Why The System Is Failing

the Mental Health

Recently, we discussed the evidence demonstrating the need for improved cultural competency. Drawing from a number of modern studies, we gave an overview of how mainstream mental health services, such as the NHS, and the model of one-size-fits-all support, are failing to meet the needs of minority groups seeking to access healthcare.

Following on, we’d like to take a closer look at the challenges individuals face and specifically why Black individuals, a social group who are statistically most likely to be diagnosed with mental health issues, are, in many cases, least likely to receive support and experience recovery.

We mentioned that the majority of therapists, that is members of the British Association for Counselling and Psychotherapy, are White. The disparity is quite large (86% White compared with 3% Black) and poses a number of issues for Black people seeking mental health support.

A great deal of mental health issues experienced by Black individuals are related to racism, as well as White hegemonic systems. For such individuals to access mental health services only to be faced with a White therapist, being expected to open up and talk intimately about such experience, places an obvious hurdle in front of their pathway to recovery. In addition, there is also an established culture of mistrust, with many Black individuals having not only their own unfavourable experiences but also those handed down to them generationally.

Black people who do engage with the mental health system are nine times more likely to be admitted to hospital, four times more likely to be detained under the Mental Health Act, and eight times more likely to be treated in high-security wards. While the reasons for these disparities are understandably complex, they can often be due to misdiagnosis, extensive wait times, and, ultimately, discrimination. It is a landscape that deters many from accessing support and, instead, promotes alienation from the system.

Short of appropriate cultural competency and diversity training, it is often the case that cross-racial pairings of White therapists with Black patients experience a number of hindrances rooted in bias. White therapists are likely to experience discomfort or lack the cultural insight appropriate to support Black patients, an issue that manifests itself in microaggressions, creating an environment detrimental to the patient’s recovery and wellbeing.

The NHS remains embroiled in such issues of racism. Alongside many accounts of infrastructure being more accommodating to White medical staff (BAME staff members generally see less secretarial and staff support), there is the continued perception that Black and other minority patients are ‘second class’. Numerous accounts detail examples of such prejudices and yet, due to the nature of systemic racism, few individuals are ever held accountable, making it difficult for Black people to see value in complaining.

As Dr. Richard Majors states, “People of colour often see the therapeutic process as a humiliating experience.”

This, however, should not paint the picture that Black communities no longer seek mental health support. In addition to demonstrably and persistently wanting to engage with mental health services, Black communities are also in greater need of such support, facing a greater likelihood of mental health issues than others, which is why the system’s failure to offer due support is an undeniably massive problem that faces the NHS.

As many services continue to write about inequalities and issues facing the UK’s mainstream mental health support system, established and diverse endeavours, like Bristol Counselling and Psychotherapy, also seek to offer high-quality therapy, with a team of accredited therapists who, together, demonstrate dedication to cultural competency.

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