Mental Health

The Strands of Equality

Sometimes referred to as ‘The Six Equality Strands’, these are the characteristics which are protected by law under The Equalities Act of 2010.  Despite this, we still have discrimination and this can have a huge impact on mental health and the treatment of mental ill health.

Mental Health and Sexuality

LGBTIQ+ stands for lesbian, gay, bisexual, trans, intersex, queer or questioning. 

The LGBTIQ+ communities face discrimination, stigma, bullying, hate crimes and social isolation.  Because of this, mental health conditions such as depression, anxiety, suicidal thoughts and substance abuse are more common.

It’s quite frightening to think that up until as recently as 1990 homosexuality was classed as a mental illness by the Word Health Organisation. So it’s not surprising that even now one in eight LGBTIQ+ people report feeling discriminated against when accessing health services.

Transsexualism has only just been removed from the ICD11 (international classification of diseases) which is good news for the transgendered community as it is no longer viewed as a mental health illness.

Mental Health and Gender

There are many differences in the way that men and women experience mental distress.

Men are more likely to die by suicide than women and women are more likely to experience depression. There are a variety of complex reasons for this so I’ve listed a few below.

Men are more likely to suffer from substance abuse which increases the risk for suicide.  They’re also less emotionally literate than women and will bottle things up.

Women are the largest single group of people affected by PTSD because of the massive amount of sexual violence they are victims of.

Women are also more likely to be diagnosed with depression because of patriarchal society but also because of gender bias in treatment. I.e. they are more likely to be diagnosed with depression even when scoring the same as men on standardised tests.

Mental Health, Race and Ethnicity

Institutional racism exists in society which negatively impacts the mental health of those from Black and Minority Ethnic backgrounds and the help that they receive.

Mental Health and Age

As people age, their role in society changes and so does their health.  Friends and relatives may pass away, children leave home, there may be money worries and they may feel isolated or not useful anymore.  

Suicide is more prevalent in men aged 44-49 and depression is more prevalent in older people.

Among younger people, self-harm and eating disorders are more common.  Schizophrenia is more common in young people aged 16-25.

Mental Health and Disability

Physical disability can have a negative impact on someone’s mental health. They may feel isolated because they cannot participate with other people in physical activities such as sport.  There may be problems accessing buildings or transport. And for those with learning disabilities, there may also be problems with communication and coping skills.  A person with a mental health condition that significantly impacts their life for 12 months or more is considered a disability and so that means they are protected from discrimination by law.

Mental Health and Religion or Belief

Having a religion, belief or spiritual practice is actually a protective factor for many. People who have a strong spiritual belief are less likely to die by suicide, suffer from depression or abuse substances.

There can be negative effects though, including feeling guilt and the need for forgiveness.  There can be stigma in expressing poor mental health in many religious communities.  A few religious groups have extreme ideologies and if you suffer from poor mental health, you’re more vulnerable to their extremism and more likely to become a victim of radicalisation.

Mental Health

Racism and Mental Health

The International Day for the Elimination of Racial Discrimination is observed annually on the day the police in Sharpeville, South Africa, opened fire and killed 69 people at a peaceful demonstration against apartheid “pass laws” in 1960.

Racism has had a huge impact on my life, from the age of 7 to 17 I suffered direct racial abuse from people in the streets and systemic racism from school, the police, and also the mental health system.

Even  though I struggled with poor mental health, and racism was a clear factor in this, it was never brought up by social workers or medical professionals. It seemed that my reaction to racism was the problem rather than the racism itself. And when I questioned it, I was deemed a troublemaker or I “had a chip on my shoulder”. I remember one psychotherapist who was keen to know about my experiences growing up as a mixed ethnicity child adopted into a white family. He was convinced this was the cause of my problems but was unconcerned when I told him “my family are great, they weren’t the ones abusing me”. He had no interest in hearing about me being regularly attacked by skinheads and squaddies (I grew up in a barrack town) or about being held back in schools, in sports or later in my career.

After the death of George Floyd, and because of the blatant racism I have experienced over the years and the racism I was now seeing online from the yoga and wellness communities, I was inspired to create my own anti-racism training. I am on the faculty teaching this for the leading yoga training provider in the UK, Yogacampus, and other large yoga training providers.

So what do we know about racism and mental health?

Your Race and Ethnicity have a clear link to mental health from exposure to more risk factors, access to services, how you are referred, diagnosis given and treatment outcomes.

Harassment, discrimination, bullying, social isolation, poverty, migration, trauma, unemployment, poor housing, homelessness, family history, stress and in particular social stressors and inner city life are all risk factors for mental ill health ill. And if you’re from a Black or minority ethnic background, guess what? You’re more likely to be affected by them.

What does the science say?

Leading researcher in this field, Dr Robert Carter, showed that many individuals who have suffered racial discrimination experienced it as a form of trauma similar to post traumatic stress disorder (Carter et al. 2009).

A more recent study examined this further and showed a relationship between racial discrimination and dissociation, which is disconnection from thoughts, feelings, memories, identity, surroundings and time.

Thankfully there is now a growing body of high quality research studying the effects of racism on mental health and even though there were clear links shown in previous research for some reason this was ignored.

What do the stats say?

  • People from Black and minority ethnic backgrounds felt the possible financial costs of therapeutic interventions were too expensive since the majority of Black and minority ethnic people were from poor socio-economic backgrounds.
  • Historically, ethnic minorities have been more likely to be prescribed antidepressants and other forms of medication rather than psychological and cognitive behavioural interventions which eliminate the need for dependency on drugs.
  • Out of 16 specific ethnic groups, Black Caribbean people had the highest rates of detention under the mental health act 2020.

I could go on with shocking statistics but let’s look at the impact of these three. 

The cost of counselling and talking therapies are seen to be out of reach for minority ethnic people and so the private route is seen as inaccessible.

Due to systemic racism suffered by Black and minority ethnic populations there may be a deep distrust of authority which causes fear of accessing free NHS medical services.

We know that early intervention is vital when treating mental health conditions.

If Black people are more likely to be given drugs than talking therapies this means that the symptoms are being treated rather than the root of the problem, which talking therapies seek to do. So the problem is still there and all that happens is the person becomes dependent on drugs.

And so if that early intervention and follow up treatment is not there, then it’s more likely that intervention will come at crisis level and the stats back this up as White people are more likely to be sectioned/referred by their GP or CMHT (community mental health team) and Black people by the police.

What can we do about it?

Real change is happening within mental health services but a deep distrust of authority is a very real thing and will take time to heal. If you haven’t experienced racism yourself this may be a hard, or even impossible, thing to understand.

To make active change now, we as individuals must not only become actively anti-racist we must empower ourselves and each other to learn about mental health and how we can support each other.

There are specialist mental health services available specifically for Black & minority ethnic people like Black Minds Matter who connect Black individuals and their families to free mental health services and Nafsiyat the intercultural therapy centre  which offers talking therapies in over 20 languages.

Mental Health First Aid England has an excellent downloadable PDF on supporting the wellbeing and mental health of People of Colour and Black people in the workplace.