Mental health in an unequal world
Mental Health Day 2021

There’s enormous diversity in the ways that counselling is delivered in the third sector. One-third of BACP members carry out all or part of their work in an array of community and voluntary sector organisations. Some of these organisations provide therapy as part of a wider offer of support. Others are dedicated counselling services. Some services are part of well-known national organisations, while many others are locally-founded collectives or groups that have come together on a mission to meet a specific local need.

Organisations that are well connected to particular communities are making counselling more accessible and acceptable to people who might otherwise be reluctant to seek help for their mental health or emotional wellbeing. This community connection can be geographical, religious or based on identities such as race and ethnicity, sexuality, disability or gender.

In recent months, as part of our work on equality, diversity and inclusion, I’ve had the opportunity to speak to managers and counsellors in third sector counselling organisations about the work that they’re doing in their communities. A common thread in these conversations has been the ability of services to adapt to change and respond to emerging need across the course of the COVID-19 pandemic. Lessons learned and new ways of working are being taken forward as restrictions have eased.

Alongside the lessons about the practicalities and logistics of delivering online and telephone therapy, services have taken note of how these enforced changes to delivery models have shifted the demographic of their clients.

For instance, BACP-accredited Gloucestershire Counselling Service (GCS) noted an increase in the numbers of people from non-white and minority communities making contact and seeking support when the service switched to telephone and online delivery. For Emma Griffiths, GCS Chief Executive, this was both a positive development and a wake-up call for the service.

Emma says, “For many years, we’ve proudly stated that GCS is here for all members of our community, but it’s become increasingly clear that we need to be doing more to make sure that our offer of support reaches people from diverse backgrounds.”

GCS has now established links with the imam from a local mosque, exploring ways to strengthen collaboration. The imam has completed GCS counselling skills training and has provided the service with valuable feedback about its delivery and how it can be more inclusive.

Evidence suggests that while people from all communities have benefited from the increased availability of evidence-based therapies in recent years, members of minority communities with mental health problems are currently less likely to access therapy, less likely to have good outcomes and more likely to report negative experiences in therapy, compared to white majority service users.¹ Further policy and research in the past year has shown that people from marginalised and racialised communities are at increased risk of death from COVID-19 and that longstanding and enduring disparities in health remain.²

From other third sector counselling organisations, we’ve heard of the need to deliver culturally-informed services, the importance (for some but not all clients) of shared characteristics between client and therapist, and of the shortage of funding for community organisations to deliver innovative initiatives.

Emma is keen to use her experience as an organisation leader to support improved access to counselling.

Emma says, “We’ve seen in our own organisation, the value of reaching out and making connections with community leaders who have the trust of their communities. The more we can do to improve diversity of therapists and clients, the stronger we will be as a profession and a society.”

1 Centre for Mental Health (2020) Mental health inequalities factsheet
2 Public Health England (2020) Disparities in the risk and outcomes of Covid-19