Minority groups disproportionately impacted

Racial inequality

We know that people’s race and ethnic background impacts on their experiences of mental health services and being sectioned. Black people are four times more likely than their white counterparts to be detained under the Act and are more likely to be subjected to coercive treatment.

The reasons for this are complex, but evidence suggests that the over-representation of BME groups under the Act is the result of mainstream mental health services often failing to understand or provide services that meet their particular cultural needs, alongside a lack of staff diversity at senior levels, negative stereotyping and institutional racism.

I could not identify with a white, middle-class psychiatrist. I couldn't sit down friendly and talk about the issues that were affecting me, my rape, my beating up etc. that I'd gone through. I couldn't sit there and talk to this strange white, middle-class man. For a long time, I couldn't talk to any of them. Maybe one or two of the Black nurses…but they weren't the ones documenting and dealing with my case.

Multiple disadvantageSpeaking to people with experience of homelessness also identified a lack of joined-up services and the failure to understand multiple needs. People were not being taken seriously by services and they were not being given priority.Lack of access to servicesA recurring theme from our engagement work is that it is not until someone reaches crisis point that they are able to access the services they need, and even then, not always. People aired their frustrations of desperately needing help but being unable to access it because of the lack of services. One of our participants told us that they felt lost in the system because they were being transferred from place to place without getting the help they needed.While others spoke about their mental health deteriorating because of the delays in getting help, especially during the night and on weekends when many crisis services are closed.

"When you're homeless and you ask to be sectioned they just think you want a roof over your head. When you ask to be sectioned it's because you really need it. We're on the streets for months, we're used to it."

We heard an overwhelming view that earlier support from mental health services would often remove the need for detaining someone under the Act.

Police intervention

Many people we spoke with questioned the need to involve the police in order to access mental health services when they reach crisis point.

African Caribbean people are more likely than the general population to access mental health services through contact with the Police rather than through the health system, which is the main route to treatment for most people. Participants from our focus groups pointed to the lack of trust in the police from BME communities being related to previous incidents of institutionalised racism and discrimination towards Black people; this distrust is transferred when being detained.

Some people told us that contact with the police was found to be intrusive and unpleasant, for example one participant shared her experiences of several Police Officers invading her home to detain her son and entering his bedroom after they were asked to leave.