Report suggests unequal mental health treatment for black patients

A survey by the Healthcare Commission of equality in mental health services has drawn attention to disproportionate inpatient admission rates among black people of African and Caribbean origin.

The Commission’s Count Me In 2006 census, which interviewed 32,000 psychiatric inpatients, also found that black patients were disproportionately represented in the areas of:

* Involuntary admission under section 37/41 of the Mental Health Act
* Referral from the Criminal Justice System rather than health care services
* Duration of stay in hospital
* Use of hands-on restraint

In these areas, the survey found people of African and Caribbean origin “over-represented” in comparison with white, Asian, Chinese and other ethnic groups.

Last year, 40% of psychiatric inpatients were detained under the Mental Health Act on the day of admission to hospital and, of all those detained, 28% were from a minority ethnic group.

Those who identified themselves as Black Caribbean, Black African, Black Other, White/Black Caribbean Mixed and White/Black African Mixed were between 19% and 38% more likely than average to be detained.

The report’s summary states: “Patterns of mental illness and the ways in which mental health services are used vary considerably between different ethnic groups.

“Addressing this requires the active participation of several groups and individuals: politicians, policymakers, providers of services from all sectors, commissioners of services, users of services, carers, voluntary agencies and minority ethnic groups themselves.”

Responding to the census, Professors Kwame McKenzie and Kamaldeep Bhui of University College, London said the findings made “grim reading” for people of African and Caribbean origin living in England and Wales.

“These disparities reflect the way health services offer care according to racial group, and seem to satisfy the well established and widely known definition of institutional racism,” they said, in an article for the British Medical Journal.

“People who think that claims of institutional racism may harm patient care should be aware that until disparities and remedial action were seen through this lens no strategy existed for improving mental health services for black and minority ethnic groups.

“In response, a systems level approach called Delivering Race Equality has been developed to improve mental health services. Leadership is needed to ensure that it is taken up.

“But there is a danger that its impact will be undermined by other government policy, such as the proposed amendments to the Mental Heath Bill, and there are also wider questions about whether treatment is being offered and delivered effectively.”

To read the Healthcare Commission’s Count Me In 2006 census, go to