Care Quality Commission

Mental health racism claims are “meaningless” and “insulting”

Accusations that mental health services are racist are “meaningless and insulting” and create poor morale among staff, two psychiatry professors have claimed.

Black people are three times more likely to be admitted to psychiatric hospital and up to 44% more likely to be compulsory detained, a report last year revealed.

The report, entitled Count Me In and produced by the Healthcare Commission and the Mental Health Act Commission, covered almost 34,000 mental health inpatients.

On the back of the report, the government launched a five-year race equality action plan in a bid, it said, to eradicate racism in mental health services. Seventeen strategic health authorities were asked to set up non-discriminatory mental health projects.

But writing in the September 23 edition of the British Medical Journal, professors Swaran Singh and Tom Burns argued that figures in the Count Me In census may be due to the the social exclusion and low socio-economic standing of black and ethnic minority people, as much as racism.

They said evidence showed that rates of psychiatric disorder are high for all migrants, irrespective of ethnicity.

Singh and Burns wrote: “Rates of psychotic disorder are high not just among the African-Caribbean community in the UK, they are high for all immigrant groups globally.

“The excess is also not restricted to non-Western minorities. Rates of schizophrenia are high in migrants to Denmark from Australia and Greenland, in Finnish migrants to Sweden, and in Britons, Germans, Poles, and Italians who migrated to Australia.”

They continued: “Shared experiences of discrimination, social exclusion, and urbanicity may all contribute to this increased risk and also explain a greater increase in communities exposed to higher levels of such experiences, such as black and ethnic minority communities in the UK.

“Ethnicity and psychosis is simply not a black and white issue.”

Singh, professor of social and community psychiatry at the University of Warwick, and Burns, professor of social psychiatry at the University of Oxford believe the racism claim “damages the profession [of psychiatry] and patients”.

They called the accusation “vague, meaningless” and “insulting”.

“It devalues the thoughtful research that has been conducted to better understand these problems. It undermines morale and recruitment as staff feel undervalued and blamed,” they wrote.

“Secondly, it distracts both professionals and minority communities from trying to understand these very real differences. Blaming others may bring temporary comfort but is hardly likely to lead to increased understanding and remedial action.”

They continued: “Thirdly, and most gravely, it damages the welfare of current and potential ethnic minority patients. If they anticipate a racist and discriminatory reception from us then it is no surprise that they stay away from seeking help until it is too late and there are few alternatives to detention and enforced treatment.”

Singh and Burns also wrote that claims of racism in mental health services acts as a “self fulfilling prophecy” by contributing to a mistrust of services by ethnic minorities, leading to a delay in seeking help seeking, with increased use of detention and coercive treatments for ethnic minority patients.

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