Black groups take issue with D.H. over race impact assess meant on mental health bill

The controversy around changes to the UK’s mental health legislation looks set to run and run. Not only has the government had to scrap two bills because of vociferous protests, but proposals to amend the Mental Health Act 1983 are in trouble too, as campaigners from ethnic minority groups condemn the process by which the statutory race equality impact assessment is being carried out.

Mental health charity Mind says research data consistently show that a disproportionate number of people from ethnic minorities are subjected to compulsory treatment. Latest figures from the Healthcare Commission’s census show that black and mixed race people are up to 44 per cent more likely than average to be detained under the Mental Health Act. This makes participation by ethnic minorities especially crucial in the consultation about how the amended legislation will affect them as mental health service users.

But this is proving tricky, as the Black Mental Health Network has just withdrawn its co-operation from the Department of Health on the running of the consultation.

Network co-chair Marcel Vige says that he discovered, through a third party, that two parallel consultations were being carried out by DH officials. While the network was working with the DH in partnership – or so it thought – on the scope, implementation and facilitation of the assessment consultations, it found the department was organising its own events independently. This felt like a betrayal, echoing the sense of powerlessness that people from ethnic minorities have often faced within the mental health system.

“We’re arguing that the assessments are invalid without the input of the Black Mental Health Network,” says Vige. “They’re now saying that we’re running out of time, but the importance of this issue means you can’t  subordinate it to a deadline – especially as the DH has acknowledged and apologised for errors in the process.”

The DH has described the withdrawal as being down to a “temporary breakdown in communications over the timing of the events”. A spokesperson has stated that the department accepts responsibility for the problems and was saddened by the network’s decision to withdraw (see and search under “Marcel Vige” for more background). The DH says it hopes to restore a more collaborative approach before publishing the race impact report when the amending bill is put before parliament.

Without the backing of the network, the integrity of the assessment process becomes questionable, and Vige reports that the consultation events now being run unilaterally by the DH have been poorly attended and constrained in their scope.

If the wholesale pull-out by a key group representing the very people who the assessment is intended to serve wasn’t enough, there are also questions being asked about the integrity of a race impact assessment that only  looks at the amending bill proposals in their own right rather than their overall effect when implemented on the original 1983 act.

This legislation was never examined for its effects on and attitude towards service users from ethnic minorities. So with only a patchwork – and now discredited – consultation process taking place, it’s likely that the confidence among ethnic minority groups in the eventual legislation will be poor. With the DH firm that the amending bill must go through by the end of July – or,at worst, carried over into the first half of the next session, no matter how penitent it is about the consultation process, there seems little time left to build bridges.

Devon Marston, 48, is African-Caribbean and has been admitted to hospital for psychiatric treatment several times both under section and voluntarily. Founder of Sound Minds, the mental health music charity, he now campaigns on behalf of mental health service users from ethnic minorities.

“The law needs to be changed, or ethnic minorities will keep on being targeted. And it needs more service users to be consulted, rather than just ‘experts’. It’s the voice of those who are suffering that people need to hear.

“The first time I was sectioned was in my early twenties. Since I’d been living rough my health had been deteriorating, though I didn’t realise it, and my mum had called my GP. The next thing I knew everyone was saying I had to go into hospital. Then the police turned up, and I had no idea why – I thought I must have done something wrong. And of course now I know it was because they were sectioning me, and they’d brought the police just in case, because I was big and black. They thought I might be violent, though I’m not violent at all.

“I thought I was fine. So I went to see the nurse and I was like, ‘hi love, I’m all right you know, you’ve made a mistake, I’m fine, I’d like to go’. And she pressed a button and all of a sudden there were four big blokes who came and wrestled me to the floor and injected me with a tranquilliser. I was out for four days.

“There was never any chance to talk to anyone about the racism in the way I was treated. But things are gradually beginning to get better. You can express yourself a bit more. But there’s still racism and  aggression towards black patients, and the system doesn’t understand people from a different background.

“In future it should be about giving people from minorities services that are culturally applicable  to them. When it’s to do with your mind it’s not like physical health. You have to research and find out how someone’s different cultural background could have affected them in how they relate to the world. White people are offered more choices in how they’re treated, and that’s because the staff understand their cultural background.

“And also, there’s the plain fact that some people from ethnic minorities find it hard in school, so when doctors and nurses are talking to you, they can be using language you don’t understand because you’re not educated enough. That means people from those communities might not understand their treatment or be able to participate in making decisions and choices about it. That has to be acknowledged and made allowances for.”

Abina Parshad Griffin, 48, is mixed race and has been  a mental health service  user since her childhood.

Now an adviser to government mental health tsar Louis Appleby Abina is also chair of the Disability Rights Commission’s Mental Health Action Group. She is diagnosed with chronic post-traumatic stress disorder, psychotic depression and schizophrenia.

“I’ve been sectioned quite a few times and, yes, I have experienced racism. But you have to remember that racism can work in several ways; it doesn’t just come from white people. For instance, I was once treated by an Asian psychiatrist who said ‘the reason you’re messed up is because you’re mixed race’. Being mixed race is the worst of all worlds, because you also get racism from black people who look at you as not ‘pure’.

“It’s quite endemic in the system to think that if you’re mentally ill you must be stupid, and if you’re black and mentally ill you must be bloody stupid. And then, of course, when you’re sectioned you’re completely powerless, so when you experience racism you’re not in a position to say or do anything about it. There has to be a way found of  dealing with this so patients can report what is happening to them and have account taken of it.

“It’s not just staff. It’s other patients too, and all through the system. When I first became involved in service user involvement and  advisory type work in the trust, the [patient] panel was dominated by three white middle class service users. And they hated it whenever I brought up the issues of race and class and would make jokes about it.  It is as if when you bring up issues other people see as marginal – race, class, gender, the effects on mental health of living on benefits – you become a threat both to the system itself, and to other service users who are comfortable in that system.

“I spoke at one conference recently, sharing a platform with the mental health tsar. And I think I made him angry because, after he had said that the new amendments to the Mental Health Act will get through no matter what, I raised the point that, rather than worrying about the current amendments, we have to be careful about the issues stemming from the existing act that are already against the Human Rights Act, and get those sorted.”

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