Addressing mental health inequality head on
with Dr Samara Linton
My name is Samara – I’m a writer, content producer, and former junior doctor.
I began my professional journey in medicine, studying at university before working as a junior doctor in the NHS. It was my curiosity about people—how they think, how they act, how their bodies work—that drew me to medicine. Over time, this same curiosity led me into a full-time career in storytelling through writing, editing, and content production. My focus has invariably been the stories and experiences of those who exist on the margins, whose lives don’t fit into mainstream narratives. More often than not, my work centres on the mental health experiences of people from marginalised communities, in part because of my own experiences of mental distress.
Image credit: Michael Bailey
I’d like to focus on three key areas for this article: first, the fact that mental health issues can affect everyone but not equally; second, the importance of creating safe environments for people to share their mental health experiences; and finally, practical ways to advocate for mental health awareness, support, and equity.
Mental health does discriminate
I first came to terms with my mental health difficulties as a medical student. I found myself resonating with the symptoms outlined in my psychiatry lectures and decided to see my GP, who gave my distress a name. However, the relief I felt at not being alone in my experiences was coupled with a disconnect with my peers who shared the same diagnostic labels—their home lives and family conversations were vastly different from my own.
Popularly quoted statistics like “1 in 4 adults will experience mental health problems in their lifetimes” aim to normalise and destigmatise mental health problems. While these statistics serve as valuable reminders mental health difficulties can affect anyone, they also mask the fact mental health touches each and every one of us very differently. Mental health does discriminate, because society discriminates.
It is increasingly being recognised that marginalisation and discrimination not only increase the risk of mental health problems but also shape how people experience those problems.1 For example, Black women experience higher rates of anxiety and depression, while Black men are most likely to have psychotic disorders.2 Black people are also over-represented in mental health services and are more likely to have negative experiences of services, such as higher use of restraint, seclusion, and criminal justice system involvement.3 Black people are also 3.5 times more likely than white individuals to be detained under the Mental Health Act.4
Creating an environment where people can open up
We often place immense pressure on people who are struggling with their mental health to open up and explain how they’re feeling. This can be a huge mountain to climb, especially when the person they speak to may not relate to their experience or how their distress manifests. Navigating a healthcare system that requires specific language to convey your needs—or one that may not fully understand cultural nuances—can add to the challenges of accessing care.
We need to foster environments where everyone feels safe to share their mental health struggles, knowing that their experiences will be heard, understood, and respected.
Black people were found to be less likely to be offered psychological therapy than their white counterparts.2 Moreover, for people whose contact with mental health services are shaped by traumatic experiences such as being detained, there can be very little incentive to open up to mental health professionals or actively engage with treatment.5
It’s important to create spaces where everyone feels safe sharing their mental health experiences, confident that they will be heard, understood, and respected.
Championing advocacy
We live in an unjust, unequal society where our social and economic status, our racial, gender, and sexual identities, and the labels we carry all shape our experiences of mental distress and care. This is where advocacy becomes critical.
Advocacy can look like challenging prejudice and discrimination in the workplace. It can look like helping someone who is struggling with their mental health explore the options available to them or accompanying them to appointments. It can look like joining a community advocacy group or a charity that helps people access the mental health care they need.
There are so many brilliant grassroots organisations, like Black Thrive, that advocate for people who feel alone or unsupported to access the help they need and deserve. Many of these organisations work with communities, voluntary groups, local government, and the private sector to address the social inequalities that negatively impact people’s mental health. Others work to help people navigate the complexities of mental health services and nurture community through peer support, group meetups, and more.
I highly recommend looking into the resources and support available in your community and working out what will work best for you and your needs.
You can hear more from Samara on Series 2 of the Mind If I Join You? podcast and check out her book The Colour of Madness here.
This article has been developed and funded by Lundbeck and is intended for UK audiences.
References
- Hatch SL, Gazard B, Williams DR, Frissa S, Goodwin L; SELCoH Study Team; Hotopf M. 2016. Discrimination and common mental disorder among migrant and ethnic groups: findings from a South East London Community sample. Soc Psychiatry Psychiatr Epidemiol. ;51(5):689-701. doi: 10.1007/s00127-016-1191-x. Epub 2016 Feb 13. PMID: 26875153; PMCID: PMC4846681.
- GOV Cabinet Office. Race Disparity Audit. Summary Findings from the Ethnicity Facts and Figures website. Available at: https://www.gov.uk/government/publications/race-disparity-audit/ [last accessed October 2024]
- NHS Race and Health Observatory. Ethnic Inequalities in Healthcare: A Rapid Evidence Review. Available at: https://www.nhsrho.org/research/ethnic-inequalities-in-healthcare-a-rapid-evidence-review-3/ [last accessed October 2024]
- GOV. Detentions under the Mental Health Act. Available at: https://www.ethnicity-facts-figures.service.gov.uk/health/mental-health/detentions-under-the-mental-health-act/latest/#main-facts-and-figures/ [last accessed October 2024]
- Harwood H, Rhead R, Chui Z, et al. 2023. Variations by ethnicity in referral and treatment pathways for IAPT service users in South London. Psychological Medicine. 53(3):1084-1095. doi:10.1017/S0033291721002518
