Proposals to reform the Mental Health Act to tackle racial disparity and lower rates of detention and community treatment orders among Black Asian and Minority Ethnic (BAME) groups will be futile without systemic, societal change, experts have warned.
The long-awaited Mental Health Act (MHA) White Paper, published last week, pledged “decisive action” would be taken to cut disproportionate use of the act among certain groups. Black people are over four times more likely than white people to be detained under the act and over 10 times more likely to be subject to a community treatment order (CTO) – under which people are discharged from detention but placed under conditions on their lives and treatment.
Part of this would be achieved by tightening conditions for people to be detained or subject to a CTO, while the paper also sets out plans to subject mental health trusts to a patient and carer race equality framework (PCREF) designed to improve their response to Black and ethnic minority communities and improve access to culturally appropriate advocacy.
Scope for change limited without addressing ‘racist society’
But Hári Sewell, a social worker by background, former mental health trust director and now a consultant in mental health and equalities, said he was sceptical about the scope for change “while Black people are still living in a racist society”.“Think of the response to an impoverished community drinking contaminated water because there is no clean water supply, if you improve your treatments and service structures, the experience of crisis may be less problematic but the number of cases coming through will not significantly reduce,” he said.
Furthermore, Sewell said the underlying principles of mental health meant that the focus on looking for signs and symptoms of an illness could lead to “inattentional blindness to the role of racism in people’s presentations”, exacerbated because many forms of racism were invisible to many in the profession.
