Written evidence submitted by Mr Anokh Goodman (Clinical Lead for Cultural Connections, Transformation and Belonging/Systemic Family Therapist at Bradford District Care Trust) (CMH0157

Introduction

This submission is made on behalf of Anokh Goodman, I work for Bradford District Care Foundation Trust, Act As One (Bradford District and Craven Partnership), and I am board member for Association of Family Therapy (AFT).

I am a passionate advocate for mental health system reform and transformation, with over 20 years of experience working in community mental health and social care settings. My work has been dedicated to creating spaces for meaningful connection, reciprocal growth, and ethical co-production. Through my experience, I have seen both the strengths and challenges of community mental health services and am committed to shaping a system that is more equitable, relational, and responsive to lived experience.

Bradford has been at the forefront of innovative, person-centred approaches to mental health, championing models that prioritise co-production, ethical involvement, and community-led transformation. As part of this work, our organisations have led on initiatives such as Stepping Stones to Wellbeing, the Ethical Involvement Fellowship, and Going Beyond PCREF, all of which challenge traditional models and seek to create sustainable, culturally responsive mental health services.

Our reason for submitting evidence is to ensure that the voices of service users, families, carers, and community organisations are central to shaping national policy. We believe that true transformation requires a shift from top-down models to grassroots, relational approaches that empower communities to lead their own mental health journeys.

I have used some of the initiatives I have led on to connect to the themes of each question and bring to life some real ways of embodying a different approach. Here is summary of each project:

Here’s a brief overview of each of the documents you provided:

1. Ethical Involvement Fellowship -
   This outlines a structured approach to ethical involvement in mental health services, emphasising co-production, lived experience leadership, and reciprocal growth. It serves as a framework to ensure that service users, carers, and communities are actively involved in shaping mental health policies and practices in a way that is meaningful, sustainable, and equitable.
2. Stepping Stones to Wellbeing Groups
   The Stepping Stones to Wellbeing initiative focuses on community-led mental health support by creating safe, inclusive spaces where people can connect, heal, and grow. The poster visually represents the core principles of this model, highlighting the importance of relational support, cultural responsiveness, and grassroots engagement in mental health services.
3. Going Beyond PCREF - Positive Disruptions
   These ideas I have developed challenge traditional approaches to implementing the Patient and Carer Race Equality Framework (PCREF) by advocating for deeper systemic change. It critiques the tokenistic implementation of equality initiatives and calls for a fundamental shift towards relational, intersectional, and anti-racist approaches in mental health services. "Positive Disruptions" refers to the need for bold, transformative actions that dismantle systemic barriers and create truly inclusive, person-centred care.

These projects collectively emphasise ethical involvement, relational care, and equity-focused transformation in mental health services, forming the foundation for your submission.

What does high-quality care look like for adults with severe mental illness and their families/carers?

High-quality care for adults with severe mental illness (SMI) must be person-centred, trauma-informed, and co-produced with those who use the services. This means moving beyond top-down models and instead investing in ethical involvement, reciprocal relationships, and long-term systemic change.

Key elements of high-quality care include:

• Ethical Involvement & Co-Production: Empowering service users to shape and co-produce services ensures that care is meaningful and responsive to real needs. The Ethical Involvement Fellowship model emphasises supporting lived experience leadership and fostering inclusive collaboration.
• Community & Connection: The Stepping Stones to Wellbeing initiative demonstrates that care should not be isolated to clinical interventions but should also create spaces of belonging, fostering connectedness, hope, and empowerment to reduce social isolation.
• Addressing Structural Inequalities: The Going Beyond PCREF framework highlights the need to integrate intersectionality, ensuring that care is not only race-conscious but also considers gender, disability, and socioeconomic barriers.
• Long-Term Commitment to Change: High-quality care is not just about short-term improvements but embedding cultural shifts that prioritise meaningful participation and health equity.

How could the service user journey be improved within community mental health services and in accessing support from other services/agencies?

The service user journey can be improved by:

1. Embedding Co-Production & Ethical Involvement: Traditional service models often fail to fully integrate service user voices. Ethical involvement, as outlined in the Plan on a Page, ensures that those with lived experience shape their own care pathways.
2. Creating Relational Support Networks: Social isolation is a key challenge. Stepping Stones to Wellbeing demonstrates that relational groups rooted in community, culture, and identity can provide transformative peer support.
3. Improving Cross-Sector Integration: Mental health care should not function in isolation but be linked with housing, employment, education, and social care to address the wider determinants of health.

How could this be measured/monitored locally and nationally?

