With African and Caribbean people far more likely to be diagnosed with a serious mental illness it is fitting that World Mental Health Day falls in Black History Month this year.
Black men in Britain are 17 times more likely than white counterparts to be diagnosed with a psychotic illness.
In Lambeth, with the country’s biggest black population, we at Lambeth council launched a new report aimed at tackling this kind of inequality. We hope to end a situation which means that while 26% of Lambeth’s population is black, nearly 70% of the borough’s residents in secure psychiatric settings are of African or Caribbean heritage.
We also never want to see a repeat of the circumstances that led to the death in 2008 of black musician Sean Rigg who died in police custody after being restrained by officers during a schizophrenic episode. The coroner’s report, highlighting serious failings by the local NHS and police, led to the establishment of the Lambeth Black Health and Wellbeing Commission that launched its final report on 10 October.
Our aim in establishing the commission was for health professionals, councillors, residents and others to come up with practical ideas to improve the prevention and treatment of mental health with our black communities.
The commission heard from the public health team that poverty, neglect and abuse can all be important factors in making mental illness more likely. The commission’s recommendations to improve housing, job creation, parenting skills and support for those at risk from abuse and neglect have all been accepted by Lambeth’s health and wellbeing board.
The commission found that more than two thirds of the money spent on mental health in the borough was spent in hospitals with the manager of one of those hospital wards saying that 20% of his patients should be treated elsewhere. We agree and by intervening earlier, in the community and in primary care we can stop people ending up in the most coercive and expensive settings.
Groups like Brixton Soup Kitchen, Blockworkout and Kids Company, who work directly with vulnerable young people, have all helped the commission understand the gap between those who need help and the formal services that should support them. As a result the commission recommends giving these kinds of groups the skills and connections they need to help people where they are, which is not necessarily in the mental health trust.
By spreading power and skills we help tackle inequality and reach the most vulnerable. It is also vital that more children are supported as fewer than 20% of Lambeth’s young people with a mental health condition get any formal help. We also heard that teaching children mental health resilience techniques through social and emotional education saves a massive £84 for every £1 spent on it. We want every school in Lambeth delivering this sort of education to enable their pupils the best chance of staying well in order to learn and thrive.
On patient experience we have called for an end to physical restraint in hospitals and for police officers to be trained with black mental health service users so that they always respond humanely to people in distress. If people feel confident that they will be well treated by public servants there is a better chance they will seek the help they need early enough to make the most positive difference.
Last spring we tested these, and other, ideas with over 150 residents who gave up their Saturday and contributed their own thoughts to the finished report.
With stalls and presentations at community events we have recruited hundreds more residents to find out more and potentially act as wellbeing champions in their communities.
Inequality has been part of the problem so our report and its implementation cannot be left to the professionals but must be owned by everyone with a stake in improving wellbeing in our communities. The Lambeth Living Well Collaborativehas made a great start in involving service users and carers in commissioning and delivery of mental health services but we need to go much further.
With cooperation we can reduce abuse and neglect, poverty and inequality; we can improve education, employment and a sense of community; and if we succeed, fewer of our residents, of whatever colour, will suffer like Sean Rigg and so many others have done in the past.