Report says mental health racial bias in England and Wales is ‘inexcusable’

Lawmakers and colleagues said ministers should use legislation to address an “unacceptable and inexcusable” failure to address racial inequality in the use of the Mental Health Act.

The joint committee on the draft mental health bill says the bill did not go far enough to tackle the failures that were identified in a landmark independent review five years ago, but which still persist or may even worsen.

In the UK, blacks are four times more likely than whites to be detained under the Mental Health Act (MHA) and more than 11 times more likely to receive a community treatment order (CTO) in the UK – eight times higher in 2018. , based on NHS statistics for 2021-22.

Some minorities are also more likely to stay in detention longer, be detained more than once, and be detained by contacting emergency services or the criminal justice system.

The committee noted that the MHA’s landmark 2018 review by Prof Simon Wessely – to which the bill is a response – aimed to address racial and ethnic inequalities, but that these problems have not improved since, and that “by some key measures, they are deteriorating rapidly”.

Lady Buscombe, chair of the committee, said: “We believe stronger measures are needed to bring about change, particularly to tackle the racial disparity in the use of MHA. To date, failure is unacceptable and inexcusable.

“The government should strengthen its recommendation on enhanced selection and give patients a legal right to require a pre-selection document stating their preference for future care and treatment, thereby empowering both patient choice and their voices.”

The report, released on Thursday, says the orders should be lifted for most people, as CTOs represent “the sharpest racial disparity in the use of the law” and evidence of their overuse as an alternative to discharge and doubts about their effectiveness. . Suggested exceptions are for those participating in criminal proceedings or convicted and their continued use needs to be reviewed.

Other key recommendations include the explicit requirement to respect racial equality in the bill, and mandating healthcare organizations to appoint a responsible person to collect and monitor ethnically disaggregated data on detentions under the MHA. These should feed the annual figures published by the government and policies that reduce inequalities.

The committee heard evidence that it is difficult to pass legislation to directly impact racial discrimination, particularly where legislation such as the Equality Act and the public sector equality mandate already exists.

The report states: “While it may be difficult to legislate on unconscious bias or for clinicians to take into account the experience of minority groups, the code of practice considers those who use the MHA as a guiding principle that the following factors – the ‘celebration of anti-racism in Europe’.’”

The Committee also recommended stronger mandates be given to bodies appointed to ensure the provision of adequate community services to end the inappropriate long-term detention of persons with learning disabilities and autism.

A Department of Health and Social Care spokesperson said: “We are taking action to address the unequal treatment of people of black and other ethnic minority backgrounds with mental illness – including by tightening the criteria by which people can be detained and treated as community members. .

“The government will now review the committee’s recommendations and respond when the time comes.”

Leave a Reply

Your email address will not be published. Required fields are marked *