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Akram: When setting expectations, explain that in this interaction, sectioning will only be introduced to the table as a last resort. One stereotype which young Black men said is a massive barrier to accessing services is being labelled as aggressive. We know that when young people are in crisis, experiencing severe mental health distress, it can manifest physically such as punching the wall or throwing a chair. Using this as a reason to section or call the police can have a damaging effect on the relationship between young Black men and crisis services. A lot of young Black men have a fear of being sectioned because of personal experiences or experience of their loved ones. When discussing sectioning, ask the young person questions like, what is your understanding of sectioning? Do you have any questions about being sectioned? And clearly explain to them why it is necessary at that point, and what happens next.
[END OF VIDEO]
We introduced ‘sectioning’, our attitudes towards sectioning, as well as the reasons behind this in the Barriers to Access guide.
‘Black men are 4 times more likely to be sectioned under the Mental Health Act than their White counterparts.’ (NHS Digital, 2019)
Sectioning instils a fear of being stuck in the system for us. We have a fear that sectioning is another ‘label’ attached to our name which makes us navigating through spaces such as employment and education a bit harder.
“for a black person, a psychiatric hospital is seen as the place where they drug you up, and at worst even kill you”. – (Department of Health and Social Care, 2018)
‘..research reveals that one in four young people (24%) would not confide in someone if they were experiencing a mental health problem, with many fearing that it could affect their job prospects.’ – (Prince’s Trust, 2017)
We know that when young people are in crisis, mental health distress can manifest physically, such as punching the wall or throwing a chair. However, we associate this with a high risk of being sectioned.
Therefore, we might try to appear really ‘composed’ when you see us. In addition to aggression, are there any behaviours or stereotypes which increase the likelihood of Black people being sectioned more than their counterparts?
As practitioners, in our eyes, you are the ones with the authority and power to section us and have a strong influence on our experiences and outcomes throughout the mental health services journey.
Multiple publications such as Omonira, (2014) Black and dangerous? and Racial disparities in mental health: Literature and evidence review (Race Equality Foundation, 2019) including the Modernising the Mental Health Act Increasing choice, reducing compulsion Final report of the Independent Review of the Mental Health Act 1983 (Department of Health and Social Care, 2018) have highlighted the inequalities or unfairness of the sectioning process due to stereotypes we mentioned above or a practitioner’s misinterpretation of mental health distress in Black people as ‘aggression’ or being‘ difficult’. We also know that being sectioned leads to traumatic experiences for the members of the Black community and sometimes means that they never get better.
You can help by:
- Challenging colleagues you might feel are too harsh and explaining to them reasons for this. They might not be aware of the potential impact on the Black men who are sectioned, and we hope the resources we have provided along with these guides will be helpful.
- Give us an opportunity to have an Advocate (someone knowledgeable about the mental health system) present. Our family and friends might be good at providing moral support. However, they might not be trained as Mental Health advocates.
- Explore alternatives to sectioning – could any of the other options be best suited to meet our needs when you see us?
- Work with us, with services such as the police who are most likely to interact with us when we are sectioned or with your service to improve experiences of Black people in mental health services or the community when we are sectioned.
When discussing sectioning, ask the young person questions like
‘What is your understanding of ‘sectioning?’
‘Do you have any questions about being sectioned?’
And clearly explain; Why is it necessary? What does it mean to be sectioned? What happens next? Who knows that I have been sectioned? and explain their rights.
The ‘Talking about Risk’ guide provides insight into how to have difficult conversations such as ‘sectioning’ and about risk safely and effectively.
- Like all people, young Black men want to be treated with compassion, respect, empathy and trust as individuals.
- Cultural sensitivity training can help improve staff interactions between crisis workers and young Black men.
- Use clear and easy to understand language. If there are any interventions discussed, these must be explained and checked to ensure that the young person has understood.
- Young Black men in crisis are still young people and should receive the same support as other young people.
- NHS Digital (2019). Mental Health Act Statistics, Annual Figures 2018-19, Available: digital.nhs.uk (Retrieved 18th February 2022)
- Prince’s Trust (2017) Stigma stopping young people talking about mental health, Available: www.princes-trust.org.uk (Retrieved 23rd February 2022)
- Department of Health and Social Care (2018) Modernising the Mental Health Act Increasing choice, reducing compulsion Final report of the Independent Review of the Mental Health Act 1983, Available: assets.publishing.service.gov.uk (Retrieved 23rd February 2022)
- Omonira, R (2014) Black and dangerous? Listening to patients’ experiences of mental health services Why are black people with mental health problems still more likely than whites to be heavily medicated, restrained and detained against their will?, Available: www.jstor.org (Retrieved 22nd February 2022)
- Race Equality Foundation (2019) Racial disparities in mental health: Literature and evidence review, Available: raceequalityfoundation.org.uk, (Retrieved 18th February)