Published On: 27 January 2023Tags: ,

We have taken time to reflect on the implications of the announcement of a Major Conditions Strategy, and have concluded that this carries the potential to diminish the broad and complex challenges each health condition brings and to deepen inequalities for those most vulnerable. As an organisation, we have worked alongside others, to respond to previous consultations on separate conditions, for example the Mental Health and Wellbeing Strategy as well as the Dementia strategy. It is particularly disappointing that the work done is not going to be built on.

Our input into both consultations focused on the impact the strategy would have on Black, Asian and minority ethnic communities, with the recognition that some of these communities have greater risk of developing dementia compared to the wider population, and experience more difficulties in getting a diagnosis and accessing appropriate care and support. Likewise, Racial disparities in mental health and structural barriers that impact on access to, and support of mental health services is well evidenced. With this in mind, we advocated for the issue of racial inequality to be both acknowledged and clear actions identified to tackle the issues.

During the consultation for the dementia strategy, we suggested a key area of focus should be to address inequality experienced over the life-course which increases the risk of dementia, as well as impacting the experience of living with dementia. Recognising that current care and support is often not personalised, we advocated for a set of priorities which would help achieve personalisation, including a focus on coproduction with people with dementia and their carers to understand needs, issues, rights and risk, and how these are impacted by the experience of inequality. There should be a focus on improving the understanding of dementia in communities where experience of the condition may be limited. This will require workforce development to have more understanding of diverse communities and services/support needed. Another priority being the need to develop a wider range of early interventions and post diagnosis resources, such as better information and advice, and tailored support options.

We have highlighted where racism has affected the implementation of the Mental Health Act and support Black, Asian and minority ethnic communities received from mental health services.  The Mental Health and Wellbeing Plan consultation last year represented a significant step forward in addressing inequalities within mental health services and we welcomed it.  As a collaborative group we felt that a focus on the prevention of mental illness is needed, but this can only happen by addressing the structural barriers to engagement of these communities by the statutory services provided.

We emphasise the need to address the wider determinants of health and their impact on mental health. As a result working to address housing needs, employment and employment opportunities, the local environment, among other aspects of daily life, can help address mental health inequalities.  We recognise that the voluntary sector undertakes vital work in supporting Black, Asian and minority ethnic people with mental health conditions. We feel the voluntary sector should be effectively engaged by the integrated care systems and actively participate to provide appropriate support to these communities. Key services should be utilised by funding the voluntary sector as delivery partners, valuing their expertise, cultural knowledge and connections with these communities. We are disappointed that the proposed shift to focus on major conditions strategy does not mention wellbeing despite the growing decline in wellbeing, particularly for those with severe mental illness. Yet promoting positive wellbeing impacts on our mental health. Evidence of inequality in access for Black, Asian and minority ethnic communities to treatment that promote positive wellbeing means re-evaluation of such services is needed.

We will work to ensure that the insights and actions we have previously shared are addressed by the proposed Major Conditions Strategy, but we are also clear that this change in Government approach represents a missed opportunity to improve the experiences and outcomes for Black, Asian and minority ethnic communities.