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Racism and mental health

If racism is affecting your mental health, we're here for you. Our information can help you understand the impact of racism – and choose how and where to seek help. If you're finding it hard to get the support you need, our tips can help you find a way forward.

20 minute read

Choosing our words

There is no 'one size fits all' language for talking about race and identity.

Group labels bundle many identities and experiences together. This obscures the fact that people in these groups don't all have the same experience of race. And we don't all face the same challenges. Some terms (like 'BAME') can feel particularly crude, or unhelpful.

Our approach on this page is to:

  • Be specific wherever possible, and avoid acronyms
  • Use descriptions purposefully in appropriate contexts
  • Use terms that our research suggests are widely understood and acceptable to people affected by racism

 

But we know that language is constantly evolving. The words we choose matter, and must grow with us.

Help us do better: use the Was this page useful? feature at the bottom of this page to tell us what you think.

Talking about race and racism

Racism means using the concept of race to judge or treat some people worse than others. It exists in many forms, and on many levels in society – including in healthcare. It can include acts of discrimination and prejudice towards individuals and groups. It can also describe wider systems of oppression.

For those of us who are disadvantaged and harmed by racism, this can feel stressful and upsetting to explain to those who are not.

You shouldn't have to.  

But it can also feel validating and helpful to find new ways to define and describe our experiences. 

Definitions of terms and concepts

Race is a label that groups people together based on similar physical traits, such as skin colour. Racial labels, like Black, were developed to wrongly define some of us as biologically different to others. This was a way of justifying violence and oppression. For example, the British Empire developed the idea of a racial hierarchy, with White people at the top, to justify colonialism and slavery.

But despite these roots, we may now feel that race describes an important part of our identity. We may connect and have a sense of solidarity with people who share our experiences of race and racism.

Race also has a definition in the law. The Equality Act defines race as including our:

  • Colour
  • Nationality
  • Ethnic or national origins

Ethnicity usually refers to a group of people who share a long-standing cultural, national or language identity. Race and ethnicity are different. But they are both included in definitions of racism.

Interpersonal racism is when a person treats you poorly or unfairly because of your race. This might be colleagues, classmates, strangers, service staff, and even family members or friends. It can happen in person or online.

Sometimes it's very obvious, with a clear intention to harm or offend. This is often called overt racism. It can include:

  • Being physically attacked or threatened
  • Being verbally abused, or called racially offensive names
  • Being bullied or excluded

But often racist comments or actions are more subtle, and may not be intended to cause harm. This is often called covert racism or microaggressions.

Covert racism can come from unconscious bias. This is when someone unknowingly accepts racial stereotypes, and this influences their behaviour.

But the lack of bad intention doesn't make experiencing this any easier to cope with.

Covert racism can be much harder to identify and challenge than overt racism. Especially when other people deny it, downplay it or become defensive about it. Or if you have an ongoing relationship with the other person.

You might find you're dealing with this often – even every day. And over time this stress can build up and affect your mental health.

Institutional racism is when an organisation treats us poorly or unfairly because of our race. This can be intentional or unintentional. Many organisations don't realise how their policies and practices disadvantage people.

But it is still racism, and it affects many aspects of our lives.

For example, it shows up in:

  • Education. Teachers aren't always supported to discuss diversity or Britain's colonial history in classrooms. Contributions from people from Black, Asian and other marginalised backgrounds aren't equally covered. School exclusion rates are also higher for students from Black Caribbean backgrounds than White students. Read Mind's Not Making The Grade report to find out more.
  • Criminal justice. Police are more likely to stop and search Black people than White people. Courts are also more likely to give Black people prison sentences for drug offences than White people.
  • Healthcare. There are significantly higher rates of infant and maternal mortality in Black and Asian communities. There are also examples of racism within the mental healthcare system.

A system is something that is made up of lots of different connected parts. So systemic (or structural) racism describes how experiences of racism in many areas of life reinforce and fuel each other over time.

At system level we can see the wider impact of the inequalities and power imbalances, for example those set up by colonialism. We see how these are maintained now in policy, law, economics, culture and wider society. And how this creates White privilege.

How systemic racism can affect individuals

For example – experiencing institutional racism at school as a child might make it more difficult to find work as an adult. Bias in hiring processes can make this even harder.

