People of African and Caribbean descent suffer disproportionately when it comes to mental health and wellbeing. Black Thrive has been established as a partnership between statutory and community partners to continue the work started by the Black Health and Wellbeing Commission (BHWC) to improve mental health and wellbeing for Lambeth’s black communities.  

Black Thrive seeks to build a culture in Lambeth whereby black communities are able to thrive and improve their mental health and wellbeing, supported by relevant, accessible services, which provide the same excellent quality of support for all people regardless of their race. There is an urgent need to address these unequal outcomes.

Research shows that:

  • Black people are over-represented by 3 times in the acute end of services and 6 times more likely to suffer from death under restraint in police custody[1]
  • Conversely, they are less likely to receive preventative services[2]
  • Black people face an unresponsive system: they are 40% more likely than white people to be turned away from mental health services when they ask for help[3]
  • Detention rates under the mental health act are 44% higher amongst black patients[4]
  • Current services are Euro-centric and not culturally sensitive[5]
  • Good mental health is fundamental to good quality of life, and is linked to better cognitive and physical condition and life expectancy[6]

Our research suggests the following are relevant factors:

  • Many black communities have lost trust in services due to experiences of racism and cultural differences, as highlighted in the 2002 report Breaking the Circles of Fear[7] much of whose research was conducted in South London
  • Stigma around mental health still exists making it difficult to talk about problems and difficult to seek early help for fear of being given a diagnosis
  • Inequality and discrimination of black communities can lead to increased risk of psychosis[8]
  • There is a lack of black representation in decision-making within the NHS, as well as amongst employees of mental health services[9]
  • A lack of capacity in communities to deliver mental health interventions[10]
  • The majority of health spending is tied up in acute rather than preventative services[11]
  • Difficulty in addressing causal factors for poor mental health such as deprivation and social exclusion, which are disproportionally present in poorer and black communities[12]

These issues are compounded by a lack of data or lived experience informing outcomes, experience and over-representation within services for the black communities. The issues have persisted for decades, without any significant improvement in outcomes related to mental health for black communities. In addition to the human cost of these issues, these inequalities imporse significant costs on the health system, particularly on acute care.

[1] Care Quality Commission, Count me in Census (2010)[2] Home Affairs, Written evidence submitted by Black Mental Health UK [IPCC 23] (2012): “in terms of total deaths in police custody since 2004 in England and Wales, a disproportionate number were of Black people (20% of deaths in 2008–09 )”; [3] Department of Health, No health without mental health (2011)[4] Rethink, Behind Closed Doors: The Current State and Future Vision of Acute Mental Health care in the UK, (2006); [5] Count me in Census (2010); (6) Feedback from Social Finance roundtable held on 15 July 2014 – see appendix for more detail; [6] Kessler et al., 1994; Macran et al., 1996; Gilbert & Allan, 1998; Murali & Oyebode, 2004; [7] The Sainsbury Centre for Mental Health, ‘Breaking the Circles of Fear’, 2002; [8] ONS, Adult Psychiatric Morbidity Survey (APMS) In England 2007; [9] Kline, The Snowy White Peaks of the NHS, (2014); [10] Feedback from Social Finance roundtable; [11] NHS England, A call to action: Commissioning for Prevention, (2013); [12] JRF, Does income and inequality cause health and social problems? (2011); [13] NHS BME Network, Conference Report, (2014)