A Senior Lecturer in Clinical Psychology at the University of Exeter is set to deliver new anti-racism training for mental health staff in Devon.

Dr Suzanne Azer first developed and introduced anti-racism training for NHS supervisors on the Exeter Doctorate in Clinical Psychology programme in 2021 and has continued to develop trainings for a range of contexts, including the prison service. Suzanne is now preparing to deliver trauma informed anti-racism training to inpatient and secure mental health services in Devon Partnership NHS Trust.

She said: “I worked in NHS secondary mental health services for 15 years and in my experience as a woman with mixed heritage in the NHS and in academic contexts, the most common challenge I notice is the high level of anxiety, and sometimes denial, which surrounds conversations about racism.

“When I surveyed one staff team of psychological professionals working in mental health services in the South West region, 45 percent reported not feeling confident initiating conversations about race and racism with the communities they served, or with their colleagues. There is a lack of understanding about the cumulative impact of racism and race-based stress on the mental health of racialised communities which at times amounts to psychological trauma.

“Mental health workers have become skilled at breaking the silence and speaking about domestic and sexual violence, but there is much further to go to support staff in working skilfully with the effects of racial trauma. On the Doctorate in Clinical Psychology at Exeter, we also identified that racially minoritised trainees struggle with feeling supported in supervision when it comes to race and racism on placement. The very positive and welcome offers of support and mentoring for learners cannot in themselves address the root causes of these challenges without systemic change in all areas of practice.

“As professions that believe talking can heal, hearing that many psychological professionals could not confidently engage in dialogue around race and racism was concerning, but very much consistent with what I’ve experienced. I wanted to improve the understanding of racism and racial trauma among mental health professionals and their capacity to sit with their own discomfort in order to be in dialogue with their clients and colleagues. It’s only through making emotional space to listen deeply, without defensiveness and with an openness to learn, that the experiences of racially minoritised service users can be heard and attempts made to identify and work towards meeting their needs. This training encourages those offering clinical care and supervising trainees to understand the deep effects of racism across the lifespan and work to address it and to reduce further racial harm.”

The NHS publishes Workforce Race Equality Standard data (WRES) each year, which outline some of the challenges faced by racially minoritised staff including harassment and bullying by colleagues, managers and the public, disproportionate use of disciplinary processes, and barriers to career progression. Suzanne trains supervisors to develop their understanding of the forms that racism can take from a trauma informed perspective and offers opportunities to reflect on what might be needed to transform supervision into a space where dialogue can take place about race and racism.

Suzanne said: “Supervisors typically describe not having had training before due to the profession’s neglect of these issues and often finding their discomfort gets in the way of open dialogue.  Feedback has been very positive with 100 percent of those accessing the training reporting they would recommend it to other supervisors. Attendees reported not only feeling more confident to initiate conversations about race and racism with trainees, but that it also leads to improvements in conversations with service users about their identities and experiences.

“Despite how challenging we might all find developing these skills, I believe there is an appetite to talk about racism and changing working environments and professional practice. There has been movement towards developing anti-racist strategies, tool kits and positive practice guides, but professionals often don’t know where to turn for help and are frightened of getting it wrong. It is this shame that maintains the silence, denial, and avoidance – and identifying the issues is an important first step.

“There are similarly significant challenges in academia, which the University of Exeter is attempting to address through a range of initiatives. The needs of racially minoritised communities are under-researched and their knowledges are under-valued. For example, in our professions we rarely teach therapeutic approaches that were developed with and for Black communities by Black practitioners.

“My hope is that trauma informed anti-racist training will become mandatory in health care services. The benefits to service users accessing care, to staff and to trainees on placement are clear. There have been committed efforts to roll out mandatory face-to-face training to address inequity and upskill staff in caring for patients who experience learning disabilities and autism recently, which have been very inspiring. We now need the same resolve to mandate staff training to improve the experiences and outcomes of racially minoritised service users.”

In 2022, Suzanne worked with HM Prison Service in London to develop training on the impact of racial trauma on the mental health of prisoners, which she delivered with Dr Roberta Babb. In the coming months, they will be developing and delivering training to support inpatient and forensic (secure) services in Devon Partnership NHS Trust.

Dr Suzanne Azer convenes Clinical Skills and Reflective Organisational Practice teaching on the Clinical Psychology Doctorate at the University of Exeter and is Clinical Lead of the Psychological Professions Network South West. This year Suzanne joined the Women’s Higher Education Network’s 100 Black Women Professors Now programme.