Professor claims focusing on instituional racism detracts attention away from alternative factors

Professor Swaran Singh from the University of Warwick has again been criticised for claiming that ethnic disparities in the mental health system are not caused by institutional racism, after being awarded £500,000 to carry out a new study.

The half a million pound grant awarded by the new Institute of Health Research, part of the Department of Health is intended to explore how to reduce inequalities for black and minority ethnic mental health patients in Birmingham.

Professor Singh told Black Britain that whilst it is clear that access to mental health services differ between ethnic groups: “It has been assumed for some time that it is to do with racism within the service… but it has also dampened down debate and has stopped us from looking at things in a slightly more sophisticated manner.”


Despite the recently published results of the Count Me In census report for 2006 showing that rates of detention under the Mental Health Act were much higher among black people and referral rates from the criminal justice system has increased, Professor Singh insisted: “I don’t think it’s a straightforward racism issue, because there isn’t any evidence that that is the explanation for all the differences.”

The report also found that rates of seclusion within mental health facilities are higher among black groups and that the rates of hands-on restraints are especially high among African Caribbeans. But Professor Singh told Black Britain:

“What I am saying is that there are also other factors that we should not ignore. I think the problem in putting all of the explanation into the racism basket is that it stops us… there are much more relevant and credible alternatives…”

African Caribbean people are 44 per cent more likely to be sectioned, 29 per cent more likely to be forcibly restrained and 50 per cent more likely to be placed in seclusion. Matilda MacAttram, director of Black Mental Health UK, an organisation campaigning for justice in mental health services said that the treatment of black people within the mental health system is one of the major problems facing African Caribbean communities.

Responding to Professor Singh’s comments about institutional racism, she told Black Britain: “It is clear from the starting point of his research that there is an agenda at play. The agenda is to take the focus off the failing services – the people who are being disadvantaged and to blame the victim for the failure of the services.”

Professor Singh said in interview with Black Britain that reducing all of the problems within the mental health system to racism only served to create mistrust between service users and service providers. But MacAttram said:

“The mistrust is based on practitioners’ repeated misdiagnoses of people from African Caribbean backgrounds. The mistrust is based on the findings of the David Bennett Enquiry Report…the mistrust is based on the experience of people who are black who use the services. It’s not based on any myth.”


Professor Singh is no stranger to controversy

Professor Singh’s comments also drew criticism from Dr Kwame Mc Kenzie, a Professor of Mental Health and Society at the University of Central Lancashire and Senior Lecturer in Psychiatry at University College London. He told Black Britain that whilst some people may find it “uncomfortable” talking about institutional racism, it’s a process that has to take place in order to move forward.

The Audit Commission recommended that in order to achieve equity in services, it is necessary to acknowledge the existence of institutional racism: “The Race Relations Amendment Act (2000) is the most important driver in public services. Yes there are other factors involved but institutional racism is one of them,” Dr Mc Kenzie said.

He told Black Britain that it was clear that Professor Singh does not fully understand the meaning of the term ‘institutional racism.’ “The challenge of a multicultural society is to develop services that meet the needs of different communities and if you don’t do it, that’s institutional racism,” he explained.

Commenting on Professor Singh’s claim that focusing on institutional racism breeds mistrust between service users and providers, he stated that there were high levels of mistrust among the black communities in regard to the mental health system, which a sustained focus on the part of a coalition of voluntary organisations, charities and black majority churches working collectively had reduced substantially:

“As soon as we started looking at this from a Delivering Race Equality viewpoint, actually that led to less distrust and more people working together.” However, according to Dr Mc Kenzie, in the last year, there have been noises coming from some quarters that have sought to undermine the progress that was being made by suggesting that institutional racism does not exist in mental health services.

“We were building trust by using the common language that people understand and now we’re breaking down the trust that we had. Swaran Singh has unfortunately no credibility in the voluntary sector or in the communities. Communities don’t like him, they don’t trust him and they don’t think he speaks their language.”

Dr Mc Kenzie told Black Britain that Professor Singh’s stance is “ridiculous” and that clinicians need to move away from isolated positions where they “preach” to people and try to tell them what their needs are, to one where they listen to users and develop services based on the needs and views of the service users:

“It’s not the phrase ‘institutional racism’ that is the problem, but the fact that people like Swaran Singh refuse to engage with this discussion that is being had by everybody else.”

But Professor Singh insisted: “If we were to say that services must meet the needs of the black communities as these needs are, that would be an advance, rather than saying because there are differences, services must be doing something wrong.”

In September last year Professor Singh published a joint paper with Tom Burns in the British Medical Journal entitled Race and Mental Health: There is More to Race than Racism which was strongly criticised by people within the mental industry.

Dr Suman Fernando said the paper was "flawed" and that the authors "failed to understand the nature of institutional racism," whilst Sheila Hollis, President of the Royal College of Psychiatrists said that the paper " risks setting psychiatry back twenty years, by denying the impact of racism within psychiatric settings."