Providing advocacy services to ethnically minoritised communities - and what we have learnt
As we are celebrating our 25th anniversary this year, we’d like to mark Black History Month during October by charting the course of our specialist Advocacy provision to people from ethnically minoritised communities (see here for information about our terminology) over the last 20 years or so, and sharing our key learning around how to better meet the needs of our diverse communities.
The early days – identifying the need
At the beginning, after our Advocacy Centre opened in 1996, our services were generalist with the aim only to provide support to ‘vulnerable adults’. As time went on, and as we talked to service-users and stakeholders, we realised that, although some of our service-users were from ethnically minoritised communities, we were not necessarily meeting their needs. For example, most of our advocates were white and did not have any relevant lived experience, we were able only to offer advocacy in English, our knowledge of the comparatively small but diverse communities across Newcastle was only emerging and we did not have the necessary skills and experience to advocate for people with very particular needs e.g. refugees, asylum seekers and victims of torture.
We knew that we wanted to serve those communities better and, after extensive networking with other projects, we built on our understanding of the needs of local ethnically minoritised communities, the existing provision and the gaps. In 2003 we held a stakeholder workshop which considered possible models and there was overwhelming support for advocacy provided by our existing advocacy service working closely together with the interpreting service. Without exception all of the local stakeholders interviewed felt that the need for a service in Newcastle that provided BME (Black and Minority Ethnic) case advocacy in health and social care remained high:
There are no other resources so the needs are still there. Some communities are not very large but have very high needs and no community workers.
Developing our first specialist service
We set out to seek funding for a specialist service and were delighted to secure three years’ funding from the then Big Lottery Fund in 2005 to set up an innovative project – known then as the BME Advocacy Service. This was the first service of its kind in the UK. Its aim was to target advocacy resources to those communities in Newcastle most in need of support, with an emphasis on support around health and social care needs.
The project involved an Advisory Group of stakeholders which would be involved in developing the service model and shaping its future. The Group included a mix of community organisations and health and social care representatives.
At that time the ethnically minoritised population in Newcastle was approximately 6.9% [estimated in 2006] with about 1500 asylum seekers and approximately 4500 to 5000 refugees by 2007. An analysis at the start of the project identified particular need and/or lack of existing provision in the Chinese, Congolese, Iranian, and Bangladeshi communities. We therefore concentrated on building up our relationship with those communities, recruiting and training bilingual advocates with language skills and experience appropriate to those communities.
The model is good – advocates have training and supervision; there is confidentiality and trust and the service is respectable. Separation from the community is a strength.
We did extensive outreach work across those communities, making links with other agencies, producing publicity materials in multiple languages and basing drop-in sessions in community centres.
Over the initial three years of the service we successfully built up strong relationships with those and other communities, earning their trust, resulting in a growing reputation, positive recommendations by word of mouth and increasing numbers of referrals.
We used bilingual advocates and interpreting services as needed and service users were supported by advocates with a shared cultural background where this was appropriate. One of our areas of learning was that whilst it was often desirable for advocates to share a cultural back ground with service users, some service users preferred not to have an advocate from their community due to political, religious or ethnic origin differences.
Our service model recognised that some of these service-users required particularly high levels of support due to the extent of their needs, language issues, experiences of trauma and lack of knowledge about systems and their rights. Over 50% of clients were asylum seekers or refugees.
The Advisory Group collectively brought a vast range of knowledge and community intelligence to the service. Stakeholders saw this as a key strength of the project:
When a gap in services is identified they proactively follow up on issues and feed them into the advisory group. It is a good advisory group with lots of relevant people involved who use the information in their work.
Our BME Advocacy service both informed and benefitted from our other advocacy services, with advocates sharing skills, knowledge and training.
We exceeded all project targets and the outcomes from the service were compelling in proving the need for, and beneficial impact of, our advocacy support. Evidence demonstrated very positive outcomes for individual service-users, who had better access to health and social care services, improved self-confidence and increased knowledge of their rights. In addition the project was successful in influencing on a wider stage using case studies and strategic advocacy to affect policy change.
An independent evaluation covering the first three years of the project was undertaken and it was hugely positive:
The stakeholders were very consistent in believing the need for the project remains high, and there is not another organisation providing similar services. This is an effective and well run project highly valued by local stakeholders and clients of the service.
The evaluation report made strong recommendations with regard to continuation funding:
The responsibility for reducing inequalities in health and social care provision rests firmly with the commissioners and providers of those services, with a particular responsibility resting with Primary Care Trusts (PCTs). The ‘Delivering race equality in mental health strategy’ recommends that PCTs and service providers ensure adequate investment in and provision of culturally appropriate independent advocacy.
The next phase
Due to the success of the project, and the robust evidence in the evaluation report, the Primary Care Trust took responsibility for continuation funding in 2008. Today, we are contracted by NHS Newcastle Gateshead Clinical Commissioning Group to provide a service to people from ethnically minoritised communities across Newcastle and Gateshead as part of our Health and Care Advocacy Service.
