Abstract
‘While everyone is entitled to their own opinions, they are not entitled to their own facts' (attributed to Daniel Patrick Moynihan). The President of the Royal College of Psychiatrists recently reiterated the College's determination to tackle institutional racism in psychiatry, as defined in the MacPherson Report (MacPherson, 1999). This reaction was prompted by a paper suggesting that racism was perhaps not the only explanation for ethnic differences in rates of psychosis and detention under the Mental Health Act 1983 (Singh & Burns, 2006). Although not providing a scientific criticism of the BMJ paper or any evidence to the contrary, the President stated that the paper risked setting ‘psychiatry back by 20 years’ (Hollins & Moodley 2006).
Highlights
Racism in mental health servicesA person from a minority ethnic group who has a serious mental illness is not given an adequate diagnosis, not provided with a coherent treatment plan, not offered appropriate treatment and does not have their needs met
The MacPherson Report defines institutional racism as ‘the collective failure of an organisation to provide an appropriate and professional service to people because of their colour, culture or ethnic origin
The Ritchie Inquiry into the care and treatment of Christopher Clunis (Ritchie et al, 1994) recorded a catalogue of similar shortcomings. From his very first contact at Chase Farm Hospital where ‘the opportunity for early diagnosis and possibly effective treatment was lost’ (p.14) to a desire by social workers ‘not to stigmatise a patient, or label him in any way as violent or a difficult person, which it was felt might work to his disadvantage’ (p.19), the care provided to Christopher Clunis gives salutary lessons on what happens when objective clinical assessments are made subservient to socio-political concerns
Summary
A person from a minority ethnic group who has a serious mental illness is not given an adequate diagnosis, not provided with a coherent treatment plan, not offered appropriate treatment and does not have their needs met. How would similar failures manifest in mental health services? Such failures occur repeatedly over many encounters with the services, and several clinicians individually and collectively contribute to the poor decisionmaking. These experiences are replicated nationally for patients from minority ethnic groups
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