After a long wait of three years, the government has published a White Paper responding to the Independent Review’s recommendations to overhaul the Mental Health Act’s (MHA) legislation on sectioning people against their will. But does it live up to expectation and what does it fail to address?
The response addresses a number of issues within the MHA but fails to fully scrutinise an element of mental health services that is severely holding it back: institutionalised racism.
This year, two reports preceded the government response to the MHA
First, the ‘Commission on Race and Ethnic Disparities’ or as it has come to be known, ‘The Sewell Race Report’ which was in large part in response to the Black Lives Matter protests following the murder of George Floyd in May of 2020. The second, from the Education Committee ‘The forgotten: how White working-class pupils have been let down’ which sought to examine the neglect that White working-class children and young people have experienced within state education.
The former was widely criticised due to its claim that institutionalised racism is not an issue in the UK. This claim extended to their attitude towards to mental health services. The report said, ‘there is no overwhelming evidence of racism in the treatment and diagnosis of mental health conditions.’
This was despite the inclusion of findings from the Wessely Review that stated ‘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.’
The latter report by the Education Committee, although an important step in acknowledging the severe implications of classism on young people’s lives was received negatively by many. Following the ‘Sewell Race Report’, the stance from the Education Committee that terms such as ‘white privilege’ have lead to the neglect of disadvantaged white pupils has been interpreted as creating a “culture war” by MPs such as Kim Johnson, Labour MP for Liverpool.
As our previous piece on the MHA White Paper Proposals explained in full, areas of focus from the government are on:
- Choice and autonomy – prioritising service user preferences with the introduction of ‘advance choice documents.’
- Least restrictions – to limit the Act’s power by increased scrutiny of how detentions are implemented and reviewed.
- Therapeutic benefit – detentions can only be actioned if they can provide a therapeutic benefit to the individual.
- Individual focused – a shift of focus toward in the community care and in the event of a detention a Care and Treatment Plan must be implemented.
Although the reforms present in the White Paper are stated as being ‘guided’ by racial disparities experienced when accessing mental health services, the response from the government does not currently go far enough in implementing actions to address the systemic racism that permeate the Mental Health Act.
The response by experts and professionals
The charity, Mind recently released a statement on this matter and emphasised that “The report fails to outline how it will address the…disproportionate detentions and the use of humiliating and life-threatening practices among people from certain racialised communities.”
The statement continues: “Too many people – especially Black men – have died as a result of those physical and chemical restraints while under the Act… Community Treatment Orders are 10 times more likely to be used on Black people.”
- See also: 'What did the public have to say about the Mental Health Act reforms?'
- See also: 'The Sewell Race Report fails the lived experiences of mental health service users'
- See also: 'Understanding the image – collective trauma, and the psychological impact of racism'
For our story on the ‘Sewell Race Report’ in April we spoke to Dr Dwight Turner from the UK Council of Psychotherapy. We have been in touch with Dr Turner again to gain his perspective on the government response, and it’s failure to acknowledge institutionalised racism.
What is your perspective on how the recent Government response to the Mental Health Act recommendations fails to address the presence of institutionalised racism in the Act?
“The Government’s failure to recognise institutional racism within the mental health service and therefore to consider its role in mental health provision for BAME communities is another layer of the denial of institutional racism originally positive through the Race Report, [the Sewell report] that was published earlier on this year.”
What do you think the narrative being developed by the Government from the Race Report and the report on White working class and now this MHA response tells us about how the health and mental health of Black, Asian and Ethnic Minority people’s is disregarded by this Government?
“These reports have run counter to numerous other reports, say from the Sainsbury’s Foundation, which have clearly stated that institutional racism is a massive problem within organisations and Government organisations within the UK.
“The level of institutional racism has therefore impacted on the provision and the type of provision afforded to clients from minority backgrounds and has led to the high levels of misdiagnosis, incarceration, and levels of repeated psychosis and even death experienced within said populations.”
“Having worked within mental health for BAME organisations in Southeast London, I have witnessed first-hand the experiences of BAME clients on the wards of hospitals and in the community and they have often talked about the level of racism and mistreatment that they have endured whilst within these services. To therefore deny that this even exists is a denial of their experience and is very, very disappointing.”
The refusal to tackle the issue as it is, as Dr Turner said will ultimately result in the wrong kind of support being given to service users and clients from Ethnic Minority backgrounds. It is only in accepting the size and seriousness of the problem of institutionalised racism within mental health services that the appropriate changes can be made. More reforms informed by racial disparities must be made, to scrutinise instances of misdiagnosis (especially of psychosis in young Afro-Caribbean men) and maltreatment.