Why we must tackle racial inequality in mental health services

The recent verdicts over the murder of Stephen Lawrence have brought to the attention not only 19 years of dignity, staying power and resoluteness of Doreen and Neville Lawrence but also their anguish, frustration, and depression. We could not begin to imagine the psychological impact on the Lawrence family of losing their son in such a brutal way.

However, one of the sad realities for Doreen and Neville was the break-up of their marriage. It is hoped that the counselling and psychological support that they received during the last 19 years have helped them cope and be resilient.

We have moved a long way as a society when psychological therapies was the preserve either for the rich and worried middle classes or people being assessed as mad, bad and dangerous in our forensic and criminal justice system.

Over my professional life working in health and social care I have seen lot of changes. During my time working as CAB manager in Wandsworth in the early 1990s where we ran an outreach service to St George’s hospital for mental health patients; working for Mind and support the development of local branches in London and south-east England; working as a commissioner in the NHS; a civil servant for the Department of Health on public health to running the Afiya Trust we have come a long way over the last 20 years:

  • Massive investment in psychological services (including the roll-out of theImproving Access to Psychological Therapiesprogramme for children and adults).
  • Growth in professional development, standards and regulation in the talking therapies sector.
  • Growth in the recognition of equalities (Delivering race equality in mental health care, the Equality Act 2010 and Equality Delivery System).
  • Development of strategies, commissioning and national service frameworks (World Class Commissioning and No Health without Mental Health).

However, despite these changes there are a number of challenges that still prevent better mental health services for the masses and particularly for black and minority ethnic communities. Race equality and mental health is still marginalised thus preventing further change in the system.

With the development of the implementation framework of No Health Without Mental Health strategy, which will be launched in April, Afiya will engage with members of the ministerial advisory group (Afiya is also a member) to take up issues concerning BME communities and make the strategy more effective. The aims are to address the diversity of identities and experiences within communities while delivering services; develop systems to involve BME communities in policy making at the top level; support community-led social marketing campaigns to challenge inequalities and raise awareness; and recognise and respect the cultural heritage, identity and belief systems of communities.

The Count Me Survey highlights over representation and the extensive use of community treatment orders for black and minority ethnic patients and service users. They face stigma and discrimination and black people – even with medication and limited access to therapies – are still seen as mad, bad and dangerous, the survey reveals. As a society we cannot tolerate this.