As terminology has changed over the years, so have the communities across the North East.
Around 11% of Newcastle’s total population are Black, Asian or Minority Ethnic (BAME), which rises to 24% among school-age children. Newcastle Future Needs Assessment 2021
Similarly, ethnically minoritised communities have increased across the region.
18.1% define as Asian, Black, Chinese, Other White, Mixed Race, other Ethnic Groups (using Census categories) (Population UK).
We anticipate that the 2021 Census data will show these numbers to be even higher.
Over the years the skills and expertise developed within the BME service have been consistently rolled out to our other advocacy services and to the wider organisation. We continue to revise and improve our demographic recording, monitoring and reporting to ensure we have robust information about how our service users identify and to enable us to identify gaps in provision. We also review local statistics and work closely with other groups and forums such as the Haref Network to ensure we understand the needs of our local ethnically minoritised communities and adjust our services to meet them.
Further support available for ethnically minoritised communities
Due to our proven record, skills and experience in delivering advocacy to people from ethnically minoritised communities we have secured funding to provide other specialist services which meet the needs of those communities. For example, we have been funded since 2017 by Northumbria Police & Crime Commissioner to provide our Hate Crime Advocacy Service which includes support to people who have experienced hate crime as a result of their race and/or religion and have been funded since 2019 to provide a dedicated advocacy service to refugees and asylum seekers. Our other services all support people from ethnically minoritised communities, including those disproportionately affected by the Covid pandemic, such as our Families Through Crisis project.
Understanding the challenges faced by the people we support
Over the years, many factors have combined to present enormous challenges to our local ethnically minoritised communities. These include: austerity measures, Welfare Reform; the build-up and aftermath of Brexit; Covid Pandemic. Whilst these have presented challenges to people across the North-East, they cause disproportionate hardship to those from minoritised and marginalised communities, be they ethnically minoritised or those with multiple intersecting identities. Our advocacy services strive to stand shoulder to shoulder with those people, challenging discrimination and hate and supporting them to have their voices heard and their rights upheld.
Key learning
We’ve learnt a lot from delivering services to people from ethnically minoritised communities over the years. Some of the key things are:
- Terminology is constantly evolving. We’ve renamed our services over time, responding to consultations with service-users, local networks and broader societal changes. Terminology will never feel comfortable for everyone, but we feel it’s vital to be responsive to change, thoughtful about the decisions we make and clear about why we’ve made them and to take responsibility for them.
- Respect people’s right to self-identify. We always make sure we record our service-users’ self-definition, rather than making assumptions or imposing terminology on them. We also respect people’s decision not to identify if they prefer not to.
- Accurate and detailed recording, monitoring and reporting are essential to understanding who your service-users are, who you’re not reaching and gaps in your provision. We periodically review how we ask about, record and report on demographics.
- Good communication is essential to making services accessible. We always make every effort to ensure that we facilitate good methods of communication, whether that is through providing bi-lingual advocates, using interpreting services, making translated materials available or ensuring printed and online resources are available in multiple languages. Advocates are trained and skilled in ensuring clear communication, using communication aids where appropriate.
- Make time to learn about different ways of living, beliefs, customs and traditions in diverse communities
- Build strong connections and partnerships with communities and work together to understand their needs, concerns and priorities
- Understand, and don’t make assumptions about intersectionality, recognising that someone might have multiple identities across race, religion, gender, sexuality, class, disability, age etc.
- Keep your knowledge up-to-date to ensure you fight for and uphold people’s rights. We must constantly update our knowledge about, for example, immigration, mental health and mental capacity legislation.
- Don’t rest on your laurels! Continue to be responsive to shifting needs and demands from individuals and communities and review and adjust services accordingly.
Feedback from some of our service-users
Since I have come to this country, this is the first time I have had somebody who is going to care about me and is so kind and does not make me feel like I’m just a client. My advocate doesn’t say sorry I can’t help – even if she doesn’t know the answer she says - don’t worry, I’ll find out, you are not alone, we can do this together! I am so appreciative of your all your hard work helping me.
[My Advocate] shows empathy for the sadness I feels about being separated from my family and culture like nobody else does.
I hugely benefit from the services your centre provided in the past 2 and a half years. Without you guys hard work I would think I wouldn’t be still alive today! Thanks from the bottom of my heart.
Culture shock is a barrier to my socialising, learning and generally functioning in English culture but [my Advocate sincerely notes everything I am worried about and advises me in a professional way.
I felt I was served beyond compare I have never been treated better in my life.
I am so grateful to you as you have built up my wife’s self-esteem and confidence to believe in herself, that she can be a contributor to the society and also her family.
The level of service [our Advocate] extends to us is far beyond of our imaginations. I was so impressed by the supports and services which have been provided … What particularly touched my heard was that she has been so caring to help us through the tough time and always gone to the extra mile assisting us achieving our goals.
