Collaboration and communities: advancing mental health equality in vulnerable rural groups

Dr Fatin Hussain (Consultant in Community General Adult Psychiatry and AMHE Project Lead, Somerset NHS Foundation Trust) and Lee Reed (Somerset Clinical Commissioning Group's Equality, Diversity, Inclusion and Pandemic PPE Lead Officer) are members of their local Advancing Mental Health Equality (AMHE) project.  

We asked them about their experience of taking part in the AMHE Collaborative so far, and how it has given them the time, support and framework to tackle mental health inequalities in the Gypsy, Roma and Traveller (GRT) communities.  

What was your journey to sign up for the AMHE collaborative?

“One of the many impacts of the COVID-19 pandemic was that it highlighted health inequalities. When we began work to roll out the COVID-19 vaccination programme, there was an unexpected, but welcome, impact: people from vulnerable communities began approaching us about mental health support.  

"We reached out to people in the Gypsy, Roma and Traveller communities to try and ensure that they were receiving the COVID-19 vaccination, they did have a good uptake of the vaccination, however by reaching out to these communities we were able to spend time with them and build a rapport and trust.

"This led to the community leaders approaching us and asking for mental health support. We started by organising a series of coffee days where we went to the different sites, and sat and chatted very informally about mental health. These visits became known as Wellbeing Afternoons.  

"This coincided with our Trust’s inclusion group and having discussions with Somerset County Council about how to make mental health improvements and reduce mental health inequality in the county. We wanted to implement the AMHE resource. When looking into how we would do this, we came across the AMHE Collaborative. We signed up.”

How has the AMHE Collaborative helped advance mental health equality?  

“Our first step, once we were part of the AMHE Collaborative, was to identify which groups in our local population are at risk of experiencing inequalities in relation to mental health provision. We decided to continue and build on the work we had begun with GRT communities.

"We now had time, support from the National Collaborating Centre for Mental Health’s AMHE team and a quality improvement (QI) framework to help build on the trust and rapport we had developed during the COVID-19 vaccination programme. Often, as health professionals, we expect everyone to present at the health centre and access services. With the time to reflect on this and with the AMHE QI process in mind, we started thinking about how mental health services can be specific and personalised for specific groups.

"One of the approaches we decided to try with the GRT communities was to build on our Wellbeing Afternoons and start to make more visits to the different GRT sites in Somerset. What this has allowed us to do as health workers, is connect with the GRT communities by introducing co-production into our work and hear from individuals as to how they wish to access mental health support.  

"By regularly visiting the different sites across Somerset and starting discussions about mental health, we have started to hear about mental health from different groups within the GRT communities. An example of this was when we were speaking to someone who had got in touch with the community health team via phone  about a separate issue and then opened up about mental health challenges they had faced throughout their life.  

"By interacting with communities and building trust, we start to think about how a bespoke service could be created to help create a bridge for community members to use more of our services. An example of this is when we decided to take a more personalised approach to providing care to GRT communities. We made members of the AMHE project team case workers for patients from this population.

"So instead of being sign-posted to care by one health worker who visited the different GRT sites, then treated by another health worker – such as a care coordinator / key worker – who wasn’t known to the GRT communities, the patient’s care is managed by a familiar face. A familiar face who is someone who has been to the different sites and managed to build trust and rapport with prospective service users.”

What has the impact of the AMHE Collaborative been?  

“Traditionally in Somerset, we have often found that there are groups of individuals from the GRT communities who don’t always receive the mental health support that meets their needs. Often, we were only able to provide support to this group of service users once they reached crisis point.

"The support and QI expertise provided by the AMHE Collaborative has allowed us to begin to work with the GRT communities and take steps towards reducing mental health inequality in Somerset.”

Find out more about the AMHE Collaborative and how to join Wave 2 of the collaborative (starting in the Autumn 2022).  

We are also hosting a Q&A session on Wave 2 of the Collaborative on 27 June from 5:00pm to 5:45pm. Please register for this online session here.