Delivering Race Equality in Mental Health Care (DRE) is an action plan for achieving equality and tackling discrimination in mental health services in England

for all people of Black and minority ethnic (BME) status, including those of Irish or Mediterranean origin and east European migrants.

It draws on three key recent publications in particular:

• Inside Outside: Improving Mental Health Services for Black and Minority Ethnic Communities in England;
• Delivering Race Equality: A Framework for Action; and
• the independent inquiry into the death of David Bennett (although DRE itself is not a direct response to the inquiry's report).

David Bennett was a 38-year-old African-Caribbean patient who died on 30 October 1998in a medium secure psychiatric unit after being restrained by staff. As well as DRE, this document contains the Government's formal response to all the recommendations made in the report of the inquiry into David Bennett's death. The responses are overwhelmingly positive and, taken together with the action plan in DRE, comprise a coherent programme of work for achieving equality of access, experience and outcomes for BME mental health service users.

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The programme is based on three 'building blocks', first proposed in the consultation version of DRE:

• more appropriate and responsive services - achieved through action to develop organisations and the workforce, to improve clinical services and to improve services for specific groups, such as older people, asylum seekers and refugees, and children;
• community engagement - delivered through healthier communities and by action to engage communities in planning services, supported by 500 new Community Development Workers; and
• better information - from improved monitoring of ethnicity, better dissemination of information and good practice, and improved knowledge about effective services. This will include a new regular census of mental health patients.

DRE itself is just one component of a wider programme of action bringing about equality in health and social care. For example, National Standards, Local Action is the Department's current care standards and planning framework. Among the core standards that it sets out are:

• that healthcare organisations must challenge discrimination, promote equality and respect human rights (C7(e)); and
• that organisations must enable all members of the population to access services equally (C18).

DRE will support the implementation of Sir Nigel Crisp's 10-point race equality action plan in the NHS, and will also help NHS trusts to fulfil their obligations under the Race Relations (Amendment) Act 2000.

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The vision for DRE is that by 2010 there will be a service characterised by:

• less fear of mental health services among BME communities and service users;
• increased satisfaction with services;
  
• a reduction in the rate of admission of people from BME communities to psychiatric inpatient units;

Currently:

• Black people constitute 30% of the patient group in medium secure services and 16% of high secure services.
• Black people are over six times more likely than the majority population to be detained under the Mental Health Act.
• Women born in India and East Africa have a 40% higher suicide rate than those born in England and Wales.

The Department of Health has been researching these issues to provide the framework and will work with the health service, voluntary groups and local communities to consult properly on how best to improve the provision of services to Black and minority ethnic communities; ensure that those communities are informed about and consulted on services and that they are willing and able to work in partnership with services.

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