Overview

• If you are from a Black, Asian or Minority Ethnic background, you may experience different rates of mental illness than the white population.
• Things like fear, stigma and lack of culturally sensitive treatment can act as barriers to accessing mental health care for people from BAME backgrounds.
• There are options available to help you overcome some of these barriers.
• You can get help if you’re having mental health issues. And if you have problems with your support and treatment there are ways to deal with this.
• There are some organisations that provide mental health support or services specifically to people from a Black, Asian or Minority Ethnic background. Rethink Mental Illness have specific services in some areas of the country. Please see the useful contacts section at the bottom of this page for organisations that you might find helpful.

About

What does Black, Asian and Minority Ethnic (BAME) mean?

Black, Asian and Minority Ethnic (BAME) is currently used in the UK as a term to describe anyone from a non-white background. The term BAME includes people from a wide variety of ethnic, religious and cultural backgrounds.

This definition includes but is not limited to:

• Black African and Black Caribbean people
• Asian and East Asian people
• People who are mixed race

According to the most recent Census, people from BAME backgrounds make up about 14% of the population in England and Wales.

We have used ‘Black, Asian and Minority Ethnic’ as an inclusive term for people who don’t identify as white. We have chosen to use the term BAME after consulting with people from a wide variety of backgrounds. But we know that there are different terms that people prefer to use to describe themselves.

Mental illness

Are rates of mental illness different for people from Black, Asian and Minority Ethnic background?

Rates of mental illness for people from Black, Asian and Minority Ethnic (BAME) backgrounds are sometimes greater than for white people.

Compared to white people:

• Black women are more likely to experience a common mental illness such as anxiety disorder or depression,
• older South Asian women are an at-risk group for suicide,
• Black men are more likely to experience psychosis, and
• Black people are 4 more times likely to be detained under the Mental Health Act.

But more white people receive treatment for mental health issues than people from BAME backgrounds and they have better outcomes.

Some of the reasons why there are different rates of mental illness for people from BAME backgrounds are due to:

• inequalities in wealth and living standards,
• bias, discrimination and racism,
• stigma about mental health, and
• they are more likely to have mental health issues identified in the criminal justice system

People from BAME backgrounds are more likely to be living in poverty than white people. And people living in poverty are more likely to develop and experience mental health issues.

Some groups sometimes have better mental health overall compared to white people. For example, some studies show:

• suicidal thoughts and self-harming behaviour are less common in Asian people than white British people, and
• that mental illness is less common among Chinese people than white British people

Overcoming barriers

What are the main barriers stopping people from Black, Asian and Minority Ethnic backgrounds getting good mental health care?

People from Black, Asian and Minority Ethnic (BAME) backgrounds have the same right to access NHS mental health care as the rest of the population.

GPs, talking therapy services and secondary mental health services are there to help. We explain more about mental health services that can help you in the following section.

It’s important to note, people from BAME backgrounds can have different experiences of the mental health system compared to white people. Some BAME groups are less satisfied with their experiences of the NHS, GP and hospital services compared to the rest of the population.

People from BAME backgrounds have told us that some of the barriers they face when accessing mental health care are:

• cultural barriers where mental health issues aren’t recognised or aren’t seen as important,
• language barriers,
• professionals having a lack of knowledge about things that are important to someone from a BAME background, or their experiences,
• white healthcare professionals not being able to fully understand what racism or discrimination is like,
• lack of publicity of mental health support and services in some BAME communities,
• stereotyping. For example, some white people think that Black people with mental health issues will get angry or aggressive. They may consciously think this, or through unconscious biases, and
• stigma about mental illness in some communities stops some people from BAME backgrounds seeking help. This may because they feel ashamed.

How can I overcome barriers to mental health care?

Many people from Black, Asian and Minority Ethnic (BAME) backgrounds have positive experiences of mental health care which leads to recovery. But accessing mental health services and support might sometimes be a difficult experience.

People may be worried about how they’ll be perceived by healthcare professionals. This may be because they feel misunderstood, or that mental health services can’t meet their needs.

Mental health services should meet the needs of people from BAME backgrounds. But as we saw in the previous section, sometimes there are issues.

We know that it is up to mental health services to change to get things right. But there are also things you may be able do to help. And make your experience more positive.

