To mark #MentalHealthAwarenessWeek, which coincides this year with Black Inclusion Week, ARE’s Senior Communications Officer, Payal Bhavsar, sat down to talk with mental health and Windrush campaigner Patrick Vernon OBE about wellbeing, healing and mental health inclusion for Black communities. Patrick has been working with ARE for the last two years as a special advisor on our Windrush Justice Programme for people impacted by the Windrush Scandal.
You’ve been campaigning to raise awareness of mental health & wellbeing in Black people, and the current disparities that exist in our mental health services. What drives your advocacy in this area?
I’ve been involved in mental health campaigning, policy and improving services for a number of years.
Mental health and race equality matter for a variety of reasons.
If you look at the data that’s produced by the Care Quality Commission in terms of the Mental Health Act and overrepresentation, it’s been consistent for the last 30, 40 years around the use of Sections Two (detention for up to 28 days treatment) and Three (up to 6 months with further renewals) and Section 136 (removal from a public space by a police officer, for medical assessment).
Did you know?
Data from NHS England consistently shows:
- detention rates for Black or Black British people are over 3 and a half times higher than for people in White ethnic groups
- the use of Community Treatment Orders is over 8 times higher for Black or Black British people than for people in White ethnic groups
It’s also very clear that there is a lottery on Mental Health provision around the country, which needs to be addressed.
The type of culturally-specific services you get access to really depends on the NHS trust in your area.
10 – 15 years ago there were lots of Black-led mental health services providing support. There are actually not that many left now, especially in London, who provide services directly.
There are much more in the Midlands, believe it or not, such as ACCI based in Wolverhampton, which has been going 36 years now. But, all long-standing mainsteam Black-led mental health charities have now gone.
Why is this?
Nothing is sustainable. Funding runs out, key-personnel move on and change, so there is no consistent approach to delivery.
And then you have politicians saying things like “spending money on EDI is a waste of time.” They don’t understand that cultural competency is about making the landscape fairer for all, and making organisations and services more accountable to all the people they serve.
They don’t value the work that Black-led groups or Black leaders do as ‘real work’, they see it as a nice to have, an extra.
We have had a hot-cold scenario when it comes to investing in Black communities’ wellbeing: its ‘hot’, when there’s an emergency, or when government thinks we need it. We’re going through that cycle right now. Four years ago, everyone was saying we need to tackle structural racism, and have a strong approach to anti-racism but what has really changed?
They may have launched one off services, some new campaigns, but people get bored after a while, and move on.
The COVID-19 pandemic has brought mental health issues to the forefront. How has this global crisis impacted mental health awareness and services, particularly within Black communities?
The COVID-19 pandemic highlighted that everyone suffered from social isolation, anxiety, and depression, and that it was felt strongly by young people too.
It put the focus on another aspect of mental health – grief.
During the pandemic, so many Black and Asian families lost family members and loved ones, on a massive scale.
I worked with the Ubele Initiative and BAATN to commission Nafisyat to give free counselling services to Black and Asian people who had lost family members to COVID, whether directly or indirectly, and launched the Majonzi fund to help families commemorate the loss of loved ones and grieve properly: so many families weren’t able to process that grief in the ways that mattered to them due to the lockdowns.
This is a collective experience we’ve captured in an upcoming book called Black Grief.
It contains the stories of people who have lost family members because of COVID, but also speaks about Black women’s experiences of maternal grief, and the Grenfell Tragedy.
How have the stories helped you paint a picture of about the mood and attitudes of Black people in the UK when it comes to mental health?
So, we get to see two sides of mental health; we see individual interventions, experiences and attitudes, but also the wider context of collective wellbeing for whole communities.
There’s a growing recognition about community trauma as a big issue for Black people in the UK and there have been loads of examples of communal trauma and communities’ experiences of post-traumatic stress.”
The classic case cited in this is the Hillsborough Disaster, but actually, if you look at Grenfell, the Windrush Scandal, what happened to the teenage girl in Hackney who was basically strip searched at school, the experience of Black politicians like Diane Abbott, when she was threatened with violence in the public sphere, and the recent tragic events in Hainault which resulted in the murder of a young Black boy, these events trigger a lot of people, again and again, on a huge scale. They lead to an outpouring of feeling.
And we can’t forget, the murder of George Floyd back in 2020 triggered millions of Black and Brown people around the world, because it was such a clear example of the ongoing nature of systemic racism.
This has an impact on our sanity and our resilience as well, trying to thrive as a community in this kind of world.
Could you elaborate on the gaps that different groups within Black communities face in accessing mental health support? How do issues of intersectionality come into play?
There are lots of gaps. A lot of services still have a one size fits all approach.
So, if you look at the main interventions for Talking Therapies in the NHS, which are basically IAP services and CBT, they’re still very strange: even though they’ve made adaptations to reflect cultural differences, the approach is still based on a very strong Eurocentric model which does not reflect the needs, nor the lived histories and experiences, of different communities.
There’s also lots to consider around Child and Adolescent Mental Health Services (CAHMS).
A lot of black, young, Black and Brown children typically get access to mental health support through CAHMS. But, when they do get access, it isn’t always culturally appropriate.
