Black patients, equal access: How SLaM achieved early intervention parity
In 2021, only 60% of Black service users at South London and Maudsley NHS Foundation Trust (SLaM) received Early Intervention (EI) treatment within two weeks, which was below the London average of 74%.
EI services provide fast access to treatment for serious mental health conditions like first episode psychosis, where early support can significantly improve long-term outcomes. The delay wasn’t just a metric: it meant more severe symptoms, longer hospital stays and delayed recovery.
Today, the picture has changed. By May 2025, Black and White service users were accessing EI services at the same timely rates, a result of years of focused, anti-racism system change. Between March and May 2025, 77% of all service users referred to EI at SLaM were seen within two weeks, outperforming the London average of 68%.
This milestone didn’t happen by accident. It was driven by the Trust’s Patient and Carer Race Equality Framework (PCREF) - a pioneering programme co-produced with service users, carers, staff and community partners to address racial disparities in access, experience and outcomes in mental health trusts.
“We built a model of anti-racism mental health care that is not only visionary, but demonstrably effective” Shania Ruddock, Deputy Director of PCREF
At its core, PCREF reshaped decision-making through a ‘Triple Leadership’ model: each borough formed local teams co-led by staff, service users, and community representatives. In Lewisham, for instance, teams designed borough-specific solutions, such as the ‘Through Our Eyes’ anti-racism training, which reframed how staff understand and respond to Black service users’ needs.
Crucially, through this framework, SLaM overhauled its data systems. Where once disparities were invisible, now real-time dashboards monitor progress across six key equity metrics - including EI access.
Over time, through these initiatives, these changes made a measurable difference: by January 2025, the gap in waiting times had narrowed significantly, and by May, Black and White service users were receiving EI care at the same speed.
Other structural shifts helped too. The rate of GP referrals for Black service users nearly doubled, from 13% in 2020/21 to 25% in 2024/25 - reducing reliance on crisis routes like A&E or the police. Advance Choice Documents (ACDs), championed by Peer Support Workers, empowered patients to shape their care before reaching crisis point.
These improvements are about more than percentages. They reflect real improvements in how people experience care - with greater trust, safety and respect. They also prove that equity is possible - with leadership, co-production and data that drives action.
SLaM’s achievements in early intervention show what’s possible when an organisation actively commits to anti-racism in both principle and practice. It’s a step towards mental health services that listen better and respond more fairly to the people they serve. As Annette Davis, PCREF Service User and Carer Chair/Lead, put it:
“This is more than a programme. It is a movement.”
The work continues - shaped by communities, service users and carers - to keep driving race equity from intention to action across mental health care.
