Pledge to Reduce Ethnic Inequalities in Mental Health Systems

Welcome to the UK’s first national pledge calling on senior leaders in NHS mental health trusts, public bodies and commissioning to declare their commitment to reduce ethnic inequalities in mental health care systems. The pledge also has supporters, largely from the NGO and BAME voluntary and community sector, community groups and mental health activitists who have the expertise to partner with senior leaders to help eradicate ethnic inequalities in health and social care. Join us and be part of the wider network.

Synergi Collaborative Centre Stroke

Black, Asian and minority ethnic (BAME) communities are facing disproportionate risks in mental health services that require urgent action, intent, shared vision and collaboration.

The context is stark. Ethnic inequalities in mental health care are longstanding and exceptionally large, disadvantaging BAME people in access, care, treatment and outcomes.

BAME people have a higher risk of experiencing ‘symptoms’ of psychoses, an even higher risk for a diagnosis of a psychotic condition, are more likely to experience adverse pathways to and through care, are subject to coercion and restrictive care, compulsory admissions and treatments, and poorer outcomes and follow-up.

Undeniably, the cost of coercive care is great, financially, but also in terms of trust and confidence in mental health and social care systems. The Black Lives Matter movement, and the worldwide protests in response to the killing of George Floyd, have resulted in renewed calls to address institutional racism. This makes it even more urgent to achieve a fair and equitable mental health system. This is why it is now time for action.

We believe it is unacceptable that despite 30 years of research, inquiries and reviews into this issue, a staggering 80% of recommendations made to address this problem have not been implemented fully. It is unacceptable that despite longstanding and pervasive ethnic inequalities, there are no plans for meaningful and sustainable change.

This ‘Statement of Intent’ is a call for commitment from CEOs and medical and nursing directors of NHS mental health trusts, commissioners and public bodies.

As senior leaders of mental health services and commissioners of mental health care, we will:

  1. Initiate fundamental service level changes to reduce ethnic inequalities in access, experience and outcomes.
  2. Measure, monitor and report the nature and extent of ethnic inequalities and progress made.
  3. Work in partnership with local BAME communities, service users and relevant community agencies.
  4. Provide national leadership on this critical issue.
  5. Ensure inclusive and sustainable change in our localities and communities.
  6. Support timely and progressive research and policy development.
  7. Contribute to a biannual progress update as part of this Statement of Intent.

Some of this work is already underway in different parts of the country. For example, South West London and St George’s Mental Health NHS Trust, in collaboration with Wandsworth Community Empowerment Network, is implementing an Ethnicity and Mental Health Improvement Project, in a co-produced partnership with local stakeholders, including a range of diverse and multicultural community and faith networks.

Leeds City Council, NHS Leeds Clinical Commissioning Group, Leeds and York Partnership NHS Foundation Trust and a local stakeholder group of NGOs, BAME voluntary organisations, community groups and activists, are collaborating with Synergi’s Creative Spaces model to tackle ethnic inequalities in the risk and consequences of severe mental illnesses among the city’s BAME population.

Greater Manchester Health & Social Care Partnership (made up of all NHS organisations and councils, emergency services, the voluntary sector, Healthwatch and others, including the Mayor of Greater Manchester) has been working to reduce the ethnic inequalities gap. As part of their Covid-19 response the Partnership has collaborated with local BAME organisations and provided significant funding for critical mental health services for ethnic minority communities in the county.

We note that making the necessary changes will be complex and will take time. However, the scale of the task should not deter us from making a start in true partnership with communities across the health care systems.

This ‘Statement of Intent’ is an opportunity to pursue systems change as part of a constructive, bold, transparent and collective voice.


Tom Riordan
Tim Ryley
Chief Executive
Dr Sara Munro
Chief Executive
Cllr Rebecca Charlwood
Victoria Eaton
Director of Public Health
Jim Barwick
Roisin Fallon-Williams
Roisin Fallon-Williams
Dr Hilary Grant
Medical Director
Dr Navina Evans
Dan Barrett
Sarah Blow
Accountable Officer
Vanessa Ford
Acting Chief Executive
David Bradley
Sir Richard Leese
Evelyn Asante-Mensah
Clare Parker
Executive Director of Nursing, Healthcare Professionals and Quality Governance
Dr Nihal Fernando
Medical Director
Claire Molloy
Chief Executive
Dr Tom Tasker
Dr Sandeep Ranote
Medical Director
Helen Bellairs
Simon Barber
Joanne Hiley
Executive Director of Nursing and Quality
Joanne McDonnell
Executive Director of Nursing and Governance
Dr Alice Seabourne
Medical Director
Neil Thwaite
Gill Green
Director of Nursing and Governance
Andrew Maloney
Director of Human Resources and Deputy Chief Executive
Rupert Nichols
Warren Heppolette
Executive Lead