Racism and racial injustice are not new phenomena - but the past few weeks have been exceptionally difficult for those of us inhabiting black and brown skin. For weeks now, the BAME community has been at frontline of the Covid crisis, with a disproportionate rate of infection and death and a government apparently unwilling to respond. Now, the eruption of protests in response to police brutality against the black community gives a stark reminder that racism and racial injustice are still far from insignificant features of modern society.
But let’s zoom out from policing and even from the frontline of the coronavirus crisis to look at the mental health system. Still we can’t escape the fact that black people disproportionately receive more coercive and restrictive treatment than their white counterparts. Black and minority ethnic people are more likely to be turned away when they reach out for early help for their mental health, and black menare four times more likely to be detained under the Mental Health Act and are grossly overrepresented in a criminal justice system that caters poorly to mental health needs.
As a sector committed to helping young people build the best possible future and a movement committed to promoting young people’s rights, we cannot ignore our role as part of a system where our black young people are more likely to be criminalised than cared for.
What do human rights say about race and mental health care?
At Youth Access, we champion a rights-based approach to young people’s mental health and wellbeing. The human rights issues around the Mental Health Act and the enforced detention of people – especially black people – when they are mentally unwell is relatively widely discussed. But human rights law actually says we have the right to maintain the best possible standard of mental health and the right to access the best possible support to stay well – not just the right to a hospital bed when things get really bad. Evidently, that right is under particular threat for black people.
How our right to mental health should be met is spelled out, too, so much so that actually, internationallaw reflects almost to the letter what we hear from young people year after year, up and down the country: mental health support should be available to all without long waits or only at crisis point. It should be accessible to all and meet them where they’re at, considering where they live or hang out, which digital platforms they use, what they can afford, the language that makes sense to them, etc. It should be acceptable to different communities, tailoring services to be sensitive to different cultures, ages, genders, sexualities and abilities. And it has to be of good quality, and that means listening to young people about what works for them, in their individual treatment as well as in the system at large.
Vitally, human rights – and our NHS, which pledges to uphold those rights - are built upon the premise of equality and non-discrimination. And this bit is important: Equal doesn’t mean identical. Ensuring equal access to support means making a specific, tailored offer to enable specific groups to accessthat support. Where our health system caters relatively well to the specific needs of infants or the elderly, it falls way short of the mark for young adults, and especially those of black and minority ethnicity.
Another core principle of a human rights approach is that of participation. We – Youth Access and our members – consistently make that case to decision-makers in the mental health system: young people deserve to be heard. We are bold in our efforts to ensure young voices are at the heart of everything we do, from shaping our policy demands to designing our services and even making up our workforce.
On that premise, how can we expect to build a system that meets the needs of black young people if they never had a seat at the table where decisions were made about what that system looks like? How can we offer peer support if a black young person walking through our doors sees nobody that can relate to their experience?
What does this mean for services and professionals supporting black young people’s mental health?
There is no one-size-fits-all solution to address health inequalities, especially when the form and impact of racial injustice and racial trauma will vary from community to community and from individual to individual. But there are some basic foundations which we can all put in place and build upon, to make sure we’re doing the work as professionals and as a sector to uphold and fulfil the rights of black young people.
A good place to start as an individual is to actively acknowledge the context outside of the therapy room or youth centre. Young people don’t exist in a vacuum, and neither does their mental health. Just as we have been quick to respond to young people’s needs through the coronavirus crisis, we must also recognise and proactively respond to the impact of societal or political events and the lived experience of racism. Right now, that means making a conscious effort to understand and acknowledge the Black Lives Matter movement and check in with the black young people in your community.
From here, you can seek to understand how racialised experiences might play out in your own practiceor service. Make a conscious effort to understand the concept and symptoms of racial trauma, racial identify models and power dynamics. Our Senior Participation Officer, Zoe, has produced a comprehensive guide to get you started on that journey.
At the service and system level, we must keep engaging, listening to and acting on the insights and feedback of black young people so that we can make sure the services we offer are accessible and acceptable to them. We mustn’t make assumptions or generalisations - lots of studies look at the barriers faced by BAME communities, but ‘minority ethnic’ is by no means a homogenous identity, nor, even, is ‘black’.
We must also recompense this labour – if you would otherwise pay staff or consultants to share similar expertise, young people also deserve to be appropriately rewarded for their efforts. At Youth Access, our staff team has a whole range of diverse lived experiences. We hire to make sure we have that range in-house, and work hard to foster a culture where this diversity of experience is listened to and respected. This week, even more than usual, we’ve seen the value of that representation, as we were able to speedily publish a selection of resources to support black young people’s mental health, based on the experience of our young, black campaigns assistant.
And related to this, we need to look at our workforce and workplace practices, of course in terms of representation, but also in terms of how we train, supervise and support staff of all races so that minority members of the team feel safe and supported, especially though times such as these, when they are likely to be struggling under the weight of the past few weeks’ news cycle.
At Youth Access, we know that our members work tirelessly to make sure young people’s rights are met. Many of our network already offer specialised support for black and minority young people, and lots of us have learning to share, as well as questions to raise. As individuals, we have a duty to stand against racial injustice. As a movement, have a wealth of knowledge and the collective power to open up and level up mental health support for black young people. Together, we must work to make sure that young black voices are heard and that young black people are served as part of a system where all young people’s rights are met.
Youth Access is currently preparing to convene a community of practice focusing on improving BAME young people’s access to and experience of mental health support. Youth Access members can express an interest by contacting our Programmes Manager, Jess Lee at jess@youthaccess.org.uk.