Mental health: ethnic minority experiences
Discrimination due to mental health
Research suggests that people who are seen to be 'different' or 'threatening' are more likely to experience discrimination and be treated negatively. This is true for people from Black and minority ethnic communities and those with mental health problems. Many people experienced discrimination on the basis of their ethnicity as well as direct and indirect racism in their lives generally but also in their dealings with the mental health system.
Some felt these negative experiences had contributed to their mental health problems. Experiences of racial discrimination are therefore discussed elsewhere on this website (see 'Getting a diagnosis of a mental health problem', 'Views about causes of mental health problems', 'Getting information about mental health', 'Outpatient & community services', 'Being in hospital for mental health problems', 'Being sectioned under the Mental Health Act', 'Prescribed medication for mental health problems and their side effects', and 'Talking therapies & ECT for mental health problems'). Here, people talk about experiencing discrimination because they have a mental health problem, although their ethnicity was sometimes relevant too and might have even added to the discrimination (see below).
The stigma of having mental health problems
Many people talked about the stigma or taboo associated with mental health problems which they felt existed regardless of ethnicity. People felt that they were seen by others as dangerous or threatening and several said that people with mental health problems were feared, especially those with schizophrenia: “you're demonised in society”.
Some felt that others suspected that they were pretending to be unwell and didn't want to work, or might be incapable of work. Others said they weren't taken seriously or were even made fun of. A few people mentioned that people expected them to be different in some way from people without mental health problems. Some thought other people might make these assumptions and judgements because of their lack of understanding or awareness about mental health issues: “we're not mentally unbalanced all the time”. A few people thought discrimination was widespread and encouraged by the media.
Some people thought that mental health issues were more taboo in certain cultures and countries and some felt that discrimination against people with mental health problems was a particular issue within their own communities and their home countries. This sometimes affected the amount of support people got as well as their use of mental health services.
Comparing responses to mental and physical health problems
People often compared mental illness with physical illness. They said that whereas having a mental health problem was seen as “the worst thing that can happen”, physical health problems were not considered as important. Some felt that people responded differently to physical illness, for example, being more sympathetic or making more effort to be accommodating at work: “if I had one leg, they'd be tripping over themselves to bleeding find a special chair but when it's mental health, no one wants to know”. This was thought to be partly because mental health problems are not immediately visible.
Hanif thinks people don't want to talk about mental health problems and unlike when someone has a physical illness, they don't visit or offer sympathy.
Hanif thinks people don't want to talk about mental health problems and unlike when someone has a physical illness, they don't visit or offer sympathy.
And of course stigma is very much prevalent within all this, you know, especially because as soon as, you know, we go and say that, you know, Hanif, in my case certainly enough because the stigma was very real, because a lot of people in the community, of course once they got wind of, you know. And of course they observed my behaviour, you know. And of course they all said, Hanif's gone a bit, you know, crazy. And so of course that element also has its, you know, had a part, you know, because then of course it's also a subject nobody wants to talk about, you know. Because, you know, they might say silently but nobody wants to actually, not confront but nobody actually wants to, so nobody would even come to say to, for example, my dad and say what's wrong because it's a subject nobody, you know, like when you have cancer or something you, you know, you know, go and visit them if you're sick. In this case what do you do? I mean you don't go and kind of visit and, you know, come home and say, 'Oh how's your son?' you know. There's a sympathy, you know, because normally if someone in the home is sick, we have visitors. You know, many cultures, in our culture certainly, you know, if my mum is ill or somebody's ill, you know, we will get visitors coming in, you know, just to wish us well. If it's cancer or diabetes, not diabetes but more so one of the kind of major, you know, kind of, you know, long term illnesses, especially if its cancer or someone's had an accident. You know, you'd get visitors, you know, coming home and yeah. You know, coming for sympathy, I mean to give, to offer sympathy and well wishes and prayers.
But in the case of mental health, you know, it's, it's, you know, do you go, do you not go? No one knows there are no protocols really. In terms of there is no, there is no good guide, there is no good practice guidelines [laughs]. You know, how to deal with it. Four years through experiences now I'm probably, I'm still not sure myself actually, you know. How would I, you know, how I would I go and, you know, say if I knew somebody, you know, would I approach, you know, go and offer my sympathies or some support directly to the home, or not? It's, you know, in a work setting I would I know to an extent how to offer help and support because I'm in that kind of work. But outside of that field it's, I still myself sometime struggle how one offer's support to people, you know, once, you know, that, you know, they've, you know, they've had an episode of an illness which might be serious.
Experiences of direct discrimination
In some cases, people had experienced discrimination as a result of their mental health problem in all areas of their lives. A few people felt that people with mental health problems receive worse physical health care because they are not believed. A few said they had been treated badly by the police.
Ugo says the police did not recognise that she had a mental health problem because she is Black; she was barred from her church when she was diagnosed.
Ugo says the police did not recognise that she had a mental health problem because she is Black; she was barred from her church when she was diagnosed.
