Black, Asian and Minority Ethnic (BAME) communities
In England and Wales, nearly a fifth of people come from a BAME (Black, Asian and minority ethnic) background.1 The mental health of BAME communities is important because people from these communities often face individual and societal challenges that can affect access to healthcare and overall mental and physical health.2
Data collected on mental health in minority ethnic groups can often be subject to small sample sizes, meaning our ability to look at mental health within a specific ethnic group is sometimes limited.
For instance, there may be a small number of people from a certain ethnicity group taking part in a research survey. This means that there is much more we still need to know about ethnicity and mental health in the UK.
What will we cover?
We will first look at the impact of issues such as racism and discrimination, and then provide key mental health statistics for specific BAME communities.
Important influences on BAME communities’ mental health
- Racism and discrimination
- Social and economic inequalities
- Mental health stigma
- Criminal justice system
- Other factors
1. Racism and discrimination
People from BAME communities can experience racism in their personal lives, ranging from casual slights to explicit hurtful comments and verbal or physical aggression.
- Research suggests that experiencing racism can be very stressful and have a negative effect on overall health and mental health3-6.
- There is a growing body of research to suggest that those exposed to racism may be more likely to experience mental health problems such as psychosis and depression.4-7
2. Social and economic inequalities
BAME communities are also often faced with disadvantages in society. They are more likely to experience poverty, have poorer educational outcomes, higher unemployment, and contact with the criminal justice system, and may face challenges accessing or receiving appropriate professional services.8-9 For example:
- Among 16 to 24 year olds, unemployment rates are highest for people from a Black background (26%) and from a Pakistani or Bangladeshi background (23%) in comparison with their White counterparts (11%).10
- Even when employed, men and women from some ethnic groups are paid less on average than those from other groups with similar qualifications and experience.11
- Pakistani and Bangladeshi communities consistently have high rates of poverty, as do Black, Chinese and Other ethnic communities.12
- Homelessness is a key issue among minority ethnic groups, with 37% of statutory homeless households from a ‘BME background’ in 2013.13
Each of these can act as risk factors for the development of mental health problems.
3. Mental health stigma
Different communities understand and talk about mental health in different ways.
- In some communities, mental health problems are rarely spoken about and can be seen in a negative light.9 This can discourage people within the community from talking about their mental health and may be a barrier to engagement with health services.
4. Criminal justice system
There is growing concern over unmet mental health needs among BAME individuals within the criminal justice system, particularly in the youth justice system14,15.
- One 2016 report on the youth justice system in England and Wales found over 40% of children are from BAME backgrounds, and more than one third have a diagnosed mental health problem.16
- The level of need may be even greater than this as it has also been found that BAME individuals are less likely to have mental health problems or learning disabilities identified upon entry to the justice system14.
5. Other factors
Many groups face inequalities in physical and mental health. This can be due to factors like disability, sexuality, gender and age. In order to understand different BAME communities’ experiences of mental health problems and of services provided it is also necessary to consider these other aspects in addition to race and ethnicity.
Different BAME groups and particular mental health concerns
Different BAME groups may be more likely to face particular mental health concerns. It is important to note, however, that our understanding of these mental health concerns is limited by the quality of the data collected.
Black / African / Caribbean / Black British people
- The Adult Psychiatric Morbidity Survey (APMS) found that Black men were more likely than their White counterparts to experience a psychotic disorder in the last year.18
- Risk of psychosis in Black Caribbean groups is estimated to be nearly seven times higher than in the White population.19
- The impact of the higher rates of mental illness is that people from these groups are more likely than average to encounter mental health services.20
- Detention rates under the Mental Health Act during 2017/18 were four times higher for people in the ‘Black’ or ‘Black British’ group than those in the ‘White’ group.21
- The Count Me in Census, which collects information on inpatient care, found higher than average admission and detention rates for Black groups in every year since 2006 to 2010.22
- Black men were reported to have the highest rates of drug use and drug dependency than other groups.18
- Whilst the White Caucasian population experienced the highest rates for suicidal thoughts, suicide rates are higher among young men of Black African, Black Caribbean origin, and among middle aged Black African, Black Caribbean and South Asian women than among their White British counterparts.23
Asian/ Asian British
This term refers to people in the UK from Indian, Pakistani, Bangladeshi, Chinese and any other Asian backgrounds.
