3: Frames and boundaries of race and ethnicity in Mental Health Act assessments


The subject of race inequality in mental health has been scrutinised by policy makers and researchers for decades. Despite government initiatives such as ‘Delivering Race Equality in Mental Healthcare’, there seems to be an intractability in relation to the closing equality gaps. In the midst of this, one of the decision makers in compulsory mental health work – the Approved Mental Health Professional (AMHP) – is at the sharp end of the data that attracts the sternest criticism: the higher-than-average rates of detentions of racialised minorities. Though solutions may be found in attending to socio-economic obstacles to equality in mental health, practising AMHPs need to have the skills to critique and amend their own practice so that they can take account of the antecedents of poorer mental health in the lives of racialised people whom they assess, and to mitigate against the impact of their own unconscious bias and prejudices. This chapter revisits the data in relation to ethnic inequality in referrals, pathways and outcomes from Mental Health Act (MHA) assessments for racialised minorities. Drawing on the latest research, key decision-making points are analysed to identify where biases may be affecting practice. Attention is given to unconscious bias and individual skills in challenging models, practice and policies that institutionalise the disadvantage of racialised minorities.

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