Mental Health Services: Black and Minority Ethnic Communities

Lord Bishop of Worcester Excerpts

Tuesday 28th November 2017 Lords Chamber

[The Lord Bishop of Worcester]

My Lords, I, too, am very grateful to the noble Lord, Lord Boateng, for securing this debate and, like the noble Lord, Lord Ouseley, pay tribute not only to his eloquent introduction but to all he has done in this area. We owe him a great debt of gratitude.

Some of the evidence which has already been cited—there is lots more— concerning black and minority-ethnic individuals and mental health is a dreadful indictment of our society. One of the most shocking statistics to me is that UK minority-ethnic individuals are 40% more likely than white Britons to come into contact with mental health services through the criminal justice system rather than through referral from GPs or talking therapies. There have been a number of explanations for these differences, including limited awareness of or reluctance to engage with statutory services at an early stage of illness, possibly due to previous poor experiences, the belief that services are not culturally appropriate, or the stigma around mental health in some communities. Cultural differences in how mental health is perceived may also decrease the likelihood of individuals seeking care before reaching crisis point.

However, it has been recognised that differences in treatment for individuals experiencing mental health issues also arise from what is politely described as cultural differences on the part of the onlooker—in particular in relation to a number of high-profile cases involving Afro-Caribbean men, to which the noble Lord, Lord Boateng, has already referred. The problem arises from racialised views of a black man being more aggressive or out of control. Such views are racist and a terrible indictment on our society.

It is good that organisations working with black and minority-ethnic communities around mental health have recognised and responded to many of these issues. Understanding them and highlighting best practice, as has been indicated, is crucial to tackling poor mental health outcomes in black and minority-ethnic communities. I fear that the Church’s record has not always been good in its attitude to mental health or indeed, in its attitude to black and minority-ethnic people. We are now working very hard on both, and I hope that we have something positive to offer.

Medical Ethics: A Christian Perspective, published by the Mission and Public Affairs Council as a position paper, articulates salient theological themes informing Christian approaches to healthcare in general and adumbrates four guiding ethical principles arising from them: affirming life; caring for the vulnerable; building community; and respecting the individual. I make reference here only to the imperative to affirm life. That is to say that every individual life has purpose, value and meaning, even if some individuals may doubt that for themselves. It also means that we wish to see everyone attain the highest quality of life possible in whatever circumstances they find themselves. A civilised society is one that fundamentally affirms life and ensures that this and other benefits and protection are fairly experienced by all its members.

In practice, of course, this means giving particular attention to vulnerable individuals and groups. History indicates that the powerful will often neglect or abuse the vulnerable unless strong and specific action is taken to protect them. Caring for the vulnerable, however, goes beyond issues of protection. It includes ensuring that vulnerable people are supported, cared for and enabled to live fulfilled lives, and being afforded the same respect as other members of society. That is what is at stake here. You do not have to be a Christian to sign up for all that.

As the noble Lord, Lord Boateng, suggested, most people agree on what needs to be done—on both sides of this House, in the other place, and in wider society. If we are to be a truly civilised society, we need to put resources into ensuring that these problems are properly addressed. The noble Lord, Lord Boateng, has suggested some sensible, practical ways forward while we await the outcome of the welcome inquiry into mental health legislation which the Prime Minister has announced.

What can the Church do? We have been looking at this as part of a black and minority-ethnic concerns mental health project. In Breaking the Circles of Fear, the Church of England Mission and Public Affairs Council published a report in which we make it clear that in addition to church leaders, church workers and chaplains becoming more fully aware of mental health issues among black and minority-ethnic individuals, we want to ensure that cultural competence is displayed by all those ministering to individuals with poor mental health.

That could have a large effect on wider society. The Church has a ready-made network of communities, buildings and pastoral contacts that we want to utilise in helping to design and deliver culturally appropriate and accessible services in collaboration with local communities. Being embedded in communities, the Church can play a leading role in helping to educate both communities and health professionals with regard to health issues. At all levels the Church can be a voice for the voiceless, helping to reduce the stigma often associated with early mental illness, and thereby helping to address the problem of the lack of early intervention among black and minority-ethnic individuals.

I stand with the noble Lord, Lord Boateng, in commending the Prime Minister’s initiative on mental health and in pressing for the question of patient care to be addressed in the meantime, before the independent inquiry reports. I hope that the Minister will be able to give assurances on this.