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This article has been withdrawn as it was published elsewhere and accidentally duplicated. The original article can be seen here: 10.1108/17570980200800008. When citing the article, please cite: Joanna Bennett, Frank Keating, (2008), “Training to redress racial disadvantage in mental health care: race equality or cultural competence?”, Ethnicity and Inequalities in Health and Social Care, Vol. 1 Iss: 1, pp. 52 - 59.

Social policy in the UK has subsumed race inequality into a wider framework of inequalities, managing diversity and social exclusion. However, the David Bennett Inquiry and the Race Relations Amendment Act (2000) have placed ‘race’ firmly back onto the policy agenda, particularly within mental health services. In response to the Inquiry and as part of a wider strategy, the Department of Health has set out proposals to improve mental health services to black and minority ethnic (BME) communities. Although there is a long history of race equality training to address race inequality in public services in the UK, the definition and effectiveness of race equality training remains unclear.This paper presents an overview of approaches to training in the UK, the evidence of effectiveness and explores whether cultural competency is an appropriate and adequate framework to address race inequality.

It has been acknowledged that the disparities and inequalities for black and minority ethnic (BME) communities in mental health in the United Kingdom (UK) has reached such proportions that it is considered a public health issue. This paper reviews training as one of the strategies that have been employed to address these inequalities and draws on a historical review and a scoping exercise in England which mapped approaches to race equality training in mental health services. The historical review showed that the concept of race and racism has been replaced by culturalism as an explanation for all racial inequalities and is the central framework for race equality training. Whilst the survey showed that the majority of mental health services were providing training for their staff, there is much fragmentation and a lack of robust evaluation demonstrating effectiveness. While education and training have a key role to play in developing knowledge and skills to address racial inequality, current approaches are fundamentally flawed.

One of the main features of the reform of the Mental Health Act 2007 was the introduction of community treatment orders (CTOs). CTOs represent a fundamental shift in the rights of people with severe mental health problems, who have been detained in hospital under section 3 of the Mental Health Act and subsequently discharged. The call for the introduction of CTOs or similar legislation has been a feature of mental health policy over the past 20 years. Despite the detailed discussion of the relationship between ethnicity and psychiatry, there has been very little attention paid to the way that race was a factor in the community care scandals of the 1990s. This article, through the consideration of two very high profile cases ‐ Christopher Clunis and Ben Silcock, explores the media's influence on the construction of the debate in this area. In particular, it explores the way that the media reporting of the two cases had a role in not only perpetuating racial stereotyping, but also the stigmatising of those experiencing acute mental health problems. In addition, with the use of government papers obtained under the Freedom of Information Act, it considers the response to and the attempts to influence the media debate at that time.

Although the sexuality of people with mental health problems raises important clinical, social and legal concerns, there is relatively little written about the subject, and it is clear that staff often feel confused and embarrassed when discussing these issues with colleagues, carers and service users. Staff are often unsure about how to balance service users' rights to live a full life (including the right to express themselves sexually) with the need to protect people considered to be vulnerable. Here, Richard Pacitti and Graham Thornicroft describe how Mind in Croydon made a film about sex, relationships and mental health to help explore these issues further.‘Those of us who have been diagnosed with major mental illness do not cease to be human beings by virtue of that diagnosis. Like all people we experience the need for love, companionship, solitude, and intimacy. Like all people we want to feel loved, valued, and desired by others.’ (Patricia E Deegan, 1999).‘Not having a relationship if you want one can be like that constant feeling of being hungry and not being fed.’ (Bill, contributor to Unspoken)

The increased involvement of customers in their experience is a reality for all service organisations. The purpose of this paper is to explore the way organisations collaborate with customers to facilitate consumption of cultural experiences through the lens of co-production. Although organisations are typically an integral part of the co-production process, co-production is typically considered from a consumer angle. Aligned with the service ecosystem perspective and value-in-cultural context, this research aims to provide greater insight into the processes and resources that institutions apply to co-produce experiences with consumers and the drivers and inhibitors of such processes.

Case study research with three exemplar organisations, using in-depth interviews with key informants was used to investigate the processes organisations follow in co-producing the service experience with customers, as well as the drivers and inhibitors of organisational co-production of the service experience in the cultural sector.

The findings illuminate that cultural organisations are co-producing the service experience with their customers, as revealed through a number of key processes: inviting customers to actively participate in the experience, engaging customers and supporting customers in the co-production of the experience. Increasingly demanding consumers and a changing competitive landscape are strong external drivers of co-production. Visionary leadership and consumer-focussed employees are internal factors impelling organisations to co-produce experiences with consumers. A strong curatorial orientation, complex organisational structure, employee attitude and capability gaps and funding constraints are impediments towards organisations co-producing experiences with consumers.

This paper addresses a gap in Service-Dominant logic theory, arts/cultural marketing and broader services marketing literature by proposing a broadened conceptualisation of co-production of the service experience. This conceptualisation can be used as a platform to derive strategic imperatives for managers of service organisations. The findings highlight the key practices and resources that are central to organisations co-producing experience with customers. In this way, greater understanding of institutional logics and practices that underpin experience co-production emerges.

Organizational researchers studying well-being – as well as organizations themselves – often place much of the burden on employees to manage and preserve their own well-being. Missing from this discussion is how – from a human resources management (HRM) perspective – organizations and managers can directly and positively shape the well-being of their employees. The authors use this review to paint a picture of what organizations could be like if they valued people holistically and embraced the full experience of employees’ lives to promote well-being at work. In so doing, the authors tackle five challenges that managers may have to help their employees navigate, but to date have received more limited empirical and theoretical attention from an HRM perspective: (1) recovery at work; (2) women’s health; (3) concealable stigmas; (4) caregiving; and (5) coping with socio-environmental jolts. In each section, the authors highlight how past research has treated managerial or organizational support on these topics, and pave the way for where research needs to advance from an HRM perspective. The authors conclude with ideas for tackling these issues methodologically and analytically, highlighting ways to recruit and support more vulnerable samples that are encapsulated within these topics, as well as analytic approaches to study employee experiences more holistically. In sum, this review represents a call for organizations to now – more than ever – build thriving organizations.