In Part 1 it was pointed out that black people seem to be getting a raw deal from the mental health services. Black people are more likely than white people to be admitted and detained within the mental health services. Significantly, the agencies pointing at the perceived injustices have not offered any explanations for the indifferent treatment of black people within the mental health services.
The system, as opposed to individual psychiatrists, was (according to research) to blame. I therefore, made an assumption that perhaps different socialisation and culture contributed to differences in the perception of aggressive, threatening or violent behaviour which led to the disproportionate representation of black people in the mental health service. It was also argued that the tools of measurement were based mainly in one culture and that did not always suit the minor population groups.
Part 2 will explore the different questions around the institutional racism claims. It sounds rather suspicious that a far-reaching conclusion about the discriminatory perception of a service will be made merely on the over-representation of a population group without giving objective explanations. Can we assume that black people are universally mistreated and white people are universally treated better within the mental health services?
In recent years two unfortunate cases in which young people died (Baby P and the seven year old girl, Khyra) made the headlines. The parents were white and black, respectively, and in both cases the parents’ mental health was questionable; indeed some people blamed both the mental health and social work services for the lack of supervision of the clearly needy parents.
I find it significant that both sets of parents were from a poor back ground. Do black people from all socioeconomic backgrounds receive poor treatment compared to white people from the poorest socioeconomic group? Can we assume that a privileged black person will receive worse attention compared to a working class white person? We need to see how mental health service performs across all social groups in Britain, not only black people. Only when it has been ascertained how different socioeconomic groups are treated can we reliably argue that black people only are indeed treated unfairly.
Is it black people or all ethnic minorities suffering undue unfairness within the mental health service? If all minority ethnic groups are unfairly treated then we can put the blame on the service. However, if only black people are the victims what is the reason for their targeting and why those from the Caribbean? Is it a coincidence that an ethnic group with less representation in the psychiatrists will be over-represented in the patient group?
BBC News (2007) reported findings of a research carried out by the Institute of Psychiatry in London to test if there was a racial bias in terms of doctors’ psychosis diagnoses in black people. Ethnicity details were removed and only symptoms presenting retained to be used by psychiatrists for assessment. Psychosis was diagnosed nine times more often in black people from the Caribbean (BBC News, 2007). This figure was consistent with the rate of this group’s presence within the mental health services. The findings of the research are quite significant in dealing with attitudes towards mental illness in black communities but caution needs to be advised as this is just one study when many more will be required.
The institutional racism as it stands now affects more blacks from the Caribbean than the rest of the racial group. One would hope that if only the system were racially faulty, the effect of the bias would be felt equally by all black people coming into contact with the mental health services. On the other hand, if racist psychiatrists were working within an equally racially biased system there would be a higher chance that only a specific group would be affected yet the motive remains a myth! As has been noted earlier, there is no evidence that psychiatrists compromise their clinical judgement on racial grounds.
I do accept that there is a problem within the mental health services regarding the treatment of black people but I have doubts the problem of racism starts there. A look at the socioeconomic indicators of black people in Britain today will surely illustrate a higher level of deprivation within black communities. Black people are most likely to be unemployed, unskilled, living in single parent households, involved in drug dealing and abuse of cannabis. Arguably, these people are by virtue of their lifestyles more likely to be exposed to stressful situations and eventual mental breakdown. We have to look at removing the predisposing factors while improving the mental health services. I believe no amount of change within the mental health services will solve the current problem if black people are still unemployed, living in poor housing estates lacking in essential facilities such as good schools, GP services and community centres.