Then at work, institutional and interpersonal racism can be a barrier to promotion. These barriers can affect your income.

Not having enough money can have a negative effect on your health. This also contributes to people with first-hand experience of racism being under-represented in management jobs. Which makes it less likely that services will meet people's needs.

Health problems can then further affect work and income. Work, study, money, housing and physical health are all connected to our mental health. This creates a vicious circle of disadvantage.

Systemic racism and the pandemic

The coronavirus pandemic has highlighted the impact of systemic racism. Black and Asian people have been more likely to die from coronavirus.

Reasons for this include:

  • Employment inequality. Working in frontline jobs makes exposure to coronavirus more likely.
  • Income inequality. Having a lower income makes it more difficult to take time off work to isolate.
  • Housing inequality. Living in more crowded accommodation makes it more difficult to isolate.

Microaggressions are the most common form of covert, interpersonal racism. They can be very subtle.

They can include things like:

  • Implying that you don't belong, such as questions about where you're 'really' from
  • Making assumptions about you because of your race, like that English isn't your first language
  • Making assumptions about your heritage based on your skin colour
  • Making negative statements about people who are the same race as you, while saying 'but you're an exception'

Often microaggressions aren't intended to cause harm or offence. But that doesn't make this kind of racism any less painful to experience. The term 'micro' doesn't mean the impact on you is small.

It is still racism, and its impact can build up over time.

'Racial gaslighting' describes the way that some people or organisations deny or downplay the existence of racism. This discounts and undermines the reality of people's lived experiences of racism.

It might include comments like:

  • 'You're being too sensitive' or 'you can't take a joke'
  • 'You think everything is racism'
  • 'I don't see colour'
  • 'I can't be racist because....'

It could also include wider institutional denials of racism. Often despite all the evidence of inequalities between racial groups.

Institutional and systemic racism are hard to see from looking at isolated incidents. And microaggressions are often unintentional. Some people may not understand that this is all racism.

But having your experiences denied or downplayed by others is harmful. It can make racism even more difficult to challenge. And it can make it harder to cope with.

Colourism

Colourism is when someone treats you differently based on how light or dark your skin shade is. It's sometimes also known as shadism.

We are all exposed to subtle messages in society and the media about lighter skin being preferable. This can make some of us feel like our skin shade is too dark, or like our hair or features don't meet society's 'ideal'.

Those of us who are Mixed race may find we experience colourism in conflicting ways. We may be treated as 'too dark' in some situations and 'too light' in others. This can lead to feeling doubly excluded.

Casteism

Casteism means prejudice or discrimination on the basis of caste. We may experience casteism within South Asian communities if we are born into a caste that is traditionally considered 'lower'.

Caste is different from race. But researchers sometimes consider casteism as part of race discrimination. This is because it can have similar effects on our lives. It can also often overlap with colourism.

Islamophobia

Islamophobia means prejudice and discrimination against Muslims, and people assumed to be Muslim. It disadvantages people because of their perceived race, culture and religion. This is a form of racism.

Islamophobia also often overlaps with other forms of racism - for example based on skin colour.

Antisemitism

Antisemitism means prejudice and discrimination against people from the Jewish community. It disadvantages people because of their ethnicity, culture and religion.

Antisemitism is different to other forms of racism, such as racism based on skin colour. But it is still a form of racism, and it can have similar effects on our lives.

A privilege is any perk or advantage which is granted to one person or group of people, but denied to others.

So 'White privilege' refers to the day-to-day advantages that come from being White (or assumed by others to be White) and thus not facing racism.

Some people feel that this term is not clear enough, because it only links privilege to skin colour. But this kind of privilege can also apply to other racialised traits – like names and accents. It can also exclude people who are seen as White in some spaces, yet who do face all forms of racism. Like people from the Jewish community, and Gypsy, Roma and Traveller communities.

At Mind we use this term to convey that people who do not face racism hold privilege.

White people may experience prejudice, discrimination, stigma and disadvantage for many other reasons. But not facing an extra layer of disadvantage on the basis of one's race is still a privilege.

Anti-racism is taking action to challenge racism and promote equality. It is more than not being racist – it is about working against racism.

Allyship (being an ally) is when someone takes action to support a marginalised group.

