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Census reveals unprecedented levels of racism within the NHS

by Matilda MacAttram
9/12/2005

The findings of the first national census of mental health hospitals has revealed unprecedented levels of racism is having a devastating effect on health and the well-being of Black communities who come into contact with the service.

Lee Jasper quoteThis census confirms once and for all that mental health services are institutionally racist and overwhelmingly discriminatory. They're more about criminalising our community than caring for it.quote
Lee Jasper Chair of the African and Caribbean Mental Health Commission

Launched by Health Minister Rosie Winterton at a National Conference on BME (Black and Minority Ethnic) mental, held in London this week the census report entitled ‘Count Me In’ has surpassed the worst fears of community leaders, while confirming suspicions that Black people are more likely to be locked up on secure psychiatric wards despite having similar rates of mental illness as other ethnic groups.

The Count Me In census is the first national ethnic census of inpatient mental health services. It is part of Delivery Race Equality (DRE), the Government’s five year plan for combating racism with mental health services. Rolled out partly in response to the allegation of racism in the NHS, which hit the headlines last year after Sir John Blofeld, chair of the independent inquiry into he death of David ‘Rocky’ Bennett stated that the NHS is institutional racist. The Bennett report is one of the latest in a long line of reports that exposed what Blofeld described as the ‘festering abcess’ of institutional racism within the NHS.

David Bennett died in psychiatric care after he was forcibly restrained by five nurses for 25 minutes. Census findings show that Black men are 29% more likely to be subjected to physical control and restraint and are 50% more likely to be secluded than white men.

Pathways into care are also more traumatic, census findings indicate that Black people are twice as likely to be referred to psychiatric services via the police or judicial system and are up to 44% more likely to be detained under the 1983 Mental Health Act.

Appalled by these figures Lee Jasper Chair of the African and Caribbean Mental Health Commission told the audience of professionals, service users and carers at the launch of this report: ‘this census confirms once and for all that mental health services are institutionally racist and overwhelmingly discriminatory. The routes Black people are force to take into the system proves that mental health services are more about criminalising our community rather than caring for it.’

Mental Health Act Commission chairman Professor Kamlesh Patel admitted: ‘this census demands an explanation. Until these reason become clearer, it is unwise to draw premature conclusions.’ Black mental health experts disagree, David Robertson, chair of the Brent Black African and Caribbean Mental Health Consortium told Blink: ‘I don’t think that these figures demand an explanation – I think these findings demand action.’

National Ethnicity Census for Mental Health Services Panelists at launch of the first National Ethnicity Census for Mental Health Services

There is widespread concern that DRE does not have the resources or genuine backing at the highest level to make any significant changes to the daily discrimination Black people using mental health services are subject to. ‘DRE is all very admirable and we will all sign up to it but what precisely will have changed in a years time from the figures that we see today.’ Jasper asked. He called for a commensurate response to this crisis rather than more policies and frameworks and a commitment to anti racism and driving down these figures. ‘These figures are appallingly bad and call for an institutionalised response to the problem of institutionalised racism. This means giving up power to either Black community organisations, Black staff within the organisations and Black service users,’ Jasper explained to a stunned audience.

Consultant psychiatrist professor Sashi Sashidaran sat on the panel of the Bennett Inquiry he was saddened at these figures but confessed that he has anticipated bad news along these lines and pointed out : ‘Without setting specific targets for clinical services nothing is going to improve. Since mental health modernisation reform began 10 years there has been a 40% increase in mental health budgets over the last three years with just a fraction being set a side for BME programmes..’

The reason for this is very clear Professor Sashidran explained: ‘having diversity management and policy changes which seems to be the focus of DRE and the Focused Implementation Sites (FIS) does not actually make health care organisations like the NHS really challenge discrimination.’

Like Jasper he is adamant that there has to be a commitment at the highest level of the DOH to take on the anti discriminatory agenda within mental health. ‘There was a refusal to acknowledge the existence of institutional racism within the NHS. If it doesn’t start with that and if there is no acknowledgement of what the problem is no matter how much you talk about delivering race equality it is not going to happen,’ professor Sashidaran added.

Jasper agreed: ‘ the response has to be one of political leadership from the top and a commitment to anti racism and driving down these figures.’

quoteWe spend 4.5bn on mental health in this country, which is a huge amount of money and there is absolutely no ring fenced money for BME mental healthquote
Consultant psychiatrist professor Sashi Sashidaran

Health campaigners believe that this crisis in BME mental health is a result of a clear failure of leadership in this area. ‘They can’t keep on saying things are going to get better the Modernisation Programme started with the publication of the National Service framework in 1999 they have had six years to get it right’ professor Sashidaran pointed out.

The Government’s refusal to implement any of the Bennett Inquiry recommendations in any meaningful way over a year it was published and the findings of the Government’s own Advisory group condeming their lack of acknowledgement of the important of the Bill for Black people confirms the lack of commitment around this issue.

With no performance targets in relation to BME mental health or quality standards in place or additional funding there are grave fears that it is clear that this situation will only get worse.

‘We spend 4.5bn on mental health in this country, which is a huge amount of money and there is absolutely no ring fenced money for BME mental health. This is a serious issue and substantial changes will not come about and they are necessary it the current pattern continues.’ professor Sashidaran added.

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Resources:

pdf The recruitment and retention of BME staff in the NHS

pdf Race Equality Foundation briefing: The impact of racism on health inequalities

pdf Race Equality Foundation briefing: Effective communication with service users

pdf Race Equality Foundation briefing: Improving the quality of palliative care

MIND: Rights Guides

pdf BME Needs Assessment: Diabetes and Hypertension

pdf Independent Inquiry into the death of David Bennett

pdf Draft Mental Health Bill

Links:

Nightingale Declaration

hyper GUIDE to the Mental Health Act.

MyHealthnet

Black People's Mental Health Association

Cancer Black Care

Black and Asian Therapists Online

African HIV Policy Network

National BME Mental health Network

The Afiya Trust

BMESpark

Fanon Care

The Federation

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