Mental health inequalities are varied and affect the access, treatment and outcomes that people can expect to receive. The Advancing Mental Health Equality (AMHE) resource was developed to support commissioners and service providers to tackle inequalities in mental health care in an achievable and measurable way and to ensure that support, care and treatment is:

• high quality
• appropriate to meet needs
• accessible and serves people, regardless of any structural, societal or cultural barriers, or protected characteristics
• supportive, compassionate and fair
• effective, leading to the best possible outcomes.

The ‘Healthy minds’ mayoral action within the London Health Inequalities Strategy highlights that Londoners’ mental health and physical health are equally valued and supported and the mayor will argue for Londoners to have fair and improved access to mental health services (including psychological therapies), and demand better access to mental health support for those who need it. Addressing mental health inequalities across London calls for partnership working across various partners in the capital.

Mental Health Inequalities and the Impact of COVID-19

Though it is still too soon to fully understand the impact of the pandemic on mental health needs and demand, there have been some initial studies highlighting the emerging impact of the pandemic on mental health. The COVID-19 Social Study run by University College London, and published during wave 1, found that people from ethnic minority backgrounds have had higher levels of depression and anxiety across the pandemic, and lower levels of happiness and life satisfaction. Further, whilst 17% of people from white backgrounds have reported being often lonely during lockdown, this figure has been 23% amongst those from ethnic minority backgrounds.

A report by the Centre for Mental Health (Covid-19: understanding inequalities in mental health during the pandemic) showed that some groups and people with particular characteristics were at greater risk of experiencing worsening mental health as a result of the pandemic. These groups include:

• People with a pre-existing mental health condition, whose access to services has been disrupted as a result of the pandemic
• People who live with both mental health problems and long-term physical conditions that put them at greater risk of the virus
• Older adults who are both susceptible to the virus themselves and much more likely than others to lose partners and peers
• Women and children exposed to trauma and violence at home during lockdown
• People from the ethnic groups where the prevalence of COVID-19 has been highest and outcomes have been the worst, notably people from Black British, Black African, Bangladeshi and Pakistani backgrounds.

Further information is in the COVID 19 section of the resources.

Addressing Health Inequalities in IAPT Services

Some IAPT services have collaborated with various partners to address inequalities in population groups across the four dimensions above. A few examples are:

• City & Hackney Psychological Therapies and Wellbeing Alliance with Orthodox Jewish, Turkish Kurdish, African and Caribbean communities – (see case study)
• Camden, Islington and Hammersmith & Fulham services work with Age UK to increase access for the older age groups.
• Several others, partner with employment support organisations such as Jobcentre Plus, Citizens Advice and borough local authorities to address unemployment, money and housing issues.
• The London Mayor’s office page also has information on providing financial support during COVID-19 pandemic
• Healthy London Partnership’s Coping Well During Covid Webinar series, on Managing Financial Anxiety

More details are available in the ‘Working with specific population groups’ and ‘Working with partners’ sections.