To be an ally, a White person should:

  • Recognise their own privilege
  • Educate themselves about racism
  • Use their privilege to amplify marginalised voices
  • Work with marginalised groups to challenge racism
  • Speak up and actively challenge racism when they see or hear it

Decolonisation can mean many different things.

It can mean the historical end of colonial rule. But it can also mean challenging the cultural dominance of Western ideas over others. It can mean breaking down the lasting impact colonialism has had on society.

In mental health services, this can mean working to:

  • Recognise the dominance of Western ideas about mental health, including diagnosis and treatment
  • Highlight a variety of cultural ideas about mental health
  • Increase diversity in the mental health workforce

At Mind, we are committed to becoming actively anti-racist in everything we do.

Learn about our anti-racism work

Angela's story: the biases I face as a Black woman

Pen on an empty notepad

“The mental health professionals would double-check everything I said with my White male partner.”

How racism can affect your mental health

Experiencing racism can make us more likely to develop mental health problems. It can also lead to internalised racism and internalised colourism, and racial trauma.

Our experiences of racism are also personal to each one of us. And they intersect with many other factors.

You might find that you:

  • Face overlapping discrimination to do with other aspects of your identity, like your gender, sexuality or religion
  • Feel that some experiences apply to you directly while others don't
  • Feel differently about your experiences at different stages in your life

You are not alone. But your life experience is still unique to you.

“Even if race is a human-invented construction, we still grow up with race as a fundamental part of our reality” – Mind information reviewer

Difficult feelings and experiences

Racism can make us feel:

  • Unwelcome, lonely or isolated. Especially if people or organisations have said or implied that you don't belong.
  • Anxious, fearful and unsafe. You may worry about how people are going to perceive and treat you. You might feel visibly different and vulnerable when you are around lots of people of a different race. You may spend time thinking about how you'll protect yourself before entering certain spaces.
  • Angry or frustrated. Particularly if you're being treated unfairly, and if you feel powerless to control it.
  • Stressed. All kinds of racism can contribute to stress. This might be events such as sudden, unexpected abuse from another person. But it can also be a more long-term impact of encountering regular microaggressions. Or from the ongoing effects of systemic racism on your life. This can partly help explain links between racism and physical health problems, like increased blood pressure.
  • Unusual and strange. Especially if people highlight, mock or criticise things that are 'different' about you. This process of making you feel as if you don't fit society's norms is sometimes called being 'othered'.
  • Confused or unsure about whether you've experienced racism. This is especially true if others ignore or deny your experiences. It can make you question your reality. This is sometimes referred to as racial gaslighting.
  • Forced to suppress how you feel. You may find that you can't show or even fully feel your natural responses to your experiences. To avoid more abuse, and keep yourself safe, you may feel like you must not react to racism. This can leave you feeling numb, or mean that the experience stays with you for a long time.
  • Overwhelmed or worn down. You may encounter racism regularly in lots of different parts of your life. This can have a cumulative effect on your mental health. You may feel surrounded by racism.

“We get that agency of emotional response removed from us. All human beings react emotionally, but there you are, in that moment of being abused and you're having to stop the natural response of anger or sadness because you don't wanna escalate something.” – Isaac, member of our young Black men programme

Risk of specific mental health problems

Research suggests these experiences can also contribute to specific mental health problems, including:

If you experience any of these effects, it's important to remember that it is not your fault.

Being a particular race does not cause mental health problems. It is the racism you encounter in the world that may contribute to you feeling unwell.

Internalised racism and internalised colourism

Internalised racism is when we hold negative views about ourselves because of our race. Internalised colourism is when these views relate to our skin shade.

Both these experiences can:

  • Be conscious or subconscious. You might not realise that some of your negative feelings stem from internalised racism or colourism.
  • Contribute to the pressure we feel to change or downplay parts of ourselves. This can include our hair, clothing, accent or even our skin. When society compels people in a minority to act like people in the majority, it's called assimilation. It can feel like we must 'fit in', to protect ourselves from racism.
  • Feel constant, exhausting and disempowering. For example, we may feel like we have to play different roles in different spaces to stay safe. This is sometimes called code-switching.
  • Make us feel cut off from parts of our identity and culture. This can leave us feeling unsure about who we are.
  • Lead to low self-esteem and mental health problems.

