing providers. A training group was established to draw on the specialist knowledge and expertise within the Sanctuary group and develop a tailored training course, which would aim to improve awareness of the mental health needs of asylum seekers and refugees amongst staff in these key service providers. The training has been delivered to over 100 NHS staff, with a further 12 courses planned. To enhance the training course, a DVD film was produced by the specialist film maker, Diversity Films, to capture the narratives of 6 asylum seekers and refugees in Scotland. This is being used as a resource to accompany the training and is having a powerful impact on training participants. The film recently won an award at the Scottish Mental Health Arts and Film festival International Film Awards.

The Sanctuary programme clearly meets the criteria of the 'Respect for diversity' category and embraces the principles of the Mental Health Act.

The programme was developed to address the specific mental health needs of asylum seekers and refugees and influence mainstream service development. In relation to the criteria specified in this category, the Sanctuary programme has successfully delivered on the following criteria:

1) Consultation and engagement of an 'equalities' client group in service delivery: the research involved engagement with over 100 asylum seekers and refugees, gaining the groups' views on a number of issues including barriers to accessing services and the cultural appropriateness of service provision. This report has been disseminated to service commissioners and mangers in statutory mental health services in Greater Glasgow and Clyde and helped to inform service development. The Scottish Government have also been informed of the research findings.

2) Developing the skills and capacity of mainstream staff: the programme has directly influenced the skills and capacity of mainstream staff through its staff training programme. 8 courses have been developed to over 100 NHS staff and a further 12 courses are currently being planned with NHS staff and housing providers. The course has the following objectives:

• Explore reasons why people flee their country of origin
• Describe the asylum process
• Define torture and its potential consequences
• Identify factors impacting on asylum seekers/ refugees living in exile
• Demonstrate increased awareness of how to provide a culturally sensitive service
• Discuss how this work can impact on the worker
• Have knowledge of concepts of positive mental & well being, mental ill health and service / treatment responses including recovery

The initial evaluation of the first 8 courses has been extremely positive, with the use of the film 'Inside stories' having a particularly strong impact on staff attending the courses.

3) Delivering information that is accessible and culturally appropriate: the community conversation awareness workshops have used training material that is accessible and culturally appropriate. To ensure this has happened, the training materials were developed in partnership with peer educators from asylum seeker and refugee communities. In addition, the staff training has involved a session on culturally sensitive practice.

4) Developing peer support networks: the Sanctuary programme has developed a network of peer educators to deliver the community conversation programme. This has helped to develop capacity within asylum seeker and refugee communities in Glasgow. In addition, the community conversation workshops have successfully promoted peer support as an explicit aim of the workshop.

In terms of the principles of the Mental Health Act, the Sanctuary programme specifically embraces the following principles:

Non-discrimination - the focus of the Sanctuary programme on challenging stigma and discrimination fits well with this principle of the Act

Equality - the focus of the programme on promoting equality and enabling staff to practice without discrimination on the grounds of language, religion or national or ethnic or social origin fits well with this principle

Respect for diversity - the programme has been designed in a way that respects the diversity of participants in the community workshops in relation to religion and ethnicity by for example recruiting peer educators from a range of ethnic backgrounds . The staff training aims to ensure that service users should receive care, treatment and support in a manner that accords respect for their individual qualities, abilities and diverse background

Participation - service users are involved in this programme. The 'Inside Stories' film contains the narratives of asylum seekers and refugees with an experience of mental health problems and the content of the film was informed by the ideas of this group. The staff training stresses the need to involve service users in all aspects of their assessment, care, treatment and support and the section on culturally sensitive practice highlights the need to provide information should in a way that makes it most likely to be understood

In conclusion, the Sanctuary programme is an excellent model of good practice, which has embraced the principles of the Act and improved outcomes for asylum seekers and refugees in Glasgow.