People from black communities are undoubtedly overrepresented in the forensic mental health system, this anomaly is impacted heavily by the fact that the system seriously disadvantages black people within their remit (Narco, 2007; Department of Health, 2003). African-Caribbean people are more likely to receive coercive forms of care, spend longer in hospital and experience greater rates of transfer to higher security facilities (NIMHE, 2003 cited in Vige, 2005). Figures show that, at each heightened level of security in the psychiatric process, black people are increasingly overrepresented, from informal to civil detention, and then in detention on forensic sections within the courts and criminal justice system. Evidence, establishing the inexplicably high rates of diagnosis of schizophrenia amongst African-Caribbean people is vast (Narco, 2007; Department of Health, 2003). This misdiagnosis of schizophrenia stems from the stereotype that black men are “prone to violence”. When diagnosing black men, this racial stereotype is often an unconscious thought in a clinicians mind, this can also be known as “racial profiling” in the criminal justice system (Whaley, 2004). Black peoples distrust of the “white society” that can also be seen in FMH settings stems from the level of racism experienced and contributes to what was formerly known as “healthy cultural paranoia” or “cultural mistrust” (Whaley, 2004). This essay aims to discuss theories such as cultural competency and institutional racism looking at how this impacts on how black people are treated in forensic metal health settings such as Broadmoor as well as general mental health settings. Focusing particularly on deaths that have occurred in custody involving black men.
Figures have shown that black communities are over 40% more likely than average to be referred to mental health services through the criminal justice system (Mental Health Foundation, 2014). The 2005 Healthcare Commission census17 of mental health patients in England and Wales, showed around 9% of inpatients were black, despite the fact that black people comprise just 2.2% of the population according to government figures. Some research suggests that actual numbers of African Caribbean people with schizophrenia is much lower than originally thought (Mental Health Foundation, 2014). African Caribbean people are also more likely to enter the mental health services via the courts or the police, rather than from primary care, which is the main route to treatment for most people. They are also more likely to be treated under a section of the Mental Health Act, are more likely to receive medication, rather than be offered talking treatments such as psychotherapy, and are over-represented in high and medium secure units and prisons (Mental Health Foundation, 2014).
Institutional Racism and Stereotypes
Institutional racism could be highlighted as a key reason for discrimination in forensic mental health settings as well as...