Speak to someone you can trust

Speaking to someone you trust can be the first step to getting the help you need. This may be a family member, friend, or health care professional. Try to be open and honest about how you’re feeling if you choose to tell someone.

Taking this first step might make you more comfortable and less anxious about seeing your GP or other mental health services.

Take a friend or relative to your appointment

You can take a person you trust, like a friend or relative, to an appointment with you. They can support you and it might ease any anxiety you have about the appointment. The person can speak on your behalf if you want them to.

Ask for a healthcare professional who is from a BAME background

Some people find it easier to speak to someone from the same or a similar background. This might be because they feel like they will be judged less and have an increased sense of empathy. It can also help to overcome cultural and language barriers.

You have the right to see any GP in your surgery. So, if there is a GP who is from a similar background as you, you can see them. You can ask the GP surgery about the backgrounds of the GPs.

You have the right to ask ”do you have a GP that is from a BAME background? This is because I find it easier to communicate with someone who is from a similar background to me.“

You can ask other mental health services if you can see a professional who is from a similar background to you.

GP surgeries and other mental health services don’t have to provide a professional who is from a specific background. But you can always ask, and they should try their best to accommodate you request.

You can find more information about ‘GPs and your mental health’ by clicking here.

Tell your healthcare professional about your culture and background

You can tell mental health professionals how your culture and background is relevant to your mental health problems. This will help to create better understanding between you and them. It might help to shape your care and treatment in a way you prefer.

Engage with services outside the NHS

There might be local charities, support groups and online support forums for people from BAME backgrounds, or specific ethnic groups. You might be able to speak to others who are experiencing similar problems.

You can search for local organisations on the internet or you might find them on your local authority’s website.

Please see the useful contacts section at the end of this factsheet for organisations that you might find helpful.

You can search for local mental health advisers and organisations on the following link: www.advicefinder.turn2us.org.uk. Select ‘mental health’ from the drop-down list and put in your post code.

Your local branch of the mental health charity Mind might know of suitable organisations and support in your local area. You can find your local Mind branch by using this link: www.mind.org.uk/information-support/local-minds/

Get talking therapy from a charity or private therapist

You can get free talking therapy on the NHS if you want to. See the next section for more information on how to do this.

You might be able to get talking therapy from a local charity. See ‘Engage with services outside the NHS’ above for more information. You might be able to see a therapist from the same background as you.

You might be able to see a therapist from the same background as you by getting private therapy. Private therapy isn’t funded by the NHS, so you’ll have to pay for it yourself. Or you may have cover through an insurance policy.

The cost of therapy will be different across the country and by therapist. An average cost of a session is £40. But this is an average cost, and it is likely to be higher in London. You may get a free first session or get lower rates if you are a student, a job seeker or if you are on a low income.

You can ask about charges and agree a price before you start your counselling sessions.

We always advise that you find a therapist who is a member of a professional body such as:

• UK Council for Psychotherapy
• British Association of Counsellors and Psychotherapists

The Black, African and Asian Therapy Network has therapists from Black, African, Asian and Caribbean Heritage. You can find their details in the useful contacts section at the bottom of this page.

You can also search for private therapists in your local area on the following websites:

• British Association of Counsellors and Psychotherapists: www.bacp.co.uk/search/Therapists;
• UK Council for Psychotherapy: www.psychotherapy.org.uk/

You can find more information about ‘Talking therapy’ by clicking here.

Educate others

You can educate others in your community about mental health issues. This can help to reduce stigma. You can use our factsheets to do this. We have over 100 factsheets on lots of different aspects of mental illness.

You can access our factsheets at www.rethink.org/advice-information/.

Ask professionals to communicate with you in a way you understand

The NHS must communicate with you and give you information in a way you understand it.

You can explain your communication needs and ask for an interpreter if you need one. You can also ask a trusted person to interpret for you if you want to.

Get an advocate

You might be able to get help from an advocate if you’re having issues getting help from mental health services. Or if you need help communicating with them.

There are different types of advocates depending on your circumstances and what you need.

Advocates can help you understand your rights and help you access services. They can talk to people on your behalf or help you to speak for yourself.

Advocates are independent of the NHS and they are usually free of charge.

You can find more information about ‘Advocacy’ by clicking here. It includes information on how to find an advocate.

Understand your rights under the Equality Act

Under the Equality Act 2010, it is illegal for a service provider to discriminate against people because of their race. This includes direct and indirect discrimination. The NHS and any other organisation that offers services is a service provider.

