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Fear is preventing black people from engaging with mental health services, according to a report by the Sainsbury Centre for Mental Health.

It highlights how staff view black service users as potentially dangerous and the ways in which black service users perceive services as harmful. The report refers to staff and black service users' perceptions as "circles of fear".

The report reveals service users' fears about being admitted to hospital, and their feeling that involvement with mental health services could lead to their deaths. It also states that prejudices against black people can affect risk assessments and result in an emphasis on medication and restriction, which can lead to clients becoming reluctant to ask for help or comply with treatment. This can lead to harm, reinforcing existing prejudices and provoking more coercive responses.

The survey of more than 200 black service users, carers, professionals and police finds that stereotypical views of black people, racism, cultural ignorance and the stigma attached to mental illness often undermine the way mental health services assess and respond to African and Caribbean people.

Black people consider mainstream services to be inhumane and unhelpful, and do not feel their voices are heard. The report finds that they tend to come to services too late, often when they are already in crisis, which can also have the effect of reinforcing the circles of fear.

The report makes 15 recommendations, including a proposal for the National Institute for Mental Health to create and fund a national programme of mental health promotion aimed at black people.

It also suggests that health and social care agencies should identify practical steps to encourage black people to take up early services in community settings. Also, health and social care agencies should ensure equal access for black people to appropriate counselling and psychotherapy services.

- Breaking the Circles of Fear from 020 7827 8352