PART OF the history of Black people in the UK is the mental health consequences of contending with overt and systemic racism, the high rates of diagnosis of severe mental health problems, including disproportionate sectioning of Black people under the Mental Health Act people compared to white people, and the lack of early access to effective mental health services aligned with Black people’s needs.

Evidence suggests that in the UK Black people are at higher risk than white people of developing mental health problems like depression, schizophrenia and PTSD.

Black people are more likely to access mental health treatment through the criminal justice system than the NHS, less likely to receive therapy and more likely to be admitted against their will to hospital for treatment. Research has highlighted strong mistrust of mental health services amongst Black communities rooted in negative experiences of the mental health system. 

“There’s also of a lack of understanding, particularly amongst senior mental health clinicians, of the lived experience of Black people”

Reasons for these higher rates of mental health problems are complex and interconnected. Evidence reveals Black people being more likely to be impacted by social determinants associated with poor mental health, such as poverty, unemployment, poor housing, poor neighbourhoods, and school exclusion Research also shows the increased likelihood of Black people to be diagnosed with schizophrenia compared to white people is in part due to the influence of racial stereotypes on the decision-making of clinicians. These drivers of higher rates of diagnosis of schizophrenia amongst Black people reflect how systemic racism plays out within the mental health system.

Lack of understanding

There’s also of a lack of understanding, particularly amongst senior mental health clinicians, of the lived experience of Black people and how this is central to mental health. The disproportionate impact of coronavirus on Black people has further highlighted systemic racial inequalities. This is evidenced by Mind’s own survey of 16,000 people during the first national lockdown which showed existing inequalities in housing, employment, finances and other issues have had a greater impact on the mental health of people from different Black, Asian and Ethnic Minority (BAME) groups than white people during the coronavirus pandemic.

As the principle provider of mental health services, the NHS is key to addressing racial inequity. Its new Advancing Mental Health Equalities strategy, published today, is a positive step towards this. It outlines major areas of inequity within the mental health system, particularly in relation to race and ethnicity, and makes a number of positive recommendations about what changes need to be made to address them. The focus on both short-term and long-term goals is particularly welcome. 

However, strategies such as this are nothing new. We’ve still not seen transformative change in how mental health services are accessed and experienced by Black people. Ultimately the success of the strategy depends on its implementation. It’s going to need proper resourcing, also the buy-in of communities that have long-been poorly served by the mental health system. The likelihood of meaningful change happening will depend on the political will to drive it through the inevitable obstacles any strategy that seeks to overturn an entrenched status quo faces. 

Addressing inequality

The strategy is really is just the first step, setting out an approach to addressing inequality with mental health services. We also want to see greater government investment in services designed by and for Black people and other minority groups. All services, from GPs to talking therapies to inpatient care, need to be relevant to the lived experience of Black people. We expect an action plan from government that details how the strategy will be delivered, and who will be accountable for such delivery both nationally and locally. We also need to see the government giving support to the Advancing Mental Health Equalities taskforce, led by Jacqui Dyer, and taking its recommendations seriously. 

As the UK faces up to the disproportionate impact of coronavirus on Black people and other groups, including rates of infection and tragic loss of life, a spotlight is shone on the fact these groups are being and have long been hit hardest by mental health problems. This is why one of Mind’s five key tests for the government’s response to coronavirus is to protect those most at risk. We will be partnering with the NHS as it begins a journey to doing this to a greater degree in mental health services and demanding the government meets these efforts with adequate investment and support. 

For more information about Mind’s Five Key Tests for Government visit mind.org.uk/fivetests

For more information about Mind’s racial inequality work visit mind.org.uk/blackhistorymonth2020