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It is now increasingly understood that structural inequities contribute to poorer mental health outcomes and wider adverse outcomes. 

*A note on terminology

Throughout this document we refer to ‘Black’ people as those having a Black African, Caribbean or any other Black or Black mixed heritage, Black with a capital ‘B’ is also a political term used to describe those who have experienced colonialism and anti-Black racism. We recognise that ‘Blackness' is not a monolith and that there are multiple ethnicities, cultures and identities that shape and influence mental health. To create a more comprehensive picture, there is still more work to be done in disaggregating data on Black people's mental health experiences in the UK. However, action should always be taken to recognise and respond to unique and diasporic experiences.

Many mental health initiatives, reforms, and services have not yet been able to address the needs of Black people[1] who experience mental health problems in England. It is now increasingly understood that structural inequities, such as poverty and inequality, contribute to poorer mental health outcomes. Due to historical and current injustices, these social determinants disproportionately affect Black communities. For example, Black communities are much more likely to live in lower- income households, experience housing insecurity, and face greater rates of unemployment, incarceration and school exclusions.

All these experiences significantly contribute and at times are the cause of mental ill health. The cycles of racism, inequity and mental ill health leave a harrowing impact which is felt and evidenced across the life course from inception through to older age.

It must be accepted that racism and discrimination are often at the heart of why Black people face inequities and there are growing calls for racism to be regarded as a structural and social determinant of health, including mental ill health.

There are actionable solutions to mitigate the impact of harmful social determinants on Black people’s mental health. We can invest in resources, dismantle unfair systems, and create a more supportive environment for all.

We have formed a collective to demand positive change, ensuring we break the cycle of a system which has continued to fail Black people when they are at their
most vulnerable.


By taking an approach that centres those most negatively impacted by the systems in place, we will see benefits for other impacted groups, and for society at large; showing that we all benefit when we address the needs of those most at the margins.





The Government should develop and implement a comprehensive strategy to
eradicate racism from society and appoint a cabinet level minister to oversee

The Government should establish and consult on a vision and action plan for dismantling racism. The appointed minister must have a remit across departments including DHSC to ensure anti-racism throughout Government. Progress should be communicated publicly and regularly to ensure accountability and buy-in from communities who need to see change.


The next Government must prioritise the reform of the Mental Health Act 1983.

Rates of detention for Black people under the Mental Health Act are significantly higher compared to other groups. Work has been underway to reform the Act
through a new Mental Health Bill. We are disappointed this was not included in the November 2023 King’s Speech, despite being a manifesto commitment, and legislation existing in draft form. We now call on all major parties to include such legislation in future manifestos and plans. This must include the statutory offer of
Advance Choice Documents (ACDs) to those previously or currently detained under the MHA and improved provisions and improved support for Black autistic people and those with learning disabilities.


The government should put an end to ‘hostile environment’ policies which harm or exacerbate mental health problems amongst refugees, asylum-seekers and migrants in the UK.

Evidence shows that refugees and asylum-seekers are more likely to report mental health problems than the local population. This includes greater levels of anxiety, depression and post-traumatic stress disorder (PTSD) (Mental Health Foundation,
2022). The mental health of this group has been further threatened by more than a decade of hostile environment policies which have significantly reduced access to basic rights and services for refugees such as employment, education, healthcare and banking. The recent Illegal Migration Act 2023 as well as the proposals outlined in the current Safety of Rwanda (Asylum and Immigration) Bill risk further traumatising refugee, asylum-seeking and migrant communities.


All NHS Trusts, VCSE and mental health service providers should embed NHS England’s Patient and Carer Race Equality Framework (PCREF) by March 2025.

To ensure services are improving and equitable, the PCREF seeks to hold mental health trusts and mental health service provisions accountable to evidence and mental health statistical data (Part 1); that they co-develop measurable and
practical improvement plans to deliver the six national organisational competencies (Part 2); and that they use the evidence of patient and carer feedback (Part 3). The PCREF parts work together to inform policy and practice development within all mental health services and this includes the development of innovative service models to respond to the needs of racialised communities across the mental health pathways and system.


The Department of Education should work with racialised communities to
develop and embed an anti-racist and diverse curriculum that incorporates the histories and contributions of all racialised communities in the UK.

Anti-racist educational settings that support student mental health foster a sense of belonging and inclusion and produce a range of positive academic outcomes. The Department of Education should work with schools and colleges to ensure they are aware of the intersections between gender, sexuality, race, socioeconomic position, disability, and neurodiversity, and provide support for teachers to work holistically with students.


Policymakers, academic institutions, and funders should actively invest in and engage with community research conducted by and for Black communities in a meaningful way.

This involves challenging racial hierarchies of knowledge production and
methodologies that perpetuate racism through centring racially-just epistemologies
and culturally sensitive research practices. Research on mental health conducted
by marginalised communities often generates far richer and more relevant insights.

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