Knowledge is power: understandings of accessibility from mental health service providers in ethnically diverse communities

Background Ethnically diverse communities experience inequity across mainstream mental health services. Multiple explanations have been suggested as underpinning these, including: stigma, lack of cultural humility, inaccessible structures and widespread racism. The current study aimed to explore understandings of mental health service accessibility from the perspective of third sector service providers in the UK. Third sector organisations are those that are neither part of the public nor private sector, key examples include charities and social enterprises. In the UK, this sector provides the majority of community level mental health services. This enabled consideration of system-level barriers impacting service accessibility.

Method Semi-structured interviews were facilitated with 15 ethnically diverse participants, employed by 14 different third sector organisations. Interviews were analysed using reflexive thematic analysis.

Results Five themes were developed from the analysis: “knowledge is power”, “navigating the pathway to inclusivity”, “from cultural competence to cultural humility”, “deepening connection” and “building on a weak foundation”.

Discussion This study highlights the multifaceted understandings of service accessibility. Uniting perspectives was the necessity for services to proactively take responsibility for disseminating knowledge regarding service access to ethnically diverse communities, recognising that the availability of services is not equally learned. Participants highlighted the value of authentic connection, supported by a willingness from clinicians to self-reflect and challenge internal biases and assumptions. Mainstream services were encouraged to dismantle the institutionally racist foundations, challenge established power structures and meaningfully promote those with diverse cultural experiences to service leadership positions.