- The latest APMS found no meaningful differences between Asian people and their White British counterparts in terms of experiencing psychotic disorders or common mental health problems.18
- People of Indian and Pakistani origin showed higher levels of mental wellbeing than other ethnic groups as did those of African-Caribbean origin17.
- Suicidal thoughts were less common in Asian people than White British people, as was the likelihood of self-harming behaviour.18
- Those identifying as Asian or Asian British are one-third less likely to be in contact with mental health or learning disability services.20
- Within the South Asian community in England and Wales, research has indicated that older South Asian women seem to be an at-risk group for suicide.25
- One 2018 review found that non-European immigrant women, including young South Asian women, were a high-risk group for suicide attempts.26
- Findings from the last Count Me In census found that the number of people in the Asian or Asian British groups who spent time compulsorily detained in hospital rose by approximately 9% from 2005 to 2010.22
- There are some studies that suggest prevalence of mental ill-health (both common mental health problems and psychotic illness) is lower among Chinese people than their White British counterparts.28,29
- Chinese people are underrepresented in mental health services, rates of admission to mental health inpatient facilities in England and Wales were lower among the Chinese population compared to the national average.22 Further research is required to explore whether this is because the community experiences better mental health than the general population or if they experience specific barriers to accessing mental health services.30
Other ethnic groups
- Irish people living in the UK have much higher hospital admission rates for mental health problems than other ethnic groups. They have higher rates of depression and alcohol problems and are at greater risk of suicide.31
Comhar men's groups
We are currently working on a project with Irish men in mid-life living in Camden. The project was developed following a piece of research in the London Boroughs of Camden and Islington that identified two particular risk factors for poor mental health and suicide: being a man in mid-life, and being born in the Republic of Ireland. The self-management courses aim to equip participants with skills and learning that will mitigate that risk.
Culturally appropriate treatment and interventions
Research points to a strong need for greatly increased cultural competency in mental health services.32
This may include:
- practical improvements in language (interpreting, translating, literacy support),
- meeting faith-related and religious needs,
- culturally appropriate food,
- gender-specific services and staff,
- increasing the ethnic diversity of staff,
- and action to address and reduce experiences of racism and discrimination.
Refugees and asylum seekers
- Refugees and asylum seekers may experience exclusion, marginalisation and inequalities of access to services.33
- They are more likely to experience mental health problems than the general population, including higher rates of depression, PTSD and other anxiety disorders.34,35
- The increased vulnerability to mental health problems that refugees and asylum seekers face is linked to pre-migration experiences (such as war trauma) and post-migration conditions (such as separation from family, difficulties with asylum procedures and poor housing).36,37
- Data shows that they are less likely to receive support than the general population.38
Further information and resources
- Local Mind – a useful way of finding out what’s available in your area, such as specific BAME groups. They also have a useful information page that outlines their work in this area.
- Black Thrive – an organisation that aims to end the stigma associated with mental health and address mental health inequalities experienced by Lambeth’s Black communities
- Sharing Voices – a charity in Bradford that aims to reduce mental health and related inequalities for BAME communities.
- The Chinese Mental Health Association – an organisation that is involved in providing direct services, increasing mental health awareness and representing Chinese mental health issues in public forums and raising its profile in the overall Chinese community.
Date Last Updated
This page was last updated on 19/06/2019.
- Office for National Statistics (11 December 2012) Ethnicity and National Identity in England and Wales: 2011. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/culturalidentity/ethnicity/articles/ethnicityandnationalidentityinenglandandwales/2012-12-11 [Accessed 18/06/19].