Being Mixed race can make these experiences even more complicated. We may experience racism and colourism from multiple groups. And we may hold privilege if we're assumed to be White in certain spaces.

This can all lead us to hold contradictory views about our heritage and skin shade. We may feel both 'too much' and 'not enough' at the same time.

This internal conflict can feel very hard to manage.

“When you are a brown Hindu non-binary person, the impact of gender, race and religion on your mental health is stronger. There are constant reminders in the world of how you are different, from equal opportunities monitoring forms, to the way people look at you on the street.” – Jasmin, Mind blogger

Antonio's story: race, the police and my mental health

A young Black man wearing glasses and smiling, wearing a purple t-shirt and standing outdoors on a sport pitch on a sunny day

“I was treated like a criminal before I was offered support.”

Racial trauma

The impact racism can have on your mind and body is sometimes described as racial trauma.

There's no universal definition of racial trauma. Some professionals use it to mean all the effects that encountering racism can have on how we think, feel and behave. Others, like those using the race-based traumatic stress injury model, use it to describe a specific group of symptoms.

These include:

  • Feeling depressed or angry
  • Feeling very anxious, on edge and unable to relax (called hypervigilance or hyperarousal). For example, you might always be looking out for threats or danger.
  • Intrusive thoughts or flashbacks
  • Avoidance. For example, you might find it difficult to remember or talk about your experiences. It might feel hard to believe they really happened. You may also avoid people or places that remind you of your experiences.
  • Low self-esteem
  • Physical symptoms. For example, sweating, trembling or a racing heart.
  • Blaming yourself. There are many reasons for this. Sometimes it can be the way your brain tries to make sense of what has happened.

What you find traumatic is personal to you. You might go through something similar to someone else, but be affected differently by it. You might find it much harder or easier to cope.

“I considered it my fault that I got picked on.” – Mind supporter

Vicarious, historical and intergenerational trauma

Racism may also have a traumatic impact on you even when you didn't encounter it personally.

For example:

  • Vicarious trauma. This is when seeing or hearing about racism towards someone else feels traumatic to you. It may also bring back painful memories of your own experiences.
  • Historical trauma (or historical loss). This is when you're affected by the realisation of how your racial group has been oppressed over time.
  • Intergenerational trauma. This describes how racial trauma can get passed down in families across generations – from parents to children. This is a new field of study, and researchers aren't sure of all the ways this transfer happens. But we know that when our elders have been harmed by racism, this can affect us in turn. It can impact our self-esteem, sense of safety, and view of the world around us.

Some researchers say that racial trauma should be included as part of post-traumatic stress disorder (PTSD). Others say that it should be separate from PTSD, to reflect the specific traumatic experiences and effects of racism.

But however you choose to define your experiences, it is always ok to ask for help with your mental health. You shouldn't need to say specific things or use specific words to get support.

Ways to support your mental health

Finding support to cope with racism does not fix racism. Institutions and society as a whole must take responsibility for challenging racism in every form.

But seeking help can be an important step towards improving your mental health, and feeling better.

This section takes you through a range of options to consider, including talking to a therapist, peer support and self-care.

Therapy and counselling

Therapy and counselling involve talking things through with a professional. This can give you space to explore difficult feelings and experiences, including racism.

There's no specific recommended therapy for racial trauma. But you might find it helpful to explore:

Different people find different therapies helpful at different times. And the relationship you build with your therapist matters a lot. Whether they understand racism and are culturally competent can make a big difference to how helpful therapy can be.

The main routes to access therapy in the UK are:

  • Your GP. For advice on preparing for a GP appointment, see our Find the Words guide.
  • Self-referral. In some areas you can refer yourself to services directly. If you live in England you could use the psychological therapy service finder on the NHS website. Your GP might also give you details of self-referral services.
  • Private therapists. Private therapy is an option some people choose to explore. For example, the Black, African and Asian Therapy Network’s online directory lists therapists you could contact. There are details of more therapy directories on our how to find a therapist page. But unfortunately private therapy isn't realistic for everyone because it can be expensive.
  • Charities and local services. Some local services offer free or low-cost support. Hub of Hope lets you search for local services near you. You can also filter results using their 'BAME Support' tag. Mind's Infoline could also help you find appropriate local services.

