Case Study
Where community development and social marketing meet – Race Equality
The Glasgow model
About the initiative
The Mosaics of Meaning programme is one of many initiatives of the Greater Glasgow and Clyde Anti-Stigma Partnership to address stigma. The programme links 15 national, local and community organisations in supporting black and minority ethnic (BME) communities to address issues of stigma and discrimination associated with mental health problems.
This is a complex and underdeveloped area and this programme provides a basis for long-term work. The programme has involved research exploring beliefs about mental health and mental health problems; patterns of stigma within communities; and identifying community led solutions. An intervention model has been developed to support BME communities with 9 suggested areas of activity.
Involving ‘see me’
‘see me’ contributed in 2 inter-linked ways:
- Supporting the planning of the intervention and research design and ensuring we could disseminate the learning from this programme on a national basis.
- Practical support in developing research capacity amongst community groups, commissioning The Gate to develop and implement a training workshop for community representatives and to develop focus group questions and written guidance for facilitators.
The challenge
- Building trust amongst local community groups to support this very sensitive piece of research and gain access to the communities to explore people’s attitudes.
- This was the first time that either ‘see me’ or NHS GGC had worked with so many diverse partners to undertake community based research. It was important to try to reflect on the process of setting up and running the focus groups to be able to inform similar processes in the future.
- In order to make stigma a mainstream issue, it was important to engage with and involve partners outwith the mental health field.
- A key challenge was synthesising the different sources of evidence in a complex area in order to develop an intervention model.
- A further challenge is in ensuring that evidence is developed into practice. Fortunately, each of the community projects has remained with the programme in order to do this.
Resources
- Anti-Stigma Partnership resourced the literature review and a researcher and invested significant staff time from health improvement, mental health and diversity teams.
- ‘see me’ invested finance and staff time.
- Additional investment from other national organisations such as Mental Health Foundation and National Resource Centre for Ethnic Minority Health.
- Considerable staff time from all involved organisations, particularly the community organisations and practitioners.
What we did
The first step was developing the evidence base for action through research, comprising 2 aspects: a substantial international literature review of existing knowledge of stigma of mental ill-health among BME communities; and action research within community settings in Glasgow, led by community organisations. Six community projects that work with BME communities across Glasgow were identified: All agreed to participate in training, and recruit and facilitate focus groups to explore mental health and mental health problems, stigma, solutions, and evaluate ‘see me’ materials.
Following the training workshop, focus group questions and written guidance for facilitators were developed. An independent researcher collated and analysed all the material.
The final research report provides an overview of the key themes and solutions, highlighting differences and similarities amongst the different BME groups and across different age groups. A summary of the research report was provided to each organisation to disseminate to the participants.
The Anti-Stigma Partnership has recognised the need for retaining central orchestration of activity to continue to evaluate the mental health impact carefully, keep an eye on costs, maintain a timeline of activity to ensure synergy and avoid clashing.
What we achieved
A model was developed that enabled the improvement of understanding of mental health stigma in partnership with various BME communities. It is evidence of our achievement that each organisation that undertook the research remains involved in leading the implementation of current intervention initiatives. A full research report has been produced and made widely available. This has already gained a lot of national and international interest. Peer reviewed papers are in preparation.
What we learned
- Any initiative to tackle stigma around mental health problems with BME communities must be developed in the context of the current concepts and beliefs in these communities. Solutions must be constructed in partnership with communities.
- There is a plurality of beliefs across and within communities – matched by a desire to access different types of support, including faith-based, community-based, traditional medicine and mainstream services.
- Non-mental health organisations must be involved in the planning and implementation of anti-stigma work if the activity is to be mainstreamed
- Constructivist approaches to research and planning are valuable in areas where concepts are contested, and where we risk imposing a dominant cultural perspective
- The process applied here may be a useful way of addressing stigma with other minority groups or in situations where the evidence base remains under-developed.
‘see me’ is owned and run by an alliance of five mental health organisations: Highland Users Group; National Schizophrenia Fellowship Scotland; Penumbra; Royal College of Psychiatrists Scottish Division; and Scottish Association for Mental Health. ‘see me’ is fully funded by the Scottish Government.
Published by ‘see me’
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