- National Institute for Mental Health in England. (2003). Inside Outside: Improving Mental Health Services for Black and Minority Ethnic Communities in England, London, Department of Health
- Williams D.R. (2018) Stress and the Mental Health of Populations of Color: Advancing Our Understanding of Race-related Stressors. Journal of Health and Social Behavior, 59(4), 466-485.
- Gibbons F.X., O’Hara R.E., Stock M.L., et al. (2012) The erosive effects of racism: reduced self-control mediates the relation between perceived racial discrimination and substance use in African American adolescents. Journal of Personality and Social Psychology, 102(5), 1089-104.
- Williams D.R. & Williams-Morris R. (2000) Racism and mental health: the African American experience. Ethnicity & Health, 5(3-4), 243-68.
- Bhui K., Nazroo J., Francis J. et al. (2018) The impact of racism on mental health. Available at: https://synergicollaborativecentre.co.uk/wp-content/uploads/2017/11/The-impact-of-racism-on-mental-health-briefing-paper-1.pdf [Accessed 18/06/19]
- Wallace S., Nazroo J. & Becares, L. (2016) Cumulative Effect of Racial Discrimination on the Mental Health of Ethnic Minorities in the United Kingdom. American Journal of Public Health 106(7), 1294-300.
- Equality and Human Rights Commission (2016) Healing a divided Britain: the need for a comprehensive race equality strategy. Available at: https://www.equalityhumanrights.com/sites/default/files/healing_a_divided_britain_-_the_need_for_a_comprehensive_race_equality_strategy_final.pdf [Retrieved 18/06/19].
- Mermon A., Taylor K., Mohebati L.M et al. (2016) Perceived barriers to accessing mental health services among black and minority ethnic (BME) communities: a qualitative study in Southeast England. BMJ Open 2016
- Powell A. (22 May 2019) Unemployment by ethnic background, Briefing Paper Number 6385. [Retrieved 18/06/19].
- Barnard H. & Turner C. (May 2011) Poverty and ethnicity: A review of evidence. Available at: https://www.jrf.org.uk/sites/default/files/jrf/migrated/files/poverty-ethnicity-evidence-summary.pdf [Retrieved 18/06/19].
- Joseph Rowntree Foundation (2017) UK Poverty 2017: a comprehensive analysis of poverty trends and figures. Available at: https://www.jrf.org.uk/sites/default/files/jrf/files-research/uk_poverty_2017.pdf [Retrieved 18/06/2019].
- Institute of Race Relations (n.d.) Inequality, housing and employment statistics. Available at: http://www.irr.org.uk/research/statistics/poverty/ [Retrieved 18/06/2019].
- Lammy, (2017). The Lammy Review. An independent review into the treatment of, and outcomes for, Black, Asian and Minority Ethnic individuals in the Criminal Justice System. Retrieved from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/643001/lammy-review-final-report.pdf
- White, C. (2016). Incarcerating youth with mental health problems: A focus on the intersection of race, ethnicity, and mental illness. Youth Violence and Juvenile Justice, 14(4), 426-447. https://doi.org/10.1177/1541204015609965
- Taylor, C. (2016). Review of the youth justice system in England and Wales. Ministry of Justice. Retrieved from: https://www.yjlc.uk/wp-content/uploads/2016/12/Review-of-the-Youth-Justice-System.pdf
- Stewart-Brown S., Samaraweera P., Taggart F. et al. (2015) Socio-economic gradients and mental health: Implications for public health. The British Journal of Psychiatry, 206(6), 461–465.
- McManus S, Bebbington P, Jenkins R, Brugha T. (eds.) (2016) Mental health and wellbeing in England: Adult Psychiatric Morbidity Survey 2014. Leeds: NHS Digital.
