Sir Simon Wessely, chair of the mental health review

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With very little publicity and dwarfed by Brexit  Theresa May has committed herself to a major reform of the Mental Health Act. Last year she convened a meeting at Downing Street and appointed a former president of the Royal College of Psychiatrists, Sir Simon Wessely. to conduct a review.

This month it published an interim report with a lot of warm words, some constructive proposals and a public admission that far too many people were locked up and a disproportionate number were from  the black and ethnic minority communities. A report in the Guardian on  May 1 highlighted some of the issues.

This Friday the charity Race on the Agenda  will host a conference at the University of East London on the  Stratford campus tackling the issues head on by addressing the issue of institutional racism in the mental health service.

They will have a lot to go from the interim review report which firmly  puts the case for change by highlighting the poor  and  often inhumane treatment of people of black African and Caribbean heritage in the worse case scenarios results in deaths in police custody.

It also appears to want to redress the balance between the role of the police and the NHS.

The interim report states: “Experience of people from black African and Caribbean heritage are particularly poor and they are detained more than any other group. Too often this can result in police becoming involved at time of crisis. The causes of this disparity are complex.” The  full report  and details of its members  and terms of reference is available here.

Among some of the salient points raised include phasing out the use of police cells to detain mentally ill people and using ambulances rather than police cars to transport mentally ill  people and increasing NHS involvement by looking at NHS England taking responsibility for  commissioning of health services in police custody.

This week’s conference will  go further than the report by looking at the culture and attitudes towards black people – the stereotyping, unconscious bias  and sometimes politically incorrect racism – as well as the role psychiatry has in defining who is mentally ill.

So why should this be a risky gamble for Theresa May ? The answer is the countervailing trends in society which could mitigate against reform.

First there is austerity. The state of some mental health hospitals , including one not far from the conference in Tottenham, have to be seen to be believed because there isn’t the money to provide adequate services. Thus all the reforms in the world could fall down because there are not the staff nor proper facilities to help people.

Then there is current hostile environment which led to the Windrush scandal , the rise of Islamaphobia and the Prevent strategy  which creates a climate of fear and fuels latent racism and fear among the white community of “the other”. The fight against terrorism can morph into discrimination against  particular ethnic groups in society.

So in the worst case scenario all Theresa May will be left with is warm words and no action – which, given the hope rising from the mental health act review, could make matters worse than they are now.

That is why it is important that conferences looking at issues the report may find difficult to confront – such as institutional racism – are being held and issues thoroughly aired.