The NHS constitution says you have the right not to be unlawfully discriminated against when using their services.

If you think you’ve been discriminated against you can get free expert advice on what you can do from Equality Advisory and Support Service (EASS). Please see the Useful contacts section at the bottom of this page.

You can also complain directly to the service you are having issues with.

You can read more about discrimination against people from BAME backgrounds on the Equality and Human Rights Commission website, by clicking on the link below:

www.equalityhumanrights.com/en/advice-and-guidance/race-discrimination

You can find more information about:

• Discrimination and mental health by clicking here, and
• Complaints about the NHS and social services by clicking here.

Getting help

Where can I get help?

If you are experiencing mental health issues you can get help and treatment through the NHS. You can get help from:

• your GP,
• your local NHS talking therapy service, known as IAPT, and
• secondary NHS mental health teams, if appropriate

How can my GP help me?

You can visit your GP to get help for how you are feeling. GPs can provide treatment and advice for mental health problems and offer ongoing support.

Your GP can:

• offer you suitable medication,
• refer you to talking therapy or explain how you can refer yourself,
• give you advice on things like sleep, exercise and smoking, and
• refer you to a specialist NHS mental health service such as the community mental health team (CMHT).

Your GP might refer you to a specialist mental health team if:

• they have tried all treatment available to them. But you’re still having serious problems with your mental health,
• think your problems are too complex for them to deal with, or
• feel you are at risk of suicide or self-harm.

Your GP might refer you to a psychiatrist if appropriate. A psychiatrist is a specialist mental health doctor. They are usually part of the community mental health team (CMHT).

You can:

• ask if there is a GP in the practice who has a mental health interest and try to see that GP,
• ask for a double appointment if you need more time to talk about how you are feeling or your symptoms. GP appointments only normally last up to 10 minutes,
• write down how you have been feeling over time and what your symptoms are. This could help you tell the GP everything you want to say, and
• ask someone you trust to go with you to the appointment.

You can find more information about ‘GPs and your mental health’ by clicking here.

How can I access my local NHS IAPT talking therapy service?

You will have a local NHS talking therapy service. These are known as IAPT services, which stands for Improving Access to Psychological Treatments (IAPT). They are free to use.

They provide talking therapies such as cognitive behavioural therapy (CBT), group therapy and counselling.

You can normally self-refer to your local service by calling them directly or filling out a form on their website. The service can tell you what therapies are available and how long you might have to wait to get the therapy.

You will normally get a phone assessment to begin with to talk about your condition and symptoms. This will help the service to decide if it is right for you and what therapies are suitable.

The service only usually treats mild to moderate mental health symptoms. The IAPT service might think that you have a condition or symptoms that are too complex for them to deal with. If they do you might have to see your GP to get referred to a specialist mental health service.

You can search for your local service on the internet. You can use a search term like ‘IAPT Leicestershire’ or ‘IAPT service in Camden’.

You can find more information about ‘Talking therapy’ by clicking here.

What are secondary NHS mental health teams?

Secondary mental health teams are part of the NHS. They support people living in the community who have complex or serious mental health problems.

There are different types of secondary mental health teams that support different mental health needs. The main teams are:

• Community mental health teams support you if you have severe mental health issues.
• Crisis teams support you if you are having a mental health crisis. They offer short term support to help you avoid hospital admission. But they can arrange for you to go to hospital if you are very unwell.
• Early intervention teams can support you if you have psychosis for the first time.
• Assertive outreach teams might support you if you need intensive support because of complex mental health needs.
• Dual diagnosis teams support you if you live with alcohol or drug issues and mental health issues too.

All areas of the country have community mental health teams, crisis teams and early intervention teams. But not all areas of the country have assertive outreach teams and dual diagnosis teams. The teams sometimes have different names in different parts of the country. But the most common names are shown above.

Different types of mental health professionals work in these teams, such as:

• psychiatrists,
• social workers,
• community psychiatric nurses (CPNs),
• psychologists,
• occupational therapists,
• clinical psychologists,
• pharmacists, and
• support workers.

You usually need to be referred to these services by your GP or another medical or social care professional. But you can sometimes refer yourself to your local crisis team or early intervention team.

Who can I contact if I’m in crisis?