- Fearon P., Kirkbride J.B., Morgan C. et al. (2006) Incidence of schizophrenia and other psychoses in ethnic minority groups: results from the MRC AESOP Study. Psychological Medicine, 36(11), 1541-1550
- Baker C. (25 April 2018) Mental health statistics for England: prevalence, services and funding, Briefing Paper Number 6988. Available at: https://researchbriefings.files.parliament.uk/documents/SN06988/SN06988.pdf [Retrieved 18/06/19].
- NHS Digital (9 Oct 2018) Mental Health Act Statistics, Annual Figures 2017-18. Available at: https://digital.nhs.uk/data-and-information/publications/statistical/mental-health-act-statistics-annual-figures/2017-18-annual-figures [Retrieved 18/06/19].
- Care Quality Commission (2010) Count me in 2010. Available at: http://www.cqc.org.uk/sites/default/files/documents/count_me_in_2010_final_tagged.pdf [Accessed 18/06/19].
- Bhui K. & McKenzie K. (2008) Rates and risk factors by ethnic group for suicides within a year of contact with mental health services in England and Wales. Psychiatric Services, 59(4), 414-20.
- Williams D.R., Gonzales H., Neighbors H. et al. (2007) Prevalence and distribution of major depressive disorder in African Americans, Caribbean blacks, and non-hispanic whites: results from The National survey of American life. Archives of General Psychiatry 64(3), 305–15.
- McKenzie K., Bhui K., Nanchahal K. & Blizard B. (2008) Suicide rates in people of South Asian origin in England and Wales: 1993-2003. The British Journal of Psychiatry, 193 406-409.
- Forte A., Trobia F., Gualtieri F. et al. (2018) Suicide risk among immigrants and ethnic minorities: a literature overview. International Journal of Environmental Research and Public Health, 15(7), 1438.
- Pannu G., Zaman S., Bhala N. & Zaman, R. (2009) Alcohol use in South Asians in the UK. BMJ (online), 339.
- Calderwood L. & Tait C. (1997) Self-reported health and psychosocial well being in Erens B, Primatesta P & Prior G (eds) Health Survey for England: The Health of Minority Ethnic Groups 1999. The Stationery Office
- Natarajan L (2004) Self-reported health and psychosocial well being in Sproston K & Mindell M (eds) Health Survey for England 2004: The health of minority ethnic groups. The Information Centre
- Tran L. (2009) Evaluation of a Chinese Mental Health Advocacy and Support Project. Available at: https://www.kingsfund.org.uk/sites/default/files/field/field_document/evaluation-chinese-mental-health-project-partner-health-nov09.pdf [Accessed 18/06/19]
- Fitzpatrick M. & Newton J. (2005) Profiling mental health needs: what about your Irish patients? The British Journal of General Practice, 55(519), 739-740.
- Grey T., Sewell H., Shapiro G. et al. (2013) Mental health inequalities facing U.K. minority ethnic populations. Journal of Psychological Issues in Organizational Culture, 3(S1).
- Hynes T. & Sales R. (2009) “New communities: Asylum seekers and dispersal”, A. Bloch. & J. Solomos (Eds). In, Race and ethnicity in the 21st century, Aldershot: Palgrave Macmillan, pp.39-61
- Fazel M., Wheeler J., & Danesh J. (2005) Prevalence of serious mental disorder in 7,000 refugees resettled in Western countries: A systematic review. The Lancet, 365, 1309–1314.
- Tempany M. (2009) What research tells us about the mental health and psychosocial wellbeing of Sudanese refugees: A literature review. Transcultural Psychiatry, 46, 300–315.
- Steel Z., Chey T., Silove D., Marnane C., Bryant R., & van Ommeren M. (2009) Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: A systematic review and meta-analysis. JAMA, 302, 537–549.
- Porter M., & Haslam N. (2005) Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons: A meta-analysis. JAMA, 294, 602–612.
- Aspinall P. & Watters C. (2010) Refugees and asylum seekers: A review from an equality and human rights perspective. Equality and Human Rights Commission Research report 52, University of Kent.