Ethnic minorities have been treated woefully by mental health
services for too long. However, the government has now published
its Delivering Race Equality strategy to address this situation.
The question is, do the proposals go far enough?
Without doubt, the final draft is an improvement on the
original, which failed to acknowledge the structural change that is
needed in the whole mental health system. But, despite the
advances, fundamental problems remain with the strategy, and also
with the government’s delayed response to the David Bennett inquiry
which was combined with the strategy and published alongside.
First, there is a distinct lack of ministerial acknowledgement
of any institutional racism in the NHS. The report explains this by
saying “it is possible to hide behind the label of institutional
racism – to confuse the act of recognising it with real action and
reform”. But this is a retrogressive step back from the hard truths
in the McPherson report into the death of Stephen Lawrence. The
government has also missed an opportunity to build bridges with the
ethnic minority communities that have been alienated from the
mental health system by a history of poor treatment.
The emphasis on trusts being accountable for providing services
to meet local need is welcome, but there is an obvious sticking
point – the “tacking on” of refugees and asylum seekers. That these
groups have been included is an improvement on the original draft,
but there is little detail about how the specific mental health
issues of these groups will be met.
Most worrying, however, is the government’s rejection of the
three-minute maximum for restraining a person in a prone position,
lying face down on the floor. Prolonged use of restraint was a key
factor in the death of Bennett, and is believed to have contributed
to the deaths of others in secure settings.
Surely the disproportionate numbers of people from ethnic
minorities dying in such circumstances must be the priority of any
action plan. How else can the government meaningfully challenge
ethnic inequality in the mental health system?
Marcel Vige is development manager at Diverse Minds, the
ethnic minority unit of mental health charity Mind.