I had in the , I know when I got, I got arrested at one point for being' when I was unwell and the police took me the police station and I was stigmatised by the police station because they thought I was drunk and under the influence of drugs and I wasn't it was my mental health and they'd arrested me from the hospital but because they seen it was a black person who was unwell they didn't even think I was unwell, it was just because I was black that it was drugs and alcohol' And they left me for sixteen hours in a police cell'
Really? And have there been any other experiences like that?
No.
No nothing?
No.
Okay and what about just generally in the community have you had'?
In my church when I first became unwell and the baby got taken off me there was a social worker who worked in the church, went to the church and she told the church that they shouldn't let me in the church because I'd been diagnosed with a mental health and the baby had been taken off me and I was a danger to all the kids in the church.
And how, what happened?
So I was barred from the church.
Really?
Yes.
And I mean do, so do you go to a different church now?
No they went to the court with me and once they heard from the courts that it wasn't, they let me back, they said they was sorry and that and that it shouldn't have happened really.
That must've been a very difficult time for you.
Yes' it was it was really difficult because you, you feel like you need your spirituality and all that and then they was pushing you away through your mental health because of someone's prescription that if you have mental illness and your child has been taken off you that shouldn't be near anyone's kids and it wasn't that I'd hurt my little boy.
Some said they had no friends or had lost friends when they were diagnosed, including one man who said his friends “disappeared like leaves off an autumn tree after I was diagnosed as being ill.”
Some were also concerned about what consequences having a mental health problem might have for their prospects for future relationships.
Others felt they had been “abandoned” by their family when they became unwell: “there's this big issue of Black people they really do not help the mentally ill themselves because you don't want a mental, a nutcase in your family”.
Reena feels her family "abandoned" her when she became unwell. (Audio in Bengali, text in English).
Reena feels her family "abandoned" her when she became unwell. (Audio in Bengali, text in English).
So they were watching me for a while; they provided a health visitor, family support and also they sent somebody to help me give a bath; also somebody to talk to. But nothing really helped. And the main problem I did not mention to anyone, about what happens; who tells me off etc. My husband used to hurt me by his words; his family as well, I was very close to his family. Every Saturday it was like a party at my home. As soon as I started suffering from depression, all of them gradually abandoned me. Then there was nobody to look after me, only the kids. Even my husband didn't listen. In the end he gave up work after the daughter was married off. He did not give it up prior to this…
And before going to [local] hospital I said to my GP, told them my story and said, “Even you guys don't care for me, my family doesn't care, I haven't got many friends either. I want to talk; everything is just building up inside me.” So the GP said you can talk to me, there would be no problem. So I started talking to her slowly.
Some had experienced abuse from people in the street (see Sara's story) or neighbours: “this woman learnt about my mental health and she was telling everybody that I was a total mental nutcase and being totally abusive”. One woman was asked to leave her church because she was perceived to pose a threat to the children there.
Several people said that they had experienced some form of discrimination at work. This included not being offered jobs, being considered unsuitable and not being promoted.
Shaukat believes he hasn't been promoted at work because of his mental health problems and says his workplace should make reasonable adjustments for him.
Shaukat believes he hasn't been promoted at work because of his mental health problems and says his workplace should make reasonable adjustments for him.
Hmm... So do you, I mean, do you, do you feel like that is discrimination? Because of'?
Yeah, I mean it's, it's there's definitely, you know, like the thing is that it's very vague because of the way they measure you for promotion because it, basically it's up to the manager, you know, as my line manager to say that he's suitable for promotion. He doesn't have to really, don't have to do another interview or another test or anything. So it's my day to day working ability and what he sees. Because I don't speak that much or whatever or in a meeting I won't show the skills that they, they need, then I don't get promoted. Even though I've been there five years, most of the people who've been there after me have been promoted. And it's not major, you know, it's not a major step, it's not like I'm going into like, you know, something, a different job or whatever. It's a very similar job, a bit more responsibility, more pay, but it's totally on the manager's sort of assessment, and you know, I even know that if, if it might have been a different manager he might have promoted me. So it's not even, you know, a big difference to what the level of work that I can do to what the next level is, you know, what, that I've been able to show. But technically, you know, like if you stick with the rigid rules that they've got for assessment then, you know, my skills obviously are going to be lacking because of my anxiety or me, you know, speaking with people and that, and in meetings that, but they're not so bad. I mean, it's like, you know, I've seen other people who are more quieter, just generally because they're quiet, they don't have the anxiety and they've been promoted or whatever. So it, it basically is, is, is the, my manager's thing and he's decided that he wasn't going to promote me even though he's helped me in other issues and he's, you know, made other changes to the working day and whatever, which have been really helpful. I think he's decided that, and then he's trying to stick to his decision, not really changing his mind. And he's sort of passed it on to HR saying well they need to, you know, say like if it was a test and 45% was the pass mark, he's saying they need to lower that test mark I mean, so that you can, you know, have the same as everybody else basically, get promoted.
