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Health: Black and Minority Ethnic Psychiatric Patients

Volume 769: debated on Monday 29 February 2016


Asked by

To ask Her Majesty’s Government what steps they are taking to reassure black and minority ethnic patients, carers and users of mental health services that they are not being prescribed higher levels of psychiatric medication than those from other community groups.

My Lords, improving the experience, access and outcomes of mental health services for people from black and minority ethnic communities is a government priority. The Five Year Forward View of mental health services recommended the appointment of a new equalities champion. The Government have accepted the recommendations for the NHS and agree with the task force’s vision for the future.

I thank the Minister for his reply. In the last month there has been a government announcement on mental health. There is always a broad-brush approach to this subject. What we need to remember is that no two people are the same and that there are different cultures. People from the black and minority ethnic communities are treated differently when it comes to treatment and institutions where they are placed. That is a fact. There are more treatment options becoming relevant for people with severe, enduring mental health problems and it is not clear whether BME patients are getting access to these—for example, talking therapy. BME patients are more likely to be given higher doses of psychiatric medication. My question to the Minister is: what are the Government doing to ensure that BME patients are offered the same access to treatment options as their white counterparts, and not just psychiatric medication?

My Lords, although there is evidence that gender and ethnicity affect the efficacy and tolerability of some medicines, there is no evidence that people from black and minority ethnic backgrounds are prescribed a higher dose of antipsychotics. On the other hand, there is considerable evidence that many people from BME backgrounds are detained more, spend more time in in-patient psychiatric facilities and suffer greater seclusion, and that other aspects of mental health treatment for black and minority ethnic people are entirely unsatisfactory.

My Lords, I welcome the Minister’s comment that this is a priority for the Government, but is it not the case that this whole issue about the overrepresentation of black and minority ethnic people in the mental health services has been going on for decades and is a scandal? For example, Sarah Reed, a black woman who was incarcerated in Holloway when she was well known to the mental health services, was found dead in her cell in January. She was failed by the Prison Service, mental health services and the criminal justice system. Why are black and minority ethnic people far more likely to be locked up in prison instead of getting proper treatment?

The noble Baroness makes a very important point and that is why the Prime Minister has asked David Lammy to conduct an inquiry into this precise issue. In his recent report, the noble Lord, Lord Crisp, recommended that there should be a patients and carers race equality standard. The Five Year Forward View for Mental Health, produced recently by Paul Farmer, recommended an equalities champion. I hope that we will be able to do both those things in the near future.

My Lords, the Minister of State, Alistair Burt, said earlier this month that he would be meeting a wide range of stakeholders to look at BME groups and their unequal access to mental health services. Will the Minister confirm that those stakeholders will include faith community leaders? Black and minority ethnic people are also disproportionately members of faith communities. If those leaders could be trained in recognising the early signs of mental illness, perhaps more people would be referred earlier to the mental health services that they need.

My Lords, I will certainly have a word with Alistair Burt, the Minister of State for Health, who is having the meeting to which the noble Baroness referred. I will bring her comments to his attention.

My Lords, the Minister was chairman of the CQC so he will be well aware that the Care Quality Commission has a responsibility to lay before Parliament an annual report on the monitoring of the Mental Health Act, which it took over from the Mental Health Act Commission when it was abolished. The Mental Health Act Commission used to produce a biannual report with a very significant chapter on the details that the Minister just talked about—the disproportionate number of BME detained patients, the disproportionate use of antipsychotic drugs, and their use at levels above BNF recommendations. Why does the CQC not present that level of data and evidence any more on a yearly basis? Without the evidence and data, how can it take steps to tackle this important area?

The noble Lord raises an interesting point. I do not have an answer to his question except the straightforward, “I do not know”. I hope that when the WRES data on staff come through, they can be extended to patients and carers as well—as suggested in the recent report by the noble Lord, Lord Crisp. That information and evidence should then be made available.

My Lords, the Government seem to be setting great store by the fact that they are waiting for a review. It is well known that mental health services are massively under-resourced. Would it not be a good start to put some resources into those services?

My Lords, the Government are committed to putting more resources into mental health. There is a recognition, across all parties in this House, that mental health has been a Cinderella service for ever. We are all committed to parity of esteem between mental and physical health and more resources are now going into mental health.

My Lords, in his Answer, the Minister mentioned the Mental Health Taskforce report. It points out that, while there is a workforce race equality standard, there is no equivalent standard for access to services. He said that the Government will appoint a champion, but why not agree to set a standard and appoint a national director to make sure that it is implemented?

My Lords, there are two separate things there. We are committed to the recommendation of appointing an equalities champion. Extending the workforce race equality standard to carers and patients was recommended by the noble Lord, Lord Crisp, and welcomed by Paul Farmer in his report. I hope that we will adopt that recommendation, but I cannot promise it.