Supporting the NHS Long Term Plan: A Service Responds to Addressing Health Inequalities

Cognitive behavioural therapists take the lead in improving practice to support the LGBT+ population

Karol gives an overview:

At the end of March 2019 Time To Talk (TTT)/Sussex Community NHS Foundation Trust (SCFT) will be celebrating 10 years of providing therapeutic interventions (Counselling, Cognitive Behavioural Therapy and EMDR) for adults in West Sussex. We are humbled by the work we do with our clients, are proud of how far we have come, and of our achievements. TTT service is ever evolving, and looking at new and innovative ways of delivering therapy. We want to be flexible in our approach and address as many needs as our diverse population requires.

Towards the end of 2017 myself and Jess Dare took on the LGBT+ champion roles, supported by our Chief Psychologist, Jackie Allt. Following our attendance at MindOut’s training on “Responding to the needs of LGBTQ+ mental health – reviewing good practice”, we initiated a Quality Improvement (QI) project called “Getting Better at Engaging with the LGBT/ Non-Heterosexual Community”.

We wanted to look at how TTT meets the needs of its LGBT+ population.  Unfortunately, in line with research, our data suggested higher levels of distress for our LGBT+ cohort at the point of engagement, lower recovery rates, and higher drop-out rates.

The project, which was outlined and supported by the SCFT’s LGBT+ Network aimed at addressing the inequality, increasing access to TTT and Time to Talk Health (IAPT –Long term Condition service) and to have all our staff trained and able to deliver LGBT+ affirmative therapy.

Karol Kuczera, CBT therapist and LGBT+ champion

Jess described her experience:

Since the start of the project, I am proud to report that, with the help and support of the Trust, we have created and conducted a staff confidence and attitudes survey, set up a staff LGBT support network, moved 146 places up the Stonewall index of LGBT inclusive employers, sourced professional training to improve staff confidence with language and challenging discrimination of LGBT people and culture.  We also identified and highlighted that no positive practice guide exists within the IAPT manual for helping LGBT people (as it does for other minority  and underrepresented groups). 

We have presented to the KSS NHS England clinical network to raise the profile and support of the project and we are excited about already meeting some of the objectives already such as changing the way we collect our data not just in IAPT but now across the Trust.

One of the changes we identified early on was that by wearing rainbow lanyards, we could start conversations with people, challenge discrimination and help LGBT people to feel safe accessing our service.  Such a simple but visible change shows a massive contrast between today’s conversations and those of 50 years ago where patients were criminalised and being branded mentally ill for being homosexual

Jess Dare, CBT therapist and LGBT+ champion

Karol Kuczera and Jess Dare are both CBT Practitioners with Time to Talk. Karol is soon to start as a Darzi Fellow working on the Inclusion agenda for Health Education England (Kent, Surrey, Sussex). Jess is currently combining her clinical work (Time to Talk/Sussex Community NHS Foundation Trust) with her role as a research therapist with Sussex Partnership NHS Foundation Trust in collaboration with Brighton and Sussex Medical School.