Behind the debate on language the Commission on Race and Ethnic Disparities highlights some harrowing statistics that require urgent action.

‘A post racial society will only be possible when mental health provision is properly resourced. Equally, the mental health crisis will never be solved until racial disparities are addressed within provision’

Five days ago, the Commission on Race and Ethnic Disparities published a statement by way of reply to early criticism of their original findings in their report published on 31 March 20211. Criticism included the report not going far enough to acknowledge institutional racism across a range of sectors such as education, housing, policing, and health.  As well as the part played in a person’s experience within the mental health system. 

Criticism also reflected the findings shifting responsibility away from institutionalised and structural racism and historic precedents creating a lasting culture of acceptability onto Black and ethnic minority communities themselves, denying that racism continues to impact on individuals.

Whilst the report found lack of racism in the field of psychiatry “The Commission does not believe that the evidence it reviewed offers support to claims of discrimination within psychiatry”. Data referenced within the document demonstrates the disparity of Black people and their white counterparts face within mental health treatment.

“The Wessely Review found Black people were 8 times more likely to be subjected to community treatment orders than White people, and 4 times more likely to be detained. Figures from the Race Disparity Unit show there were 306.8 detentions per 100,000 for Black people compared with 72.9 per 100,000 White people (not adjusted for age and deprivation)2

As a charity representing the interests of those affected by bipolar disorder in the UK, we have now had the opportunity to digest the 258-page Commission on Race and Ethnic Disparities Report. We believe the report highlights real concerns about the experiences and treatment of people with bipolar of Black British, British Asian and ethnic minority backgrounds in mental health services. A detailed breakdown by mental health condition hasn’t been provided but the stark numbers do chime with the lived experience of many members of our community.

Racial trauma can lead to various mental health issues including but not limited to, “depression, hypervigilance, chronic stress, fatigue, bodily inflammation, and symptoms like PTSD4”. For example, on page 223, the report acknowledges the existence and impact racism has on parental stress and resulting intergenerational mental health conditions.

We and many in our field are acutely aware that the experiences of Black and Ethnic Minority people in mental health services is often distinctly different than the experiences of White people accessing these same services. Black people are four times more likely to be sectioned or detained under the Mental Health Act than White people3. In addition, Black people are also more likely to be given psychoactive medication instead of a talking therapy4.

Black men in the UK are also 173 times more likely than White men to be diagnosed with a serious mental health condition such as schizophrenia or bipolar disorder. This evidence shows a differential experience at play in the experiences of Black men, which may include such contributing factors for instance structural inequalities, unconscious biases, and institutional racism. Whatever unease may occur in recognising this, the facts remain; these are systemic issues. On page 223, the report confirms evidence that Black and Asian people with mental health needs are less likely to be receiving treatment and in accessing treatment may come through more negative pathways such as the criminal justice system.

These experiences compound the huge challenges they already face living with bipolar.

Despite progress in a number of areas, it is clear mental health remains one of the areas where ethnic disparities are at their greatest. Ethnic minorities, and Black British in particular, are paying the heaviest price for the historic underfunding of mental health services.

It is clear that a post racial society will not be possible unless mental health services are properly resourced. Equally, the mental health crisis will never be solved until racial disparities are addressed within provision.

To move forward hard and uncomfortable truths need to be recognised and properly addressed. Whether this is described as institutional racism, structural racism or systemic racism it is important to acknowledge that there is significant distrust of mental health services amongst ethnic minorities that needs to be overcome.

We believe this would be best achieved through proper resources to enable people with bipolar, from all ethnic backgrounds, to live well within the community. This includes increasing the recruitment and training of a multi-racial mental health workforce that can hold the trust of people from all ethnic backgrounds.

Recommendation 11 of the report - promote fairness, suggests creating a new Office for Health Disparities, and for the government to establish this by way of tackling inequality and improving life expectancy in the UK.  Working alongside the NHS the aim of this body would be independent with a remit to create a level playing field, along with research into disparities in mental and physical health outcomes for different groups and to improve on these for everyone.

Bipolar UK welcomes the opportunity to work with this body to ensure that people with bipolar from all ethnic minority backgrounds get the best possible service they are entitled to.

Bipolar UK has also launched its own Commission to look at the discrimination and trauma experienced by people living with bipolar. We will be actively seeking the views of Black British, British Asian and ethnic minority people with bipolar to ensure their lived experiences are fully captured in the report.

As a charity  we will endeavour to keep fighting for everyone with bipolar, regardless of their ethnicity, sexuality, gender and background, challenging all forms of discrimination in the mental health system.

 

1 https://www.gov.uk/government/organisations/commission-on-race-and-ethnic-disparities

 

2https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/778897/Modernising_the_Mental_Health_Act_-_increasing_choice__reducing_compulsion.pdf

 

Is there institutional racism in mental health care? - BBC News

 

4 https://www.bbc.com/future/article/20200804-black-lives-matter-protests-race-mental-health-therapy