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

Background and Aims: Ethnically diverse communities experience inequity across mainstream mental health services in the UK, which impacts their accessibility. Multiple explanations have been suggested as underpinning these inequities, including: stigma, lack of cultural humility, inaccessible service structures, and widespread racism. Research has largely focused on the experiences of ethnically diverse service users, reinforcing that the responsibility for accessing services lies with individuals. In order to shift this narrative, the current study aimed to explore understandings of mental health service accessibility for ethnically diverse communities from the perspective of third sector service providers. This enabled consideration of system-level barriers impacting service accessibility. Method: Semi-structured interviews were facilitated with fifteen ethnically diverse participants, representing fourteen different third sector organisations. Interviews were analysed using reflexive thematic analysis. Analysis: Five themes were developed from the analysis relating to participants’ understanding of service accessibility. These were: ‘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. Broadly, uniting perspectives was the necessity for mainstream mental health 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 reflected how enabling belonging, through developing collaborative, shared understandings of mental health difficulties, and forming flexible services to meet the individualised needs of ethnically diverse individuals, aids accessibility. Participants highlighted the value of authentic connection, supported by a willingness from clinicians to self-reflect and challenge their internal biases and assumptions. Mainstream services were encouraged to dismantle the institutionally racist foundations on which they are formed. This requires integration of services to challenge established power structures and meaningfully promote those with diverse cultural experiences to service leadership positions to build holistic, accessible services.