Birmingham and Solihull Mental Health NHS Foundation Trust serves one of the most ethnically and culturally diverse areas in the UK. The Trust perinatal services found the number of referrals, from some parts of the city, were lower than predicted from population data. In particular, the proportion of women of Asian descent seen in community clinics was lower than expected
Dr Darren Randall and Dr Giles Berrisford, Birmingham and Solihull Mental Health Foundation Trust, led a multi-disciplinary group of clinicians, psychologists, obstetricians, midwives, health visitors, a statistician and primary care professionals.
The team developed a new approach to identifying the need for perinatal mental health services and used the information to intervene in particular geographical areas. They increased awareness of perinatal mental wellbeing by using local media and meeting local community groups and religious leaders. They provided oral and written information, in different languages, on perinatal mental health services and other help.
Analysis was carried out to compare the distribution and ethnicity of women seen with the estimated prevalence in the population. In the absence of detailed birth data, the team used market segmentation data to estimate birth numbers per year in 132 areas across Birmingham. They compared data on estimated number of births with actual referral rates, both Asian and Black women were under represented, supporting the perception of unmet need. The model showed 35% of community referrals should be for Asian women, while they contributed only 21%. Black females were also under represented, making up 7.7% of referrals against a predicted 10.5%. A heat map showing significant under referrals and high BME birth rates was developed, to highlight target areas for intervention.
Referrals from BME patients have increased significantly.
Understand the baseline data to identify the gaps
Increased involvement of the wider community and the local leaders contributed to the project’s success.
When working with diverse communities use informal communication to understand different cultural practices, perceptions and attitudes towards mental health.
A novel approach using Experian Mosaic data was used in this project to estimate the perinatal mental health needs of the local population. Qualitative methodologies such as group sessions and one to one interviews were used to understand local practices.