Racism and mental health

20th Mar 2023
Challenging mental health inequalities

This content mentions suicide or suicidal thoughts, discrimination or discriminatory violence (such as homophobia, racism, sexism and ableism), substance abuse and addiction (which may include mentions of alcohol or drug use), trauma, depression and anxiety. Please read with care. There are details of where to find help at the bottom of this page.

A statement from Mark Rowland, Chief Executive of the Mental Health Foundation

Racism means using the concept of race to judge or treat some people worse than others. It exists in many forms, and on many levels in society – including in healthcare. It can include acts of discrimination and prejudice towards individuals and groups. It can also describe wider systems of oppression. Racism is a mental health issue because racism causes trauma. And trauma can contribute to the development and worsening of ill mental health.

At the Mental Health Foundation, we seek to shed light on a range of issues that prevent good mental health – and racism is certainly at the top of that list. We have been working hard over the last two years to put anti-racist practice at the centre of our work and we’ll be sharing more on that front later this year.

For now, I wanted to create a space for some of the incredible staff members and community partners of the Foundation with lived experience of the harmful impacts of both interpersonal and structural racism. Below, they offer their perspectives and expertise and share the resources they rely on to better understand, cope and take action against various forms of racist oppression they have encountered.

I stand humbled by their resilience and commitment to working for the health and well-being of everyone around them. I hope others reading this post are moved to action in the same way we have been moved as an organisation and staff community.

And finally, before I turn it over to the experts, a deep debt of gratitude to each of my colleagues listed below for your thoughtful leadership on a topic that is often painful to discuss. I hope that one day soon, the burden of these conversations will stop being placed on your shoulders. I look forward to your continued partnership.

Contributors to this resource, guide and blog post include:

Mental Health Foundation Staff Working Group

  • Ntale Eastmond
  • Yvonne Olang
  • Jake Dixon
  • Jessica Bondzie
  • Harjinder Bahra
  • Joden Joseph
  • Anisah Scott

Community Partner and Staff Working Group

  • Amy Woodburn, Black Thrive
  • Folade Lawan, Leaders Unlocked
  • Shola Animashaun, Colourful Minds
  • Ntale Eastmond, Mental Health Foundation
  • Dr David Crepaz-Keay, Mental Health Foundation

The impact of racism on racialised communities

The things in society which have an impact on mental health are made worse and intensified by racism for racialised communities – people who are classified by race because of the white-led systems they exist within. This affects our day-to-day quality of life. We believe that racism is created and reproduced by the same socioeconomic systems that mediate the social determinants (i.e. the circumstances in which people live and work) that shape their overall health outcomes, and no conversation about racism is complete without a thorough discussion of these links.  For example, social determinants such as adverse early life experiences or unemployment are believed to drive many deep-rooted health inequalities, such as lower life expectancy or put individuals at stronger risk of mental ill health.

We know that race and power have long been intertwined – from slavery to the legacies of colonialism, to inequalities of access and opportunity entrenched in education and health, and everything in between. Acknowledging and exploring these issues (with questions such as whose behaviours and feelings are considered ‘normal’ and whose are treated as deviations or diseases?) is paramount to addressing some of the root causes that continue to plague minority communities in all kinds of cruel ways.

Photo of a man looking thoughtful

We want to state up front that race is not something produced by the racialised. It can be understood as having arisen from material conditions that required the delineation and organisation of people into specific groups so they could be exploited and brutalised for profit. This is the process of racialisation and it does not serve the racialised, nor do racialised people reproduce it. It was born as a result of historical processes in service of the class of people who own property and sought to acquire or steal more resources, including human labour. Therefore, it is not the fault of the racialised that we experience racism. This is precisely why racialisation is a traumatic and dehumanising process – one that many racialised people have endeavoured to take an active part in navigating. Through active engagement with the experience of being racialised and out of necessity, racialised people often claim their racial designations and feel a sense of pride in them, which can serve as a protective factor for mental health (Woo, Fan, Tran, Takeuchi, 2019).

Further, we recognise that talking about racism and the inequalities it creates as separate from discrimination and inequality stemming from gender, class, sexuality, ability, immigration status, age, etc. often misses the bigger picture. For certain groups of people (like Black migrant women), experiencing discrimination across a number of different axes leads to overlapping, concurrent forms of oppression. For more on this topic, we recommend this resource on why intersectionality is vital to anti-discriminatory practice.

We also wanted to acknowledge a sad but important truth: we are tired of having this conversation. It is frustrating and disempowering knowing that recommendations from decades ago about systemic racism have still not been actioned. But we are also steadfast in our hope and belief that we’re turning a corner on these issues and will continue to do what is necessary to ensure good mental health for all, especially for our communities experiencing mistreatment, disrespect, the casual racist “joke”, microaggressions, and those encountering injustice through laws, policies, and practices designed to hold us down.