Be aware that any therapy you're offered through the NHS will depend on:

  • Your particular needs, and your diagnosis (if you have one)
  • What's available near you

You might not be offered a choice, and waiting lists can be long.

If you're not able to see a therapist right away try our self-care tips while you're waiting.

There are many reasons why you might want to ask for certain people in your treatment – or avoid them.

For example:

  • You may feel unsure about opening up to a GP from your community, who knows your family. Or who you've had bad experiences with in the past.
  • If you've been abused, you may feel unsafe seeing anyone who is the same race or gender as your abuser.
  • Or you might feel that only someone from a similar background to you will be able to help you.

You are allowed to ask NHS services for what you want. It's a good idea to tell them your needs as early as possible, when first booking your appointment.

If it's possible for the service to accommodate you, they should. But unfortunately it may not always be possible. In this case some of the organisations on our useful contacts page may be able to help you.

In the private sector you may have more choice in who you work with. But this isn't an option for many people because of the cost.

Culturally competent therapy is when your therapist:

  • Understands the differences between race, ethnicity and culture
  • Understands your cultural practices and values – but doesn't make assumptions
  • Understands how racism can affect mental health
  • Respects any cultural differences between you
  • Sensitively reflects your culture and experiences in your treatment

For example, this might include them showing awareness of:

  • How racism, colourism and casteism affect people of colour
  • Common experiences that marginalised people go through in the UK – like the pressure to 'fit in'
  • Common family dynamics and values in collectivist cultures (as opposed to individualist cultures)
  • Key tenets of different faiths, and how beliefs may relate to emotional health - for example, for those us from Muslim backgrounds, the Islamic concept of jinn may be a factor in how we understand our experiences
  • Expectations and pressure around who we should turn to for support, like elders and spiritual leaders
  • The dates and traditions of important festivals

Cultural competence does not depend on your therapist's own race, culture or specialism.

And any type of therapy can be delivered in a culturally competent or culturally sensitive way.

But for services to improve, it's really important that:

  • Therapists seek to educate themselves on how racism affects mental health
  • Therapists get proper training to support clients from diverse backgrounds
  • Mental health services hire and promote professionals from diverse backgrounds

Often when you're offered therapy, you might not be sure who your therapist will be. It can take time to develop trust and confidence in them.

Here are some questions to consider, to help you decide if you feel comfortable with them:

  • Have they had any experience of supporting people with the effects of racism? You can ask them directly. A responsible therapist will answer your questions honestly and openly.
  • Do they seem open to learning about racism, and your culture, without making assumptions? For example, do they acknowledge what they don't know?
  • Do they take your experiences of racism seriously? For example, by being respectful and not downplaying or denying them.
  • Do they seem aware of their own privileges or biases?
  • Do they recognise how your experiences of racism may intersect with other parts of your identity? For example your gender, religion or sexuality.
  • Do you feel able to be honest about your experiences of racism with them? For example, do they help you feel at ease?

Our page on how to find a therapist has a list of more things to ask when arranging an appointment with a therapist.

Unfortunately, not all therapists are confident talking about racism during therapy. This can happen even if they have had some cultural competence training.

This may make it harder to develop a good relationship with them. In some cases you may end up feeling more upset, stressed or isolated.

If your therapist's approach isn't suiting you, it might help to:

  • Tell your therapist about any problems you're having with them. They might be keen to reflect, learn and do better.
  • Show them our information about how racism can affect mental health. It's your therapist's own responsibility to educate themselves about racism. But they may welcome new information.
  • Give it some time. It can take time to build trust. And some sessions may be more challenging than others.
  • Stop seeing them, or ask to be referred to another therapist. This might feel like the right option if they're often making you feel unheard, or unsafe.

Our page on getting the most from therapy has more tips.

If you have a serious concern about any treatment you've received, you can make a complaint.

Where can I find support?

 
There are many organisations that support people affected by racism. Some offer tailored services for specific communities. Our useful contacts page lists places to find therapist directories, peer support, and other kinds of support.
 

See useful contacts

Peer support

Connecting and sharing with others who have similar experiences can be very helpful. You might want to meet people who share your experiences of mental health problems, or racism, or both. Some groups run in person, while others are online.

To find a peer support group:

Whether you can join a support group may depend on what's available in your area.

