Why equality, diversity and inclusion are essential for the future of the mental health workforce

The NHS is experiencing a workforce crisis^[1] and mental health services are under particular pressure due to the devastating Covid-19 pandemic. 

If we’re going to tackle this crisis, then it’s essential that we encourage staff recruitment and retention by promoting equal opportunities for NHS employees including those from minority ethnic backgrounds, and those with other protected characteristics.

The NHS is one of the largest employers in the world with over 1.3 million staff. It is also the largest employer of minority ethnic people in the country^[2] with nearly 20% of its employees coming from a Black, Asian and Minority Ethnic background^[3]. Yet we know that these staff members are underrepresented at a senior staff level and 88% of NHS Trust board members are white compared to only 7% minority ethnic (and 5% unknown)^[4].

The work of the diversity project at the National Workforce Skills Development Unit (NWSDU) aims to positively influence the experiences and professional outcomes of NHS mental health staff from Black, Asian and minority ethnic backgrounds, disabled groups and people with other protected characteristics.

Our recent research has shown us that, across the country, mental health NHS nurses from minority ethnic groups who have many years of experience are still on the lower payment bands - this is also true of highly qualified staff with postgraduate qualifications and Master’s degrees^[5]. Many also reported they were not presented with equal opportunities to progress and felt that race discrimination inhibited their progression. Unsurprisingly, staff often reported feeling marginalised with these barriers to progress^[6].

As a young black woman with an ‘unusual’ first name and a Shona surname, I have first-hand experience of racial and gender discrimination which can come from all areas of society, including and unfortunately clinical workplaces. I felt lucky that, at the start of my career, I found a mentor with the same ethnic background as me who was in a senior leadership position within my Trust. Like me, he was a young and ambitious black nurse that could relate to my concerns about being part of a workforce that becomes less diverse as you look further up the hierarchy. This made a major difference. My mentor was able to relate to my experiences and prepared me for career hurdles and challenges.  

This was a happy coincidence for me but, for most people seeing is believing, and this is difficult in the absence of a representative workforce and with few leaders from diverse backgrounds. For us to see improvement more widely, NHS Trusts need to promote equality networks and effectively and proactively engage with them to provide the opportunity for people to connect with mentors and role models.

Frequent monitoring of equality, diversity and inclusion at all staff levels, particularly senior staff levels, is also crucial to ensure issues are identified and organisations take accountability for promoting equal access to opportunity. 

Not only will commitment to equality, diversity and inclusion help us solve our staff number crisis, diverse staff groups represent our wider population and can bring about a richness of ideas, innovation and the capacity and cultural awareness to consider blind spots. A diverse workforce, with equal voices, will be far better equipped to address key public health priorities and meet the increasing service demand. 

We have got a long way to go to put an end to the systemic discrimination and, while there has been some progress in recent years (we are starting to see more people from minority ethnic backgrounds in senior and very senior positions within the NHS), we still need to do more to achieve equality and equity for people from all backgrounds working in the NHS.

Whilst the complete impact of Covid-19 is not yet clear, we do know our attitudes towards diversity and inclusion require a shift to support the workforce and enable the NHS to be in the best possible position to recover following the pandemic. Improving equality, diversity and inclusion can be part of the recovery and, while the workforce crisis cannot be solved by improving workforce diversity and inclusion alone, it can be part of the answer.

For more information about the project please contact Gracious Musariri at This email address is being protected from spambots. You need JavaScript enabled to view it.

Gracious Musariri

Project Manager, National Workforce Skills Development Unit (NWSDU)

Tavistock and Portman NHS Foundation Trust

^[1]  https://www.kingsfund.org.uk/projects/positions/nhs-workforce

^[2]  NHS Long Term Plan

^[3]  NHS Leadership Academy, 2021

^[4]  NHS Model Employer, 2019

^[5]  https://www.england.nhs.uk/wp-content/uploads/2020/01/wres-2019-data-report.pdf

^[6]  https://www.nice.org.uk/guidance/ng94/evidence/27.critical-care-outreach-teams-pdf-172397464640