Professor Kamaldeep Bhui, Director of Synergi, explains why the newly launched pledge to reduce ethnic inequalities in mental health systems is an important moment to action change, otherwise 'the usual practices will re-establish themselves to further compound and sustain racial disparities in health'.

Synergi Collaborative Centre Stroke

Why it is now time to eradicate ethnic inequalities

I’m delighted as Director of the Synergi Collaborative Centre to launch this powerful alliance between the NHS, local government, charity providers and BAME community groups in a national movement to transform mental health systems to be less institutionally racist, more enabling, thoughtful and inclusive; one that respects the workforce and acknowledges that all people need health care in the NHS.

This is a moment in which the defensiveness and disguises for racism have fallen away. Yet this moment will pass, if we are not mindful, meaning that the usual practices will re-establish themselves to further compound and sustain racial disparities in health.

Ethnic inequalities in the experience and outcome of mental illnesses are well established, and persist, despite efforts to focus on training, education and recruitment practices to ensure race equality.

The Covid-19 pandemic has exposed underlying structural inequalities in society, along ethnic and racial lines, as well as among front line workers and marginalised groups. These groups suffer more severe illnesses linked to Covid-19 and more deaths.

This higher risk of crisis and death are found, irrespective of employment and social status, showing how structural factors can still impact on people of colour who are perceived to be less marginalised.

Understanding how these structural inequalities arise requires the careful unpacking of colonial legacies, and the foundations of negative attitudes to racial and cultural groups, as well as the historical conflict and trauma inflicted on such groups. Trauma includes violence and war, but also economic sanctions, domination and different forms of slavery.

These legacies have shaped our society and conditioned our thinking, policies and processes, which continue to promote values and practices that are inherently linked and to societal, institutional and interpersonal racism.

The mental health system is one of many in our society, and therefore we need to take a systemic look at how to improve mental health care, by recognising the historical and traumatic legacies in the lives of people facing mental illnesses, as well as the current forms of disguised coercion and disempowerment, enshrined in our policies and practices.

Indeed, at times of austerity and financial crisis, it is the most marginalised who suffer the most and racism is often justified under the guise of active management or leadership in a crisis, which fails to recognise the hurt and harms which fall largely on the marginalised.

That is why we must act now to ensure there is sustained effort for systems change to eradicate racism in society, institutions and interpersonal care practices.

Join us: #ethnicinequalitiespledge

Photo credit: Sushil Nash