Advancing mental health equalities

Advancing mental health equalities strategy

With the introduction of our first Advancing mental health equalities strategy, we call on all mental health services to take concrete steps to fight stigma and inequalities across the sector.

In line with the governance structure established by our Mental Health Programme Board, the strategy will be overseen by the Advancing Mental Health Equalities Taskforce, chaired by NHS England and NHS Improvement’s Mental Health Equalities Advisor, Dr Jacqui Dyer.

Formed in February 2020, the taskforce meets on a quarterly basis, with membership from an alliance of leaders and experts by experience from the mental health sector, who have identified a number of short and longer term actions to support advancements in access, experience and outcomes for communities experiencing inequalities in mental health services. This includes communities with protected characteristics and other health inclusion groups.

The strategy summarises the core actions that we all need to take to bridge the gaps for communities faring worse than others in mental health services, highlighting three key workstreams:

  • supporting local systems to advance equalities
  • improving the quality and use of data
  • workforce.

The Advancing mental health equalities strategy complements the eight urgent actions that health systems must take to advance equalities in the COVID-19 emergency response and the Mental health implementation plan 2019/20-2023/24.

We will continue to work closely with patients, carers, health system leaders and other key stakeholders to ensure we collectively deliver the real and sustainable change our patients and staff deserve.

Patient and carers race equalities framework

The Patient and carers race equalities framework (PCREF) is an important part of the Advancing mental health equalities strategy, as it will be used to support NHS trusts to improve ethnic minority community experiences of care in mental health services.

The disproportionate impact of COVID-19 on ethnic minority communities and global movements to address racism have brought longstanding inequalities to the surface.

The PCREF will be an organisational competency framework to help services provide culturally appropriate care. It will be a practical tool to help mental health trusts work with ethnic minority communities and understand what steps the trusts can take to achieve practical improvements.

The PCREF was one of the key recommendations of the independent review of the Mental Health Act agreed by the government. The development of the PCREF is being overseen by the PCREF Steering Group chaired by Dr Jacqui Dyer, Mental Health Equalities Adviser to NHS England and NHS Improvement. The steering group was established in May 2020 and reports to the taskforce, with members including patients, carers and staff from the four PCREF pilot sites:

  • South London and Maudsley NHS Foundation Trust
  • East London NHS Foundation Trust
  • Birmingham and Solihull Mental Health NHS Foundation Trust and,
  • Greater Manchester Mental Health NHS Foundation Trust

The PCREF pilot sites will be undertaking community engagement in 2021 on the PCREF competencies and the best way to measure them, to develop and test their local PCREF approach.

We will continue to engage more broadly on the PCREF, building on the series of engagement events held over winter/spring 2021.

What will the Patient and carers race equalities framework do?

The PCREF is expected to consist of three core components:

  • It will set out national expectations on all mental health trusts in fulfilling their statutory duties under core pieces of legislation, such as the Health and Social Care Act, and the Equalities Act.
  • It will include a competency framework, in line with the original vision, to support trusts to improve patient and carer experience for ethnic minorities. It is expected these competencies will be similar to those referenced in the independent review (for example, staff capability, data and monitoring). The framework will aim to capture what good looks like, and how to achieve improvements over time.
  • A patient and carers feedback mechanism, to embed patient and carer voice at the heart of the planning, implementation and learning cycle.

Each mental health trust will in time have its own PCREF. This will provide an opportunity for patients, carers, communities and NHS staff to voice their experiences and ideas on how to reduce inequalities for ethnic minority communities.

To get in touch with the PCREF pilot sites, or register your interest in upcoming engagement events, please contact out national Mental Health team


Jacqui DyerDr Jacqui Dyer, Mental Health Equalities Advisor

Making mental health care fairer for all

“Every single person working in mental health has a role to play in making our services and systems fairer and challenging racism in all its forms”.

Advancing mental health equalities: looking back, taking stock and looking forward

“We have been steadfast in our determination to improve access, experience and outcomes for all populations across the country.”

Erk Gunce, Expert by Experience in our Mental Health team

Developing the Patients and carers race equality framework

“I am hopeful that the Patients and Carers Race Equality Framework will improve ethnic minority patients’ experiences of seeking mental health support in England. ”


Zoe ReedZoë Reed, Director of Organisation and Community at South London and Maudsley NHS Foundation Trust

Piloting a route to race equity in mental health

“Real change to end systemic injustice requires action by the system itself – but in partnership with the people who have everyday experiences of the injustice.”