Racial bias on mental health in England and Wales is ‘inexcusable’, says report | Mental health

Ministers must use the legislation to address an “unacceptable and inexcusable” failure to address racial disparity in the use of the Mental Health Act, MPs and colleagues have said.

The Joint Committee on the Mental Health Bill says the bill does not go far enough to address failures identified in a historic independent review five years ago, but which still persist and could even get worse.

Blacks are four times more likely than whites to be detained under the Mental Health Act (MHA) and more than 11 times more likely – up from eight times more in 2018 – to receive a community treatment order (CTO) in England, according to NHS statistics for 2021-22.

Some minorities are also more likely to spend more time in detention, face multiple detentions, and be detained through contact with emergency departments or the criminal justice system.

The committee says the landmark 2018 review of the MHA by Prof. getting worse rapidly.”

Lady Buscombe, chair of the commission, said: “We believe stronger measures are needed to bring about change, especially to address the racial disparity in MHA use. Failure to date is unacceptable and unforgivable.

“The government should strengthen its advance choice proposal and give patients the legal right to request a advance choice document setting out their preferences for future care and treatment, thereby strengthening both patient choice and their voice.” .

The report, released on Thursday, said that because CTOs represent “the starkest racial disparity in the use of the act,” and because of evidence of their overuse as an alternative to dismissal and doubts about their effectiveness, the orders should be lifted. for most people. The proposed exceptions concern those involved in criminal proceedings or convicted, for whom their continued use should be reviewed.

Other key recommendations include explicitly including a requirement to respect racial equality in the bill and requiring health care organizations to appoint a responsible person to collect and monitor data on MHA detentions, broken down by ethnicity . These should feed into annual government-released data and policies that reduce inequality.

The committee heard evidence that it was difficult to legislate to directly affect racial discrimination, particularly where legislation already existed, such as the Equality Act and the public sector’s duty to equality.

The report states: “While it is difficult to legislate for unconscious bias, or for clinicians to consider the experience of minority groups, the code of conduct can guide those using the MHA to consider these factors – that ‘anti-racism must be enshrined in serving as a guiding principle.’”

The committee also recommended stricter obligations on entities charged with ensuring adequate provision of services to the community in order to end the inappropriate long-term detention of people with learning disabilities and people with autism.

A spokesperson for the Department of Health and Social Care said: “We are taking action to address the unequal treatment of people of black and other ethnic minorities with mental illness, including by tightening the criteria under which people can be detained and subject to community treatment orders.

“The government will now review the committee’s recommendations and respond in due course.”

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