Systemic Barriers & Power Impact Framework (SBPIF) Organisational Assessment Tool

Purpose of This Tool

Katie Gregory (2025)

The SBPIF Organisational Assessment Tool is designed to help mental health services critically examine power structures, systemic barriers, and access inequities in their service delivery. It provides a structured approach for reflection, accountability, and transformation towards anti-oppressive, trauma-informed, and co-produced mental health care.

This tool can be used for:

• Service audits & reviews
• Staff training & reflection
• Service user co-production discussions
• Policy and practice development
• Accountability and transformation planning

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How to Use This Tool

This tool consists of five core domains with reflective questions and an assessment scale to identify strengths, gaps, and areas for action. Organisations can use it as a self-assessment or through facilitated group discussions with staff, service users, and stakeholders.

Assessment Scale

Each statement is rated on a 1-5 scale:

• 1 – Not at all (This is not considered or addressed in our service)
• 2 – Rarely (Minimal consideration or action, mostly reactive)
• 3 – Sometimes (Some efforts are made, but inconsistently)
• 4 – Often (Considered and implemented, but with gaps)
• 5 – Fully integrated (Embedded in policy, practice, and culture)

For each domain, score your organisation’s current position and note specific evidence, challenges, and actions for improvement.

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SBPIF Organisational Assessment Domains

1. Power: Who Holds It and How It Is Used?

• To what extent do service users influence decision-making within our organisation?
• Do we acknowledge and challenge professional and institutional power imbalances?
• Are there mechanisms for staff to challenge hierarchical structures without fear of repercussions?
• Are there transparent processes for service users and communities to hold our organisation accountable?

Score (1-5): ____
Evidence & Challenges: ______________
Actions for Change: ______________

2. Systemic Barriers: Access, Exclusion & Equity

• Do we recognise and address barriers related to poverty, disability, racism, gender identity, or neurodivergence in accessing services?
• Are our referral pathways accessible, timely, and inclusive for all?
• How do we accommodate service users with complex needs (e.g., trauma histories, multiple diagnoses, cultural or language differences)?
• Are policies and funding structures reinforcing exclusionary practices (e.g., diagnosis-dependent access, long waiting lists)?

Score (1-5): ____
Evidence & Challenges: ______________
Actions for Change: ______________

3. Meaning: Service Users’ Experiences & Narratives

• Do we explore and validate service users’ own meanings of distress, rather than relying solely on medicalised frameworks?
• How do we ensure that individuals’ social, cultural, and systemic contexts shape care plans?
• Are we enabling people to define their own recovery, rather than imposing professionalised expectations?
• Do we actively listen to service users’ experiences of oppression, discrimination, and harm within mental health services?

Score (1-5): ____
Evidence & Challenges: ______________
Actions for Change: ______________

4. Responses: How People Adapt & Resist Systems

• Do we recognise distress as a response to systemic harm, rather than an individual ‘disorder’?
• How do we support service users in self-advocacy and resistance against oppressive practices?
• Do we enable choice in treatment options, including non-medical approaches?
• How do we respond when people disengage, resist, or challenge our services? Are they met with punishment, coercion, or further exclusion?

Score (1-5): ____
Evidence & Challenges: ______________
Actions for Change: ______________

5. Transformation: Structural Change & Accountability

• Is there an organisational commitment to anti-oppressive, trauma-informed, and power-conscious practice?
• Do we measure and track systemic inequities in service provision?
• How do we ensure that service users and marginalised communities are leading service transformation efforts?
• Do we have accountability structures in place to ensure ongoing improvement?

Score (1-5): ____
Evidence & Challenges: ______________
Actions for Change: ______________

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Reflection & Action Plan

1. Which domains scored the lowest, and why?
2. Which areas need urgent attention and systemic change?
3. What immediate steps can be taken?
4. What long-term changes are required to redistribute power and improve accessibility?
5. How will we ensure accountability for these actions?

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Commitment to Change

This framework is not a tick-box exercise—it’s a tool for meaningful change. Organisations should revisit it regularly and involve service users, staff, and community stakeholders in developing and implementing solutions.

Next Steps:

✅ Share results with leadership and frontline staff.
✅ Identify specific action points for immediate and long-term change.
✅ Set a timeline for reviewing progress.
✅ Work towards co-production and structural reform.

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By using the SBPIF, organisations can move beyond surface-level reforms and begin dismantling the systemic barriers that shape mental health care.

Are you ready to challenge power structures and create real change? Start your assessment today.

Transparency Statement:
This document was collaboratively developed with the support of AI to enhance clarity, structure, and efficiency. However, all concepts, analysis, and critical reflections within the Systemic Barriers & Power Impact Framework (SBPIF) are grounded in professional expertise, lived experience, and a commitment to systemic change in mental health services.