Mental Health: Over-representation of BME patients increases

The proportion of black and minority ethnic people in inpatient mental health services has risen for the fourth year running, a survey has revealed.

The fourth annual Count Me In census found that 23% of the 31,000 people receiving inpatient care in England and Wales were from BME groups, as of 31 March this year. The proportion has risen by 1% each year from the baseline of 2005, when the proportion was 20%, according to the survey by the Healthcare Commission, Mental Health Act Commission and the National Institute for Mental Health in England. 

According to the 2001 census, BME communities made up less than 9% of the population of England and Wales.

‘Unacceptable over-representation’

Campaigners branded the continued over-representation “unacceptable”, and said the results proved that racial discrimination was “deeply entrenched” in services.

In England alone, the likelihood of being admitted to mental health wards rose for people of mixed race Caribbean, black Caribbean, black African, Indian and Pakistani origins between 2005 and 2008.

Black Caribbean people were four and a half times more likely to be admitted than population numbers would suggest in 2008.

No progress on key targets

The report concluded that key targets to reduce admission, detention and seclusion rates, outlined in the Delivering Race Equality action plan, were not being met. The five-year plan to reduce racial inequalities in the mental health system was published in 2005.

The number of people from all BME groups detained under the Mental Health Act in 2008 was disproportionately high, “with no evidence of a decline”.

Black Caribbean and black African groups were more likely to be secluded from other patients, while those from mixed Caribbean and non-British white groups were subject to higher than average rates of restraint.

Racial discrimination

Care services minister Phil Hope admitted that services still needed to do more to tackle racial inequalities, but insisted that the DRE plan was already making progress.

However, Paul Farmer, the chief executive of Mind, was adamant there had been “no sign of movement” towards its goals. The situation, three years into the programme, was “unacceptable,” he said, “suggesting that racial discrimination is an entrenched problem”.

Simon Lawton-Smith, head of policy at the Mental Health Foundation, said the results were “disappointing, but not wholly surprising”.


The survey is part of a drive to improve statistical information on the ethnicity of inpatients.

A World Health Organisation report published in October found that England and Wales, along with Estonia, had the highest rates of BME over-representation in mental health hospitals among European countries.

Related articles

Special Report: black people over represented in mental health system
Expert guide to mental health

External information

Delivering Race Equality – an action plan for reform

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