The term ‘institutional racism’ was defined in the McPherson Report on the Stephen Lawrence Inquiry in 1999 as:
Though this phrase was coined almost 20 years ago it is still very relevant today – both in understanding recent high-profile scandals such as Windrush and in understanding the health inequalities experienced by those from minority ethnic backgrounds.
Jacqui Dyer, vice-chair of England's Mental Health Taskforce and founding member of Black Thrive – a partnership-based, cross-sector organisation based in Lambeth – recently gave an interview on Channel 4 news on the inequalities experienced by the black community in mental health services. It sparked some interesting debate and discussion on social media about mental health services with many recognising the discrimination experienced by black people, and others arguing that they too have experienced poor services but didn’t belong to the black community. The inference being it’s not just this community who experience poor mental health services.
To understand the issue more deeply it’s worth looking at the data presented on the Black Thrive website which tells a compelling tale. Black people are over-represented in the acute end of mental health services and more likely to die under restraint in police custody. They are also less likely to receive preventive services, a disproportionate number of black people are sectioned and they have a worse experience in detention, as was highlighted in the recent interim report of the Independent Review of the Mental Health Act.
From this data, we can see that black people have repeatedly experienced worse treatment by the system than other ethnic groups. This needs to be addressed systematically because it is a systemic issue that requires a move away from personalising the issue and looking more closely at how structural racism manifests itself in health, and in particular mental health, outcomes for marginalised groups. Reni Eddo-Lodge puts it very eloquently in her book, Why I’m no longer talking to white people about race:
Black Thrive has developed an approach to engaging the community in working towards preventing mental ill health and promoting positive mental wellbeing.
Some examples of the organisation’s work include the development of a whole-school programme to build mental health resilience in school-aged pupils, especially designed for pupils of black, African and Caribbean descent; a community champion programme that supports the black community to have the resources it needs to deliver/direct access to services that people trust and feel comfortable with; influencing strategies on wider determinants (tackling structural inequalities) via borough plans, housing strategy and tacking poverty.
While community groups are significant partners in resolving these issues, this does not absolve those who work in health and care from taking an honest look at the pattern the data is pointing towards (and themselves) and how their policies, processes and procedures are structured, which is contributing to marginalised groups being treated unfairly. This should be addressed systemically looking at issues of unconscious bias and institutional racism and working alongside communities that have first-hand experience of both the issues and the possible solutions which will lead to better services for all.
Hear more from Jacqui Dyer, Founder of Black Thrive, at our mental health conference in June.