Black Mental Health in the UK — Overrepresentation, Causes, and How Therapy Helps
Overrepresentation in UK Mental Health Services
Black mental health in the UK is marked by stark disparities. Black men and women are disproportionately represented in mental health services, particularly through compulsory detention under the Mental Health Act UK.
• In 2023, Black people were 3.5 times more likely than White people to be detained under the Mental Health Act (228 per 100,000 compared with 64 per 100,000).
• The Black “Other” group had the highest detention rate of all ethnic groups, at 715 per 100,000.
• Black or Black British people are up to 11 times more likely to be subject to Community Treatment Orders (CTOs).
• Black men show a higher prevalence of psychotic disorders (3.2%) compared to White men (0.3%).
These figures highlight a racial disparity in therapy and services: Black people are more likely to enter care through coercive routes (police involvement, compulsory detention) rather than voluntary pathways like GP referrals or community support.
Why Are Black People Overrepresented?
Systemic Racism in Healthcare
Bias in diagnosis, treatment, and referral pathways means Black patients are often seen as “high risk” and are more likely to be detained. This reflects systemic racism in healthcare rather than higher vulnerability.
Socioeconomic Inequalities
Black communities in the UK face higher rates of poverty, unemployment, and insecure housing. These stressors increase vulnerability to mental health difficulties and contribute to overrepresentation in services.
Distrust of Services
Historical mistreatment and lack of culturally competent care foster mistrust of mental health systems, leading to delayed help‑seeking until crises occur.
Pathways into Care
Black people are disproportionately referred via police or emergency services, rather than through voluntary or preventative routes.
Cultural Stigma
Mental health stigma within some Black communities discourages early engagement, reinforcing the cycle of crisis‑based intervention.
How Therapy Can Help
Therapy, when delivered with culturally sensitive counselling, can reduce disparities and empower Black clients.
• Culturally Sensitive Counselling
Therapists who acknowledge racism, identity, and systemic oppression validate lived experiences and reduce alienation.
• Trauma‑Informed Care
Recognising the impact of racism, intergenerational trauma, and systemic stressors helps clients reclaim agency and resilience.
• Early Intervention
Accessible therapy reduces reliance on compulsory detention, offering support before crises escalate.
• Empowerment and Voice
Therapy provides safe spaces for Black men and women in therapy to explore identity, challenge stigma, and build confidence.
• Community‑Grounded Approaches
Group therapy, peer support, and culturally rooted practices (storytelling, collective healing) strengthen trust and engagement.
Final Thoughts
The overrepresentation of Black men and women in UK mental health services is not about inherent vulnerability but about systemic inequalities, racial bias, and structural barriers.
Therapy can help by bridging gaps in trust, offering culturally attuned care, and empowering Black communities to engage with mental health support on their own terms.
For meaningful change, services must move beyond “one‑size‑fits‑all” models and embrace equity, cultural humility, and systemic reform.
Sources:
• GOV.UK Ethnicity facts and figures – Detentions under the Mental Health Act
• Evidence briefing on racial disparities in the Mental Health Act
• Berkshire Healthcare NHS Trust – Why Black people are overrepresented in Mental Health Act detention