You can contact your local NHS urgent mental health helpline if you are having a mental health crisis. Most areas will have one. In some areas this service is called the Single Point of Access team.

You can find details of your local NHS urgent mental health helpline at:
www.nhs.uk/service-search/mental-health/find-an-urgent-mental-health-helpline. Or you can call NHS 111 to ask them for details.

They can arrange crisis support for you if necessary.

You can find more information about:

• NHS Mental Health Teams by clicking here
• Psychosis by clicking here
• Drugs, alcohol and mental health by clicking here

Complaints

What if I’m not happy with my support or treatment?

If you aren’t happy with your support or treatment, you can:

• talk to your doctor or another mental health professional,
• ask for a second opinion,
• get an advocate,
• contact Patient Advice and Liaison Service (PALS), or
• make a complaint.

There is more information about these options below.

Talk to your doctor or other mental health professional

If you aren’t happy with your support or treatment you can talk to your doctor or another mental health professional.

They might be able to offer you alternative treatment or increased support. Or refer you to another suitable service.

Be clear about exactly why you aren’t happy with your support or treatment and give examples, if appropriate. Tell them if you know what alternative treatment or support you want.

It might help you to make bullet point notes before talking to them. This can help you to get across all the information you want to.

Ask for a second opinion

You can ask your doctor for a second opinion.

Doctors can have different opinions, particularly on mental health. A second opinion from another doctor can help you feel more certain about the right diagnosis and treatment for you.

If your doctor agrees that a second opinion will help, they will try to arrange one for you. But you have no legal right to a second opinion.

You can find more information about ‘Second opinions’ by clicking here.

Get an advocate

An advocate is someone who is independent of the NHS but understands the system and your rights. They might be able to come to a meeting with you and your doctor and make sure you get your voice heard.

There are different types of advocates depending on your circumstances and what you need.

You can find more information about ‘Advocacy’ by clicking here. It includes information on how to find an advocate.

Contact PALS

PALS stands for The Patient Advice and Liaison Service.

You can contact your local PALS. They can help you with any problems or issues you have with an NHS service. You can find your local PALS details at: www.nhs.uk/Service-Search/Patient-advice-and-liaison-services-(PALS)/LocationSearch/363.

Complain

If you can’t informally resolve your issues with mental health services, you can complain.

You can complain verbally or in writing. Make sure that you say that you are making a complaint.

You can ask the service you complain to what their complaints policy is. They might have it on their website.

As part of your complaint explain:

• what has happened,
• why you aren’t happy, and
• what you would like to happen next.

You can find more information about ‘Complaining about the NHS or social services’ by clicking here.

Further reading

Melanin & Mental Health
This service is based in the USA. But they have some resources such as books and podcasts that you may find helpful.

Website: www.melaninandmentalhealth.com/resources/

Useful contacts

The Empowerment Group
Is a charity that understands the cultural importance of Black therapists supporting their communities. They offer heavily subsidised online one to one counselling sessions for Black individuals in the UK aged 18+. Also, they offer training services for groups and individuals of all backgrounds.

Online contact form: www.theempowermentgroup.co.uk/contactus
Website: www.theempowermentgroup.co.uk

BAATN The Black, African and Asian Therapy Network
Home of the largest community of Counsellors and Psychotherapists of Black, African, Asian and Caribbean Heritage in the UK.

Email: administrator@baatn.org.uk
Website: www.baatn.org.uk

Bayo
Bayo is a space to find collectives, organisations, and services from across the UK. Bayo is created by and for the Black community to support mental health and wellbeing.

Email: yansie.rolston@ubele.org
Website: www.bayo.ubele.org/

Black Minds Matter UK
The aim of Black Minds Matter is to ensure that black people in the UK can access mental health support. The organisation does this by helping black people and families across the nation to find professional mental health services, in addition to raising money to help cover the cost of such services.

Online enquiry form: www.blackmindsmatteruk.com/connect
Website: www.blackmindsmatteruk.com

Equality Advisory and Support Service (EASS)
This organisation gives practical advice and information about the Equality Act 2010 and discrimination.

Telephone: 0808 800 0082 (Monday to Friday: 9am to 7pm, Saturday 10am to 2pm)
Address: FREEPOST EASS HELPLINE FPN6521
Website: www.equalityadvisoryservice.com

Equality and Human Rights Commission
This organisation provides information about discrimination and the Equality Act

Website: www.equalityhumanrights.com

Language Line Solutions
Language Line Solutions is an organisation that can provide translation and interpretation services over the telephone to organisations and services.

