Racial inequalities in healthcare are persistent in the UK, with serious consequences for minoritised groups particularly for Black people. These inequalities are apparent in mental health and care, where Black adults experience higher rates of mental illness but receive the lowest treatment rates of any ethnic group—just 6% compared to 13% among White individuals (Bansal et al., 2022).

Black adults are also disproportionately more likely to enter mental health services through the criminal justice system rather than through a General Practitioner (Halvorsrud et al., 2022). In addition, they face higher rates of detention under the Mental Health Act—more than four times that of White people—and are over ten times more likely to be placed under Community Treatment Orders (Hussain et al., 2022). Furthermore, restrictive interventions, such as restraint or isolation, are used against Black patients at more than four times the rate of their White counterparts (Pedersen et al., 2023).

The Problem with Colourblind Racism

Despite decades of research, these racial inequalities are persistent. This could be partly attributed to the prevalence of a colourblind racial ideology (Bonilla-Silva, 1997) in healthcare. This ideology downplays racism as a structural issue, embedded in institutions, and instead treats racism as an individual aberration caused by personal bias. In healthcare, this colourblind ideology is further emphasised by a dominant narrative that views healthcare as supposedly evidence-based and neutral. This narrative ignores the ways systemic racism shapes minoritised users and staff’s experiences (Bansal et al., 2022) as well as  diagnosis and treatment decisions (Maina et al., 2018).

Studies from the US show that healthcare staff frequently minimise racism in their field, using language that shifts responsibility away from institutions (Cunningham & Scarlato, 2018; Okah et al., 2022). In the UK, similar trends exist where it has been shown that mental healthcare systems are built on biomedical models rooted in predominantly White colonial knowledge systems, which disregards the lived experiences of minoritised groups (Bansal et al., 2022). As a result, when racial inequalities in mental healthcare are acknowledged at all, they are often attributed to users’ individual characteristics and cultural notions rather than structural racism (Hamed et al., 2022). This leads to the silencing of minoritised users and staff’s experiences of racism as well as any attempts to challenge racism in healthcare (Hua et al., 2023).

Why Current Interventions Fall Short

Due to this individualised understanding of racism, efforts to address racism in mental healthcare often focus on unconscious bias training and increasing awareness among staff. While such interventions may improve understanding and empathy (Chapman et al., 2018), they rarely lead to meaningful material change. This is because they treat racism as an issue of personal prejudice rather than a structural problem embedded in healthcare systems (Hamed, 2022). These interventions are, for the most part, not community led which also contribute to the lack of meaningful change.

Interventions must go beyond individual attitudes and address the structural nature of racism in mental healthcare. This means changing policies, restructuring care pathways, and ensuring that minoritised voices are central in shaping solutions. Without these shifts, racial inequalities will persist, and mental healthcare will continue to fail Black and other  minoritised communities.

Moving Forward

To tackle racism in mental healthcare, we must first acknowledge its existence—not as an isolated issue but as a structural reality. Research, policies, and interventions need to recognise racism as a core organising ideology and force within healthcare, shaping who gets care, how they receive it, and what outcomes they experience.

In upcoming blogs, we’ll explore additional factors contributing to these inequalities and discuss concrete ways to challenge and undo racism in mental healthcare.

Let’s keep the conversation going. What changes do you think are needed in mental healthcare to address racial inequalities?