The coronavirus pandemic has affected how some services can operate. Our coronavirus hub has information to support you during the pandemic.

Self-care to cope with racism

Self-care can be a powerful way to reject negative messages about your identity or your worth.

It's something you can control even if you don't have much time or money. You can decide when and how you show yourself kindness. And it can help build up your energy and strength.

“How are you choosing what you believe, and how are you choosing to ignore external perceptions of yourself? That resistance of internalised racism … I think it's quite important for all of us, finding our own ways to resist this.” – Isaac, member of our young Black men programme 

When you feel able, here some self-care ideas to try:

Speaking to someone who understands racism can be helpful. It may be that having someone listen to you and show they care can help in itself.

You may want to speak to someone you know. Or you might feel more comfortable speaking to someone you don't know.

Try and take time to praise yourself and think about what you're proud of. For example, you could think about your character traits, skills or things you’ve done.

See our pages on self-esteem for more tips

You could spend time thinking about what makes you happy and what you value in life. For example, you could think about any activities you enjoy or people you like spending time with.

This may help you get to know yourself and challenge racist assumptions about who you are and who you aren't.

You may also find it helpful to connect with people who share your racial identity, to enjoy and celebrate your culture.

Relaxation can help when you're feeling stressed, anxious or overwhelmed.

See our pages on relaxation for tips

Mindfulness is a technique you can learn. It involves making a special effort to notice what's happening in the present moment – without judging anything. It aims to help you feel calmer, manage your thoughts, and be kinder towards yourself.

It has roots in Buddhism and meditation, but you don't have to be spiritual, or have any particular beliefs, to try it.

See our pages on mindfulness for more information 

Getting creative can help you express thoughts and feelings that are weighing on your mind. You could use dancing, making music, painting, poetry, writing or any other creative activity.

See our page on arts and creative therapies

“I think even if you're just putting it down on paper, you're having more of that self-awareness, you're having that little conversation and reflection with yourself. That might just make it a bit less heavy in your head.” – Kai, member of our young Black men programme

Experiencing racism can affect our body as well as our mind. Physical health and mental health are connected, so looking after one can boost both.

Being active doesn't have to mean doing sports or going to the gym a lot – although that works well for some people. But there are plenty of things you could try on any budget – and at any level of fitness or ability.

See our pages on food and mood, physical activity and sleep problems for some ideas.

You may also find that spending time in nature helps improve your physical health and your mood.

Seeing news stories or social media content about racism might sometimes make you feel anxious or overwhelmed.

In this case, you could think about switching off or limiting what you look at for a while.

If a particular person on your social media is upsetting you, think about blocking them to give yourself space.

Remember: racist abuse or bullying online could be a hate crime. If you see racist abuse happen online:

  • If the site or app is moderated, you could report the user to the site.
  • You can report hate crimes to the police using the True Vision website.
  • If you don't want to go to the police, you might be able to report it through Stop Hate UK.

“... if I'm feeling unwell or something worries/upsets me, I turn off the laptop for the day.” – Mind supporter

You may find that examining your experiences is helpful at some times, but not at others.

It can be good to spend a while sitting with your experiences. But it's also ok to try and take a break from thinking about them when this feels useful.

Try to treat yourself the way you would treat a friend. And give yourself space when you need it.

Remember: different things work at different times for different people. If you've tried something and it hasn't helped, try to be gentle and patient with yourself. Over time, you might develop your own tips too.

“I used the Black Lives Matter movement as a gateway for empowerment. My mental health was affected negatively until I channelled my energy into something positive. The protests allowed us to make noise and together we will continue to be heard.” – Antonio, member of our young Black men programme

Racism in the mental health system

Everyone with a mental health problem deserves support and respect. But unfortunately we don't always get it when we need it.

Black and Brown people are less likely to receive appropriate mental health support in the UK than White people. Institutional racism can be a factor in this. 
 
That's not to say that every person of colour will have a poor experience of seeking help. Nor that every service will treat people unfairly. Excellent care does exist. And seeking professional help is often an important step towards feeling better.

But across the sector as a whole, we see evidence of:

When compared to White British people, people from minoritised backgrounds are:

  • More likely to experience a common mental health problem like anxiety or depression
  • Less likely to receive mental health support for these problems

This might be because the mental health system fails to build our trust. If we expect to face inequality and racism in these services, we might choose not to approach them early on.
 
