DESPITE its importance, mental health is often overlooked in discussions about the effects of healthcare disparities on Black communities.

And it’s not just that the issue is overlooked by policy-makers. Although Black Britons experience mental ill-health at the same rates as people from other communities, there are significant barriers that prevent them from accessing the care they need when they do speak up.

According to The Voice’s recent Black British Voices (BBV) survey, 81 per cent of the 11,000 people who were questioned expressed a lack of trust in the mental health system’s capacity to satisfy their community’s needs. Eighty-seven per cent of respondents answered either ‘definitely’ or ‘somewhat’ yes when asked the question of whether they ‘feel there is a problem with misdiagnosis, over-medication, or unfair treatment towards Black people in the provision of mental health care in the UK’.

Previous research by the charity Mind found Black people are 40 per cent more likely to access mental health treatment through the criminal justice system which further fuels mistrust.

The results of the BBV survey would seem to indicate that not much has changed for Black people in the mental health system after the tragic death of David ‘Rocky’ Bennett in 1998.

A 2004 independent inquiry into the treatment that Bennett received described the NHS, and particularly its mental health services, as institutionally racist, stating that Black and minority ethnic communities weren’t receiving the service they deserved. Black mental health campaigners have claimed for several years that the NHS has been slow to adopt culturally competent mental health care and have championed its effectiveness.

However, the NHS is beginning to acknowledge the need for change. A landmark independent report published last month found NHS psychotherapy and talking therapy services need better tailoring to meet the needs of Black and minority ethnic groups.

The comprehensive report, Ethnic Inequalities in Improving Access to Psychological Therapies (IAPT), by the NHS Race & Health Observatory and the Collaborating Centre for Mental Health (NCCMH) analysed ten years of anonymised patient data. It found that people from Black and minority ethnic backgrounds have experienced poorer access to, and outcomes from, NHS talking therapies.

Over this period, compared to white British groups, they are less likely to access services and tend to wait longer for assessment and to access treatments. The research noted that poor outcomes can be tackled and even disappear when access is improved, and culturally sensitive therapy is provided.

Inequalities

It calls on commissioners, clinicians, and healthcare organisations to address ethnic health inequalities. This can be done by improving resources and training to enhance understanding of mental health inequality, and by recruiting culturally sensitive and ethnically diverse therapists.

Launched in 2008, the NHS’s Improving Access to Psychological Therapies (IAPT) services were rebranded in January 2023 as the ‘NHS Talking Therapies for anxiety and depression’.

“For far too long we have known that people from minoritised ethnic groups don’t get the mental healthcare they need”, says Dr Lade Smith CBE, President of the Royal College of Psychiatrists responding to the report’s findings. “This review confirms that despite some improvements, it remains that access, experience and outcomes of talking therapies absolutely must get better.

Modern psychology was shaped in an era of white supremacy, neglecting Black experiences. We need culturally relevant approaches to make therapy inclusive

Jarell Bempong, mental health therapist

“There is progress, particularly for people from Black African backgrounds, if they can get into therapy, but getting therapy in the first place continues to be difficult.

“This review provides clear recommendations about how to build on the improvements seen. I hope that decision-makers, system leaders and practitioners will act on these findings.”

Author and mental health therapist Jarell Bempong, author of the recently published book White Talking Therapy Can’t Think in Black welcomes the emphasis on culturally sensitive approaches to delivering effective mental health care to Black patients who need support and addressing inequalities in service delivery.

However, if this approach is to be effective, Bempong believes it is essential to address the training of mental health professionals.

“White-led talking therapy often fails Black people because the people delivering it often lack cultural empathy due to societal power dynamics and privilege,” he says.

“I struggled to find a therapist who understood my cultural experiences. This lack of culturally competent care leads many Black individuals to only ever accessing mental health treatment through the criminal justice system, resulting in worse outcomes.”

Bempong continues: “The problems with how mental health professionals are trained stem from a curriculum with Eurocentric origins, which excludes diverse perspectives.

“Modern psychology was shaped in an era of White supremacy, neglecting Black experiences. We need to integrate culturally relevant approaches to make therapy inclusive and relevant for Black and minority people.”

While the NHS Race & Health Observatory report found a number of areas that needed improving to help Black people better access mental health care, it also highlighted areas of good practice, improvements, and examples of effective support from Voluntary Community and Social Enterprise (VCSE) organisations and community partners. Over the last decade many of these organisations have launched innovative treatment programmes aimed at providing Black people facing ill-health with help they need.

These initiatives place cultural knowledge at the heart of patient care in an effort to create an environment that encourages open communication.

Developing culturally appropriate mental health services and collaborating with community organisations is at the heart of the work Mind does in a bid to improve Black people’s access to appropriate mental health care.

The creation of culturally sensitive treatment programmes and partnerships with Black-led community organisations are at the heart of mental health charity Mind’s initiatives to increase Black people’s access to effective treatment.

Among the programmes it has recently launched is Bayo, a collaborative project with the Ubele Initiative, Black Thrive Haringey, Young Minds and the National Emergencies Trust, which focuses on the ways in which young Black people can improve their mental well-being.

“One of the things we’re most proud of is our partnership work,” says Ariel Breaux-Torres, Head of Race Equity at Mind.

“I think that’s something that really encompasses the way that the mental health system needs to be working with the Black community. “Doing things in partnership and co-producing projects helps to amplify the voices of those that are most central to the issues. We only need to be there as a support because the knowledge about how things can improve already exists within the community.”