Behind the headlines

When the Stephen Lawrence inquiry reported four years ago, it
spoke of institutional racism not just in the police but in the
public sector as a whole. So has the situation improved? As far as
NHS mental health services are concerned, apparently not much.

According to National Institute for Mental Health in England
chief executive Anthony Sheehan, the NHS is institutionally racist
and we should not tolerate it.

Sheehan was giving evidence at the inquiry into the death of
mental health in-patient David Bennett, a 38-year-old African
Caribbean patient who died in 1998 in the Norvic Clinic, a medium
secure psychiatric unit in Norwich, after being restrained by

Asked what difference he could make, Sheehan said: “I do not
believe this organisation can tackle all racism in the NHS, but it
will begin to tackle it in mental health.” He said the NIMHE would
have a strong black presence, with 12 more appointments being made
by the end of the year. Only two of the institute’s senior
managers are from ethnic minorities.

Karen Squillino, primary prevention co-ordinator,
“Institutionalised racism is an entrenched problem in all
public sector agencies. If changes are going to occur, we need to
acknowledge our unwitting prejudices – a bitter pill to swallow.
Coupled with this, we need to see public sector agencies having a
legal requirement to deliver affirmative policies on race and
service user participation in the development and evaluation of

Bob Hudson, principal research fellow, Nuffield Institute
for Health, University of Leeds
“Back in 1998, health secretary Alan Milburn promised that
the government would not tolerate racial discrimination in the NHS,
but little seems to have been done. Evidence of embedded racism
seems to be multiplying, whether it be allocation of merit awards
to consultants or the harassment of front-line staff. Just as
worrying is that most of these incidents go unrecorded. One is
reminded of Sir Roy Griffiths’ description of community care as
‘everyone’s distant relative but nobody’s baby’.”

Martin Green, chief executive, Counsel and Care for the
“Undoubtedly the system has difficulties dealing with the
particular needs of black and ethnic minority communities, and
there needs to be far more work done on how best to ensure these
groups receive appropriate care. However, I do not think it is
helpful to simply appoint more staff from black and ethnic minority
groups. What we need are examples of how the system is failing and
of the differing needs of black and ethnic minority groups.”

Bill Badham, development officer, National Youth
“In the 1980s, research in Nottingham ‘proved’ black
people were more prone to madness than white people. What do you do
when reciting prayers is diagnosed as psychosis? Asian groups set
up Awaaz (Voice), a statutory-based, multi-disciplinary community
mental health service, offering mother tongue counselling and group
work, providing shared understanding and support, not western
diagnosis. Awaaz and its offshoot Naizingagi (New Life), are still
going strong and show that racism in mental health services can and
must be tackled.”

Julia Ross, executive director for health and social care,
London Borough of Barking and Dagenham
“Many black and ethnic minority people with mental health
problems suffer a double whammy when their health suffers, and this
is often compounded by racism. Sadly, there is no evidence that
this is getting better. As chair of Maca, the Mental After Care
Association, I know that the King’s Fund is about to publish the
rerun of its research into the London scene for mental health,
which it is anticipated will show no progress. The key to making a
difference is stronger support for those voluntary organisations
that support black and ethnic minority people in local

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