There’s also particular gap around intersectionality.
We know there isn’t enough provision for Black and Asian women, who face another level of challenges when it comes to their own lived experience of sexism and misogyny in society. We also know there isn’t enough provision for Black LGBTQ+ people around their experiences and Trans people as well.
There’s so much more work to be done to reflect the intersectionality of the Black and Brown lived experiences, which is really important.
How are people trying to address disparities in mental health services? Are there any approaches or initiatives you can highlight?
One of the key things campaigners have been raising awareness of is that mainstream services and therapies do not recognise the history of enslavement, colonisation and unstructured everyday racism.
There are lots of Black and Brown therapists and organisations like BAATN, which bring together therapists who provide alternative models to the Eurocentric ones, and many other organisations [like Black Thrive, Black Minds Matter, Aashna] who are providing services out there with an anti-racist and intersectional lens, so that mental health services can be culturally relevant, particularly for Black people.
Psychiatric therapeutic services have also had a lot of attention, and people are working on changing it to make it more representative and introducing cultural competency approaches when it comes to early support and in prevention, which has been critical.
These community-led approaches give people agency to find solutions that suit them and, importantly, permission to feel they can share their experiences of emotional and mental health problems safely, with the professionals who understand and respect them as well.
But we still have a long way to go as a country. The overrepresentation I mentioned hasn’t changed fundamentally, particularly for Black men and also for Black women, but also for other communities such as a Muslim people.
Are there any examples of good practice that you can highlight?
One good example is the work that Hackney Council is doing. They recently asked me to chair a Community Advisory Board, for which we’ve just been doing interviews and recruiting people from the community. It’s called Hackney thinking Spaces, which aims to create safe spaces for discussing and dealing with the emotional impact of systemic racism on Hackney residents’ mental health.
This is a direct result of what happened to the teenage girl being strip-searched in Hackney about three years ago now. It’s a way to integrate community perspectives and experiences, into services that benefit Hackney residents.
You’ve talked about communal trauma. This is so keenly felt by the Windrush Generation and their descendants following the Windrush Scandal. Could you say more about this?
The Hostile environment policy, definitely from the perspective of Windrush survivors, and other refugees and asylum seekers, harms people.
It harms their mental and physical health. The way the policy operates is through the basis of intimidation and fear. These two factors impact people’s identity and sense of belonging.
Rochelle Burgess’ UCL project, Ties that Bind us, the first of its kind to explore the intergenerational mental health consequences of the Windrush Scandal on Caribbean and Black African families, has shown us that the metadata around health inequalities are very real and continuing.
From Left: Patrick Vernon OBE with Rochelle Burgess, Assistant Professor UCL, with Michael Braitewaite, at the launch of the Ties That Bind Us exhibition at the Black Cultural Archives. Exhibition runs until 9th of June.
Even people doing advocacy work with the Windrush Survivors are struggling too.
I remember years ago, I had a bit of a breakdown, because I was so overwhelmed by doing supporting survivors, doing media work, working full time. It gets to you. When you hear the stories, this concept called the Carer’s Liability applies.
You are capturing and internalising some of other people’s trauma.
This needs to be recognised, especially for funders who are funding projects that have a link to civil liberties/rights/social justice.
They need to build into the programme additional resources for those delivering the programmes and are employed to help others – not just things like supervision but access to therapists through work.
I’m currently working with ARE on a Windrush Manifesto which will talk about Mental Health as a key component of the redress and compensation that people receive because of the Scandal. There will be key demands in this manifesto on culturally sensitive services. A lot of Windrush Victims and their families need counselling support right now, and this is a conversation that politicians seem to avoid having.”
What do we need to do to move forwards?
There’s been a lot of work done to amend and reform the Mental Health Act. It’s on the Black Manifesto, and all political parties have said that they would make sure reforming the Mental Health Act is on the agenda.
We can all agree it needs to be made more compassionate.
But one key area that some people want to keep, but actually needs to go, is on Community Treatment Orders. Through these, Mental Health services can bring you into their services any time. They can bring you back, without going through a sectioning process. The fear/trauma of this always lingers, if you’ve been removed from your setting/context like this.
Ultimately, the changes we want to see all comes down to having proper resources and funding to groups, so that they’re culturally led, with Black and Brown-leaders properly supported and cared for.
Illustration by Dr Pen Mendonca capturing key demands from a vigil at Windrush Square on the 6th April 2024 commemorating those who have died as part of 6th anniversary of the Home Office’s Windrush Scandal
Authors: Payal Bhavsar & Patrick Vernon
ARE is working closely with advocates and Windrush Groups to provide culturally-specific consultancy and organisational development support which includes, as a key element, a focus on burnout, mental health and resilience. We acknowledge the emotional and psychological labour of all those working towards achieving racial justice for Black communities, and are learning from our programme participants how best to support them.
For further resources on this topic, see:
- The Black Grief and Healing: available to pre-order on Amazon
- Rethink Mental Illness: Windrush Generation and Mental Health
- The Black Mental Health Manifesto: calling for structural reforms to tackle disparities in mental health care for Black people
- BAATN: The Black, African and Asian Therapy Network