Published: 17/03/2005, Volume II5, No. 5947 Page 11

Putting into place measures to improve care for black and minority ethnic patients has become part of mental health managers' 'to do' list following the January launch of Delivering Race Equality in Mental Health Care.

The document outlines plans for a reduction in the disproportionate numbers of black patients detained on inpatient wards and helping BME service users access services tailored to their needs. Improvements are expected by 2010.

But although managers acknowledge that it is vital that such measures are taken, there are concerns that for some trusts there are too many other pressures on resources to be dealt with first.

One senior manager whose trust covers largely rural areas said that although his organisation was seeking to recruit a BME manager to carry out equality training, finding someone to take the job was proving difficult.

'We have a tiny percentage of minority patients and staff, except among medical staff. It can be difficult to recruit people from ethnic backgrounds to live in areas like this, where they may feel they do not have enough community support.

'And of course there is no additional money to pay for this. We know It is important, but we do not have the resources.' He added that every time a new post is created, cuts have to be made elsewhere to pay for it.

'We are running out of options;

our executive team may have to be next, ' he said.

Other trusts face the problem of having to cater for so many minorities that decisions must be made on how many can have services tailored for them.

'We are never going to be able to meet all need, ' said an inner London trust manager. 'This is an area with many transient populations, such as large numbers of asylum seekers, and we are having to evaluate what services are available.' Looking ahead, some senior managers are expecting to see a number of mergers among mental health trusts that would see them merge with primary care trusts or with neighbouring trusts.

'Some organisations are simply too small to survive, ' said one.