So, but there isn't any, you know, official marks, you're just either good enough to be promoted or you don't. So, it's just basically making, you know, what they call with the DDA, the reasonable adjustments, you know. Like they made a, other areas of, of the work and they've made them for people with, you know, physical disabilities but, you know, they don't have to do certain tasks and that, on the job and stuff and you know, it should be done with the same, in the same way but because it's, you know, it's not a visible disability it's a lot harder to get them to look at it, and get somebody to, you know, define it, and make what changes to make and. It's, you know, it's basically saying, you know, these are the behaviours that affect, well this is the illness that affects these behaviours but they're looking for those behaviours in, in, you know, in the assessment. If I don't show them as often or consistently then I won't get promoted. So, I'm kind of stuck. And it's really annoying because of my, you know, from my previous, I've done jobs which are a lot more harder, more demanding in the past, you know, with the IT jobs and stuff and I didn't really have much problem with that, I mean showing what I needed to do during the day. But because this is an open plan office and you're working with a group of people and it's not even, you know, it's not even just that. I think it's more, it's more to do with sort of gelling in with the people, you know, like my manager has a certain relationship with other people there, or they tal
Because of this, a few people were worried about telling people at work about their mental health problems, especially in case it affected their career prospects: “that'd be like shooting yourself in the foot”. Some people were especially worried about the damage it could do to their career if they were ever sectioned under the Mental Health Act. A few people had been open with their manager and made arrangements to improve their working conditions. (Under the Equality Act, employers are required to make “reasonable adjustments” to enable people with disabilities to work - see our practical matters document on our resources page for links to further information).
Jay has arranged a reasonable adjustment with her workplace to allow her to come in late in the mornings.
Jay has arranged a reasonable adjustment with her workplace to allow her to come in late in the mornings.
Sometimes I have to come to work very late because I just can't get it together in the morning. And it'll be 11 o'clock when I'll get in to work, when I should have been here at 10. Or sometimes it will be 12.30. But I make sure the other end of the day I make up those hours. And that's the reasonable adjustment that I've negotiated with my employers. Because it, it's no good you trying to tell me, 'You know you should be in at 10.' It's not going to happen. At certain times when my head is just not behaving, it's not going to happen. It's just not going to happen.
So, you know, I think that's the other thing that keeps you like that. Because if you don't address the fact that maybe you're going to have trouble getting in on time, the more you get slow in the morning the more you panic. Because you know it's getting closer to the time and you're going to have to give them yet another explanation why you are not in yet. And because you don't want to tell them the real reason, you have to find a reason to tell them. And it can get way too complicated. So it's just easier to tell them, 'Well, look, this is it, blah, blah, blah.' So even now it's got to the point where I've negotiated one step further. If I've had a bad night and I am up later than half past two in the morning, I will phone the office to say, 'I'm going to be late.' Because I know that those pills will not have worn off by 10 o'clock. So I'm going to be late. And I won't even be awake to make the phone call to tell you I'm going to be away, going to be late. So, you know, we've negotiated that. And that takes so much stress off my head. Because I can get up, and had a bad night and get up and it will be 11.30, 12 o'clock and I can go to the bathroom, get washed and dressed and go to work. And no one's looking at me sideways. I just phone to say, 'I'm in now' and guarantee I'll be at work 'til 7, 8, 9 o'clock sometimes. And I'll just log out and everyone will see that I've made up my time. So, you know, where, where it was an issue, you've got to try and make things not be an issue in order for you to cope. And the only way for you to make it not be an issue is to tell the truth. 'This is what it is. This is, this is the best that I can do at these particular times.' And if that company or person or whoever it is can't work with that, you've got to move on. Because no job's worth it, no person's worth it, for you to get yourself in such a state it affects your health. So, yes, that's how I do it.
Telling others
Some didn't want to tell people about their mental health problems: “it's better to hide these things”. A few people said their family kept their mental health problems secret. Others were open about having a mental health problem: “I'm not ashamed of being unwell”. One woman was open about her mental health condition but said that there was a stigma (a set of negative ideas) around schizophrenia and that “you don't want to put that on your business card”. Many said they only told a select few people who they could trust. Some began to tell close friends and family, but not extended family or their community because of what they might think and the problems it could cause.
Some people said they felt embarrassed or ashamed about having a mental health problem, and a few were worried people would think they were “crazy” or would ridicule them.
People described how it upset them that others had negative ideas about them, just because of their mental health conditions. They said that there was more to them than just their mental health problem: “don't look at the mental health problem alone, I'm a person as well”. Several people felt it was important to challenge stereotypes associated with mental illness, but recognised that these issues had been around for a long time and could take years to change. Some were involved in campaigning and awareness-raising (see Hanif's story), including one woman who referred to herself as a “mad ambassador”.
Last reviewed September 2018.
Last updated September 2018.
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