Title: AddRessing the ImpAct of coviD-19 paNdEmic on the access to and experience of mental health care of people from Black, Asian and Minority Ethnic groups (ARIADNE)
Funder: Department of Health and Social Care

Abstract: Background People from Black, Asian and Minority Ethnic (BAME) groups have worse experiences of mental health care than White British groups. The COVID-19 pandemic has worsened these inequalities through reduced availability of routine community care and increased psychological distress, particularly in BAME groups; studies have also shown that the economic downturn and COVID-related mortality have disproportionally impacted BAME groups. Hence there is a greater need than ever to develop and implement policies and actions to reduce these inequalities. A participatory process provides opportunities for genuine involvement of BAME service users and other relevant stakeholders in developing these actions, maximising the likelihood of achieving real and actionable change. Aims Developing feasible and implementable solutions, i.e. actions and interventions for improving access and experience of mental health care for BAME groups, through participatory research. Methods and timelines for delivery We will use an experience-based co-design approach. The research will be carried out in four sites (Coventry and Warwickshire, East London, Sheffield, Greater Manchester), including geographical areas with different levels of social deprivation, ethnic composition and urbanicity/rurality. There will be 3 work packages (WPs): WP1 (Months, M1-6) will comprise interviews with service users, carers, NHS and community & voluntary sector staff, and other stakeholders (social care and police). This will provide a broad range of views on the gaps and inequalities in current mental health care and how the pandemic has impacted them. WP2 (M3-6) will involve separate professionals and service users workshops to identify priority areas (touchpoints). WP3 (M7-12) will comprise a series of five workshops with smaller numbers of service users and professionals to translate identified priorities into service improvement actions which can be put in practice and monitored. The first three workshops will be run locally at all the four sites, whilst the last two workshops will be online and include representatives across the four sites to identify common and generalisable actions and interventions. Theory of change and implementation plans for the developed local and national actions and interventions will be formulated in collaboration with behavioural and organisational change experts in our team. Anticipated impact and dissemination The actions and interventions arising from this study are expected to be immediately usable at both local and national levels. A final dissemination event will include national policy makers as well as local community leaders. Policy guidance will be circulated to local and national policy makers and findings summarised in scientific publications and disseminated through social media and local broadcasters. Service user involvement will not only be at the heart of the participatory design process but also play a role in steering it. We will have a lived experience advisory group working across the four areas to co-develop interview guides and other resources, provide further advice on identified solutions and dissemination. Target national groups will include the Synergi Collaborative Centre, the NHS Race and Health Observatory, the National Institute for Health and Care Excellence and the Government Commission on Race Equality.

Lay abstract: What are the aims of this study? We will work with service users, carers and professionals to create solutions for improving access to and experience of mental health care for Black, Asian and Minority ethnic (BAME) groups. What led to the study? Historically, people from BAME groups have had worse experiences of mental health care than White British people. This needs to change. There have been efforts to do so in recent years, but these inequalities persist and the recent COVID-19 pandemic may make matters even worse. We need urgent practical solutions. Some of these solutions will be specific to local areas, other may apply to different areas and have a role in national mental health care action planning. What will we do to study this? We are going to work in four areas of England, each covered by services from one mental health NHS Trust: Coventry and Warwickshire, East London, Sheffield and Greater Manchester. These areas are selected because they provide contrasts in terms of location, level of poverty, and ethnicity. Our method is called experience-based co-design (EBCD). This is a structured way of collecting information by involving different stakeholders in the process, feeding back what we find at each stage to those taking part and, finally developing solutions to healthcare problems together. We plan: (a) interviews with various stakeholders including service users, carers, NHS clinicians, voluntary sector and social care workers, and police officers; (b) separate professionals and service users workshops to identify priority areas for change; and (c) workshops to translate identified priorities into solutions which can be put in practice and monitored. We will be working in each site separately, but will share findings so the four areas can learn from each other as well. How will service users and the public be involved? We will have a 12 person advisory group made up of service users and carers and part-time lived experience researchers at all sites to help to deliver this study. One of the applicants is a service user leader who will chair the advisory group and attend all management meetings. We plan wider public engagement locally and nationally to help disseminate the action plans. How will we share our findings? What we learn from this project will be publicised both locally in our four sites, and nationally across the country. We will use professional and service user networks, traditional models such as peer reviewed publications as well as twitter chats, pod casts, blogs and local broadcasters. The project seeks to produce actionable learning within 12 months, including a document with the solutions identified and policy recommendations. Five promotional events will be organised including members of the public and representatives of all stakeholders involved.

Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: MENTAL HEALTH