Embracing inclusivity in mental health

In the bustling world of healthcare management, where every decision counts, Erk, a Turkish Cypriot with a passion for equality, diversity, and inclusion, shares his transformative journey. An expert by experience in the NHS Mental Health team, Erk talks about his mission to foster vulnerability, equity, and dignity in care

CREDIT: This is an edited version of an article that originally appeared on NHS England

“When I first arrived in the UK, 10 years ago, I had no idea what ‘mental health’ meant. As an 18-year old stepping foot in a foreign country, far away from home, I suddenly had to become independent, resilient, and resourceful. Easier said than done.

You can’t leave your identity at the door; it’s interlaced with who you are; a part of you that you embrace but also want to leave behind.

When I stepped off that plane, I was carrying with me my past trauma. I came from a culture that denied the existence of mental health and afforded much more visibility to physical health and illnesses, with an education and health system that stigmatised mental health. As a result, I spent many years of my teenage life without professional, familial, or societal support, at a time when I was trying to find my place in the world and address who I am. I was trying to navigate heteronormative systems and societies in a culture which was also rife with racial conflict and intergenerational racial trauma.

So, when I first got that phone call to assess my eligibility for NHS Talking Therapies in England, and the person asked me “What seems to be the issue?”, my response was: “How much time have you got?”. Sadly, the response is never: “As long as you need”.

Throughout my patient journey, I desperately needed therapists who understood where I was coming from culturally, so I didn’t spend our limited therapy time giving them a crash course on how my ethnicity shapes my needs. When I was too unwell to leave my house, I needed systems which understood why existing ways of therapy did not work for me. I still wonder why I was never offered online therapy, which later became possible during the pandemic. I desperately needed to see therapists who shared parts of my identity, such as people who were young, queer, from an ethnic minority background, or who understood what it feels like to be a man going through mental health challenges – and the stigma that comes with it.

It has been a rarity to use a mental health service which truly saw me as an equal partner in my treatment. This work isn’t just about co-production, it’s also about co-learning: my lived experience makes me an expert by experience. I have things to teach you as my clinical team, just as you have things to teach me as a patient in need.

The Patient and Carer Race Equality Framework (PCREF) brings it all together. We can capitalise on the implementation of the PCREF by shaping it with patients, carers, and local communities. We need to empower communities to educate staff on who they are, what their culture is and how that shapes what they need from you. We need to make decisions with communities, not for them and influence a culture shift where expertise by lived experience is as highly regarded as expertise by profession.”

Erk’s story is a testament to the transformative power of inclusivity in mental health. The journey is ongoing, with the PCREF providing a roadmap for a more empathetic and culturally attuned healthcare system. Practise managers can help by actively being the voice that questions diversity gaps in recruitment, prioritising the well-being of their team, and creating avenues for growth. Facilitate a culture where staff, from all levels, engage in a reciprocal learning process, and break down hierarchical barriers.