Black patients seeing psychiatrist for first time should have advocate, government urges

March 15, 2007
by Mike Jones

Black patients having their first appointment with a psychiatrist should be accompanied by an advocate, the government is urging.

A new Department of Health guide outlines how it believes service providers can meet the requirements of a race equality action plan aiming to eliminate the discrimination of black and ethnic minority people within NHS mental health services

The guide states: “For patients from African-Caribbean communities, fear of services can be particularly acute.

"Having an advocate (with expertise in translation where necessary) on hand during the first interview can help to settle and ease a patient into care."

Mental health minister Rosie Winterton has said there is “no excuse for inaction" for service providers who do not meet their duty to end discrimination.

In 2005, a five year action plan, entitled Delivering Race Equality In Mental Health Care, detailed how the government plans to root out anti-discriminatory practice in mental health.

The guide, entitled Positive Steps - Supporting Race Equality in Mental Health Care, lists numerous examples of existing good practice.

However, the Commission for Racial Equality announced last month that it has launched an investigation into whether the government's planned new mental health law might break race law.

Critics say a mental health bill, due to be introduced before the House of Commons after Easter, will fail to address discrimination, including the disproportionate rate that black people are being compulsory detained.

Read for yourself:
Department of Health's Positive Steps guide (pdf)

See also:
Oct 2, 2006: Mental health racism claims "meaningless" and "insulting", claim psychiatry professors - social exclusion and low socio-economic status largely causes race inequality figures, argue Swaran Singh and Tom Burns
Dec 7, 2005: 'We'll end racism in mental health' says minister - Rosie Winterton pledge follows report revealing black people are three times more likely to be admitted to psychiatric hospital

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Not just psychiatrists

Comment from: David Glasgow, forensic clinical psychologist, self employed

Date: March 22, 2007

As far as I can see, the headline is inaccurate. Psychiatrists aren't specifically mentioned in the relevant section. This of course makes a lot of sense, because the first contact point between mental health services and an individual is often not a psychiatrist.

So, insofar as anything is "urged", it also applies to CPNs social workers etc. and also the non-specific professionals sometimes used to 'triage' referrals.

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This could stigmatise further black people

Comment from: David Bowker, retired consultant psychiatrist, Manchester

Date: August 7, 2007

Surely this suggestion if implemented would rather stigmatise the group involved. I don't think any of my former black colleagues (if we are forced to talk in those terms) would take kindly to this suggestion should they require the psychiatric services themselves.

There is also the problem of an advocate making it more difficult to engage in a direct and personal way with a patient. However, should anyone (irrespective of racial origins) feel the need for a friend or advocate to be present, then this could always be accommodated in the usual way.

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