• Beyond Quantitative Metrics: Going Beyond PCREF critiques the over-reliance on audits and statistics, advocating for a balance of qualitative insights—stories, case studies, and lived experience evaluations.
• Co-Developed Outcome Measures: Success should be measured using indicators developed with service users, reflecting real-world improvements in connectedness, empowerment, and meaningful involvement.
• Longitudinal Tracking: Metrics should not just capture short-term changes but also track long-term systemic improvements and cultural shifts within services.

What is the current state of access for adults with severe mental illness to community mental health services?

Access remains inconsistent across the country. PCREF implementation critiques highlight that access can be tokenistic, failing to embed genuine equity into everyday service provision. Additionally, current models often miss structural barriers, such as systemic racism and economic disadvantages, that contribute to disparities in service uptake.

What progress has been made in implementing waiting time and access standards for community mental health services?

There have been improvements in setting targets for access, but these efforts often focus too heavily on quantitative measures rather than holistic and sustainable change. The Ethical Involvement Fellowship approach suggests that more work is needed to ensure that improvements are service user-led and not just bureaucratic exercises.

How could access be improved across the country?

• Decolonising Mental Health Services: Stepping Stones to Wellbeing shows the power of co-created, culturally informed support models that go beyond traditional NHS pathways.
• Embedding Ethical Co-Production: Rather than top-down policy changes, local communities must be empowered to shape services in ways that reflect their needs.
• Strengthening Local & National Alignment: Aligning initiatives like PCREF, NHS Long-Term Plan, and Act As One ensures consistency and sustainability in service provision.

Has the Community Mental Health Framework been an effective tool for driving more integrated, person-centred care?

While the Community Mental Health Framework (CMHF) has made strides in promoting integration, its impact has been uneven due to lack of grassroots engagement. Going Beyond PCREF critiques the top-down nature of implementation, urging a shift towards models that foster relational partnerships between NHS, local government, and third-sector organisations.

How can community mental health services work with social care, the third sector, and local government to address wider social determinants of mental health?

• Stepping Stones to Wellbeing demonstrates that community-driven initiatives can bridge gaps in mental health support by providing spaces for connection, identity, and empowerment.
• Collaborative Service Design: Ethical co-production should be standard practice, where mental health services, housing, employment support, and social care co-design holistic support plans with service users.
• Embedding Intersectionality: Ensuring that services address multiple layers of inequality—race, gender, disability, and economic barriers—will result in more meaningful support.

How could the funding system be reformed to better drive transformation in integrated, person-centred mental health services?

• Funding Long-Term, Sustainable Change: Current funding structures often prioritise short-term projects. Shifting towards long-term investment in ethical involvement, community-led models, and relational care will foster systemic transformation.
• Shifting Power to Service Users: Financial models should fund service user-led initiatives directly, allowing greater ownership and accountability for care innovation.
• Reducing Bureaucratic Barriers: Funding should be flexible and responsive to the needs of service users, allowing for grassroots innovation rather than rigid top-down approaches.

What blockers or enablers should policy interventions prioritise to improve integration?

• Blockers:
• Tokenistic engagement: Many policies mandate service user involvement but fail to embed it meaningfully.
• Bureaucratic barriers: Over-reliance on data and rigid policy structures stifles innovation.
• Structural inequities: Without addressing systemic racism, economic deprivation, and social exclusion, true integration is impossible.
• Enablers:
• Investment in Ethical Involvement: As seen in the Fellowship model, resourcing service users to co-produce care leads to real impact.
• Building Local Partnerships: Collaboration with the third sector (e.g., Mind in Bradford) allows for more community-led, accessible mental health interventions.
• Cultural and Relational Approaches: Stepping Stones to Wellbeing highlights that services must create spaces of belonging rather than just clinical interventions.

What are examples of good or innovative practice in community mental health services?

• Stepping Stones to Wellbeing: A co-produced, culturally inclusive model offering peer-led support, identity-building, and relational healing.
• Ethical Involvement Fellowship: A groundbreaking model for lived experience leadership, ensuring that service users are at the heart of decision-making.
• Going Beyond PCREF: A progressive critique advocating for deeper intersectionality, systemic change, and relational co-production in racial equity frameworks.

What needs to happen to scale up these practices across the country?

• Embedding Co-Production Nationally: Ethical involvement should be a standard requirement, not an optional add-on.
• Flexible Funding for Community Innovation: Stepping Stones to Wellbeing succeeded due to its adaptability—similar models must receive sustained funding and policy backing.
• Developing New Outcome Measures: Moving away from purely quantitative metrics to incorporate lived experience narratives, relational improvements, and community wellbeing indicators.

Conclusion

The future of mental health care lies in relational, co-produced, and ethically grounded services that prioritise lived experience, address systemic inequities, and foster genuine community connection. By scaling up these innovative approaches, we can reduce health inequalities, improve access, and create a more just, inclusive mental health system.

February 2025