It can also be difficult to find culturally competent support.

This might be because:

  • Services don't reflect a variety of cultural understandings of emotional and spiritual wellbeing.
  • Most healthcare services in the UK take Euro-centric views on mental health, and often aren't designed to meet the needs of culturally diverse populations.
  • Services don't recognise the impact of racism and systemic inequalities on mental health.
  • Services don't support people with racial trauma.
  • services don't hire a diverse professional workforce.

There is no biological evidence that Black people are more or less prone to certain mental health problems than other people.

Yet we still see inequality in who gets diagnosed with certain conditions.

For example, doctors are far more likely to diagnose Black people with schizophrenia than White people.

The possible reasons for this disparity may include:

  • Differences in stressful life events which make mental health problems more likely - including experiences of racism and racial trauma.
  • Differences in access to support early on, before problems become more severe.
  • Unconscious bias and lack of cultural competence among doctors. Some doctors may interpret similar symptoms differently in Black patients and White patients. They may make assumptions based on racial stereotypes. This may lead them to diagnose some conditions more or less often in Black people. For example, there's also some evidence that White doctors may be less confident diagnosing depression in Black people.

For example, healthcare professionals are:

  • Over four times more likely to section Black people than White people. Being sectioned under the Mental Health Act means that you can be kept in hospital against your will.
  • Three times more likely to restrain Black people, or hold them in isolation while in hospital.
  • Over ten times more likely to subject Black people to a Community Treatment Order (CTO). Under a CTO you must follow some rules after leaving hospital, or you will have to go back in.

There are many reasons for this, but one factor is racism.

There is a racist stereotype of Black men as being dangerous, or 'needing to be controlled'. This may bias the decisions professionals make about their Black patients.

Find out about Mind’s work to challenge the discriminatory use of the Mental Health Act.

Inequalities in access, diagnosis and treatment all contribute to worse mental health outcomes.

For example, compared to White British counterparts:

  • People from a Black Caribbean background who have had psychosis are more likely to find their symptoms come back again, and sooner.
  • People from a Bangladeshi background are less likely to feel better after trying talking therapy for anxiety or depression.

Colin's story: Mental Health Act review

“When they look at me they don't see Colin... they see a catalogue of Black men who come off this stereotype of being big and dangerous and angry.”

Overcoming barriers to getting support

Seeking help for your mental health isn't always easy. It can be especially hard when services aren't designed for you, or if you encounter racism within the system. It can be distressing and tiring to feel like you've tried everything and still not got the support you need. Or to feel like you're being re-traumatised by the services you've asked for help.

But it's important to remember that you don't deserve to be treated unfairly.

Whenever you feel able, here are some ideas for trying to find a way forward:

The service may not realise they aren't being inclusive. They may be able to reflect, learn and do better. If speaking to them informally doesn't get outcome you need, you can take things further.

It is illegal for UK healthcare providers to discriminate based on your race. If you think you've been discriminated against, you can make a complaint.

But we know that complaining might not always feel like a safe or effective option. If you're unsure, call Mind's Legal Line. We can help provide information about the laws related to mental health.

Advocacy means getting support from another person to help you express yourself, and stand up for your rights. Someone who helps you in this way is called your advocate.

See our pages on advocacy for details of advocacy organisations that may be able to help you.

Take a look at our useful contacts page to see if there are any other services who could support you.

For example, some local Minds offer tailored support for people from diverse backgrounds.

The Black, African and Asian Therapy Network lists some free and subsidised services that might be able to help.

You may find it rewarding to find ways to campaign against racism. It can feel helpful to have your say on how to make things better, and be heard.

Our useful contacts page lists campaigning organisations you could approach. You could also campaign with Mind for a fairer system.

If nothing is working, you may feel like you are becoming too stressed or exhausted to challenge injustice.

In this case, you might choose to focus on self-care and peer support for a while. That's ok. It doesn't mean you are accepting racism or poor care.

But you are the expert on what's best for your wellbeing right now. You can always try again when you're ready.

 

About this information

Published: July 2021
Review planned: December 2021

We worked with 20 people with personal experience of racism to develop this content. We are deeply grateful for their support. All quotes are shared with permission from our focus group participants, reviewers and bloggers.

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