Phone: 0800 169 2879
Email: enquiries@languageline.co.uk
Website: www.languageline.co.uk/

Mind: Young Black Men
This is a programme through which works specifically with young black men aged between 11 and 30 years old.

Telephone: 0300 123 3393
Email: equality@mind.org.uk
Website: www.mind.org.uk/about-us/our-policy-work/equality-and-human-rights/young-black-men

Warrior Reminder
Warrior Reminder is a community space for black and brown people to embrace their vulnerabilities, decompress and reclaim authorship over their lives. They offer a range of empowerment workshops and other workshops on a regular basis. Their website also includes a range of information resources.

Email: warriorreminder@gmail.com
Website: www.warriorreminder.com
Instagram: @warriorreminder
Twitter: @warriorreminder

Local services

Rethink Mental Illness Sahayak Asianline – Kent and W Sussex
Our Sahayak Asianline offers a culturally sensitive listening and information service for the Asian community in Kent and West Sussex. The service is for anyone affected by mental health issues - whether they are service users, carers or friends and people affected by domestic abuse. Callers may speak to us in the Asian languages of Gujarati, Punjabi, Hindu, and Urdu or English. When you call the helpline you can expect to be listened to, treated with dignity and respect, given emotional support and signposted to useful sources of information.

Phone: 0808 800 2073 (Open 4pm to 7pm Monday to Wednesday, 12pm to 3pm Tuesday to Thursday)
Website: www.rethink.org/help-in-your-area/services/advice-and-helplines/rethink-sahayak-asian-mental-health-helpline

Rethink Mental Illness Sahayak BME Floating Support – Gravesend
This service provides floating support to the BME community in Gravesend.

Telephone: 01474 364837 (Open 9am – 5pm Monday to Friday)
Address: 4-5 High street, Gravesend, Kent, DA11 0BQ.
Email: sahayak@rethink.org
Website: www.rethink.org/help-in-your-area/services/housing/rethink-sahayak-bme-floating-support

Rethink Mental Illness Bristol BAME Service
The service supports the mental health needs of people from black and minority ethnic backgrounds to recover a better quality of life. It does this through one-to-one support in accessing community facilities. The BME service works in partnership with statutory mental health teams and the BME voluntary sector. Access to interpreters can be arranged. Service literature is available in Bengali, English, Gujarati, Hindi, Punjabi, and Urdu.

Telephone: 01474 364837 (Open 9am – 5pm Monday to Friday)
Address: 4-5 High street, Gravesend, Kent, DA11 0BQ.
Email: bristolBME@rethink.org
Website: www.rethink.org/help-in-your-area/services/housing/rethink-sahayak-bme-floating-support

Other Rethink Mental Illness services
You can search for Rethink Mental Illness services in your area on our website at www.rethink.org/help-in-your-area/services

Black Thrive
Based in Lambeth, South London, Black Thrive is an organisation dedicated to combating the inequality and injustices experienced by black people in mental health services.

Email: hello@blackthrive.org.uk
Website: www.lambethandsouthwarkmind.org.uk/directory/black-thrive/

Caribbean & African Health Network (CAHN)
CAHN is a Black-led organisation set up to address the wider social determinants to reduce health inequalities for people of Caribbean & African in Greater Manchester and beyond.

Telephone: 07853 556 591
Address: Transformation Community Resource Centre, Richmond House, 11 Richmond Grove, Longsight, M13 0LN.
Email: info@cahn.org.uk
Website: www.cahn.org.uk/

Kindred Minds Southwark
Kindred Minds is a drop-in group in Southwark for people aged 18 and above from Black and Asian backgrounds experiencing difficulties with mental health.

Telephone: 020 8159 8355
Email: peersupport@lambethandsouthwarkmind.org.uk
Website: www.lambethandsouthwarkmind.org.uk/kindred-minds/

Sharing Voices Bradford
Sharing Voices delivers a range of range of services for individuals from Black and ethnic minority communities dealing with mental distress.

Telephone: 01274 73 11 66
Address: 10 Mornington Villas, Bradford, BD8 7HB.
Email: info@sharingvoices.org.uk
Website: www.sharingvoices.net