18 Oct 2023Racism harms mental health and is associated with mental illness – but a new study funded by NIHR ARC North Thames has highlighted ‘alarming’ racism that exists on mental health wards.
Researchers at the University of Oxford, QMUL and University of Birmingham say the racism they found is perpetuated by a culture of silence.
The study published today in the British Medical Journal Mental Health, found that experiences of racial discrimination exist on in-patient facilities and goes both ways between staff and patients, creating a lack of cultural and psychological safety and an unhealthy atmosphere.
It is well documented that racialised groups are over-represented as patients in mental health services, among those detained under the Mental Health Act, and they tend to be receive more coercive care and medication rather than psychological support. Yet there continues to be little academic research on this issue.
Using a new approach, researchers scrutinised the deep experiences of 10 patients who reported racism in the EURIPIDES study of patient experiences in NHS mental health services.
They found patients reported:
- Strained communication and power imbalances shaped a process of mutual racialisation by patients and staff.
- An absence of safe spaces to discuss racialisation silenced and isolated patients.
- Not reporting racialisation and discrimination made patients feel ‘othered’, misunderstood, disempowered and fearful.
- This perpetuated racialisation, prevented authentic feedback from patients, and disrupted the therapeutic alliance.
The Chief Investigator, Professor Kam Bhui, from Oxford University’s Department of Psychiatry, said: “These findings are alarming. When people feel unsafe on wards due to racism, they are silenced. We must be courageous and ask questions because if we don’t it hurts patients and staff, and costs lives, money, and quality of life. This must change if we want to have a genuinely modern, inclusive, and effective mental health service.
“Existing research on race, ethnicity and mental health shows the need for new approaches. Staff and patients need support and guidance to make mental health wards a safe place for recovery. We need to be smarter and break the circles of fear and tackle structural, institutional, and interpersonal racism.”
Co-lead author, Dr Phuong Hua, a Postdoctoral Researcher in Ethnic Inequalities at ARC North Thames, said: “NHS trusts could be more aware of how racialisation prevents authentic patient feedback, hindering improvement in the quality of services, and can weaken rapport between staff and patients.”
Find out more about the ARC NT project here.
Read a recent blog written by Dr Phoung Hua on the study here.
