A collective failure for race equality in mental health
Posted Thursday 7 April 2011
Yesterday the last Count me in census survey findings were published. It's been produced every year for the past six years as part of the Government's commitment to tackling race inequality in mental health services.
This year, we can take a long term view and make a judgement: we've failed. We've failed to change the over-representation of people from black and minority ethnic communities detained under the Mental Health Act. Hospital admission rates are still higher among some minority groups and people from Black Caribbean and Black and White Caribbean communities spend more time in secure settings.
For many years, people from Black Caribbean and Black African backgrounds have been the most over-represented ethnic groups on mental health wards. The sharp increase in the latest census could be explained by a decrease in the 'Other Black' category. However, there is still a clear over-representation amongst these groups which doesn’t look like it’s going to change soon.
The report also shows, worryingly, that more people from mixed (black/white) parentage find themselves in mental health hospitals. The rate of increase is far larger than any other ethnic group. Given that those of mixed parentage are also among the youngest inpatients this trend will only get worse with time.
The data paints a rather bleak picture for those groups that remain massively over-represented on mental health wards. The whole mental health community has to take responsibility for this situation. The Government, mental health services, local authorities, charities, individual service users — everyone has tried hard, but it hasn't made any difference. Maybe the indicator was wrong, maybe the strategy was wrong. Either way, this report tells us an inconvenient truth — despite positive changes in mental health care, we still let down too many people from black and minority ethnic communities.
So, what next? 2011 is a chance to draw a line and look again. The mental health strategy, the new Health Bill, and changes to social care and personalisation are going to change the health and social care landscape. We must make sure that those changes are to the benefit of people from black minority and ethnic communities and not to their detriment.
The new Health and Wellbeing Boards at a local level must reflect the needs and diversity of their local communities — the Health Bill needs to embed this principle. The Centre for Mental Health highlighted particular issues around people in medium secure care, often out of their area, for whom hope and recovery are distant prospects, and who cost cash-strapped trusts unnecessary amounts. Local services need to be responsive to local communities — a number of voluntary organisations, including local Minds, work with community groups in community spaces, respecting cultural perspectives on mental health.
Our Time to Change campaign will be running a major pilot in Harrow working with the South Asian community to address issues of stigma and discrimination. This kind of approach needs to be woven across the mental health strategy, the new commissioning boards and local commissioning consortia. Our Care in Crisis campaign will seek to address issues relating to acute and crisis care services.
The Count me in census has helped to have a wider picture of inpatient and detained mental health care. The Care Quality Commission have helped paint a clear picture of our inpatient system. Now is the time for the mental health community to stand up and be counted, and work with people from all backgrounds to make change happen.
What have your experiences been? How could we all make change happen? Tell us what you think in the comments below.
Paul Farmer, Mind Chief Executive
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