How does racism impact our lives?

All the various forms of racism and discrimination can lead to an erosion of self-confidence and lead to self-doubt, making us question our identity and our place in the world. The emotions brought on by these experiences can have negative effects on well-being:

  • Lower self-worth and feelings of shame. You believe the negative messages about yourself and people who look like you in your community. This is called internalised racism or internalised colourism.
  • Negative outlook and hopelessness about the possibility of change in your daily quality of life
  • Exhaustion, such as a lack of energy to plan or think
  • Anger
  • Anxiety, feeling you must stay on guard against future incidents
  • Sadness, depression or suicidal thoughts
  • Distress and post-traumatic stress disorder symptoms (PTSD)
Woman outside

Over time, the dehumanising effects of discrimination and racism can lead to racial trauma, causing someone to revisit distressing events constantly in their head. If this is left untreated, it can affect your ability to function in life and work and maintain relationships with colleagues, friends, and family. Symptoms of racial trauma include:

  • Low self-esteem
  • Irregular sleeping patterns
  • Feeling disconnected from others
  • Avoiding interactions with people
  • Avoiding new opportunities or taking risks
  • Increased alertness and avoidance of perceived threats
  • Chronic stress
  • Substance abuse
  • Aggressive behaviour

In addition to the significant impact of racism on mental health and well-being, racism also affects physical health.

Resources on racism and mental health from our staff and community partners

If you have or are experiencing racism, help is available. You are not alone.

There are a number of excellent resources available already online (we have curated a short list below) and a number of organisations, like Black Thrive and Colourful Minds, are working hard at addressing the root causes, multiple manifestations and severe consequences of racism in society. We encourage everyone reading to visit the following websites for their wealth of information:

  1. Mind’s collection of information to help you understand the impact of racism, some top tips and a comprehensive directory of where one can seek help
  2. The Mental Health Foundation’s resources on stigma and discrimination and this post on Black, Asian and minority ethnic communities, which set out how certain communities face a disproportionate amount of disadvantage
  3. Stop Hate UK’s resource page on how racism affects health and well-being
  4. Rethink Mental Illness has a page dedicated to some key facts/figures related to Black, Asian and Minority Ethnic mental health and the barriers to accessing good mental health care for these communities

Due to the abundance of carefully curated resources already in existence, we wanted to focus our energy on creating a resource that:

  • supports, empowers and encourages people to connect in times of vulnerability; and
  • encourages further reflection, introspection, and action on the part of community leaders and decision-makers to address the issue of racism and mental health head-on in their practice.

  1. The Ubele Initiative has created this platform which pulls together different organisations from across the UK that are run by and for the Black community around mental health and well-being. 
     
  2. Racism as a public mental health concern from the Collaborating Centre for Values-Based Practice; this seminar explores the structural and social determinants of race and racism as a public mental health concern.

  3. A video of Natalie Morris, author of ‘Mixed/Other’, sharing an overview of her book about the unique experiences of those of mixed-race heritage.

  4. Everyday Racism on Instagram - authors and sisters Naomi and Natalie Evans curate resources and stories and have launched an anti-racist platform via Instagram with over 200k followers.

  5. The International Society for Psychological and Social Approaches (ISPS UK) has a number of short video presentations available on the following topics:
  6. A podcast on the importance of inclusive leadership which makes the case for how belonging, inclusion and diversity give businesses (and organisations) access to a “brilliance of difference.”

  7. Black Mental Wellness provides access to evidence-based information and resources about mental and behavioural health topics from a Black perspective. Check out the site’s Coping & Wellness tab for actionable strategies like how to discuss race, discrimination, and racial trauma with youth.

  8. Melanin & Mental Health on Instagram and Twitter are social media pages dedicated to “promoting mental wellness of Black/Latinx people.”

  9. Black Male Mental Health on Instagram is a collection of perspectives, stories, and healing.

  10. A podcast on intersectionality and structures of inequality, domestic abuse and violence against women and girls; it is a conversation between Maki Kimura (UCL Political Science & UCL Arts and Sciences Lecturer) and Pragna Patel (Founding member of Southall Black Sisters).

  1. A recent article summarising research on how the chronic stress of structural racism and discrimination damages brain circuits and mental health by Tarek Younus. You can also listen to the article by following the link.

  2. The Health and Race Observatory conducted a rapid desktop literature review on mental health inequalities in BAME communities. The recommendations on page 45 are worth a read and would be especially relevant to MH service providers. You can access the shorter summary report here.

  3. Being mixed race comes with its own unique implications. Here is a study on childhood narratives of mixed race people related to risks to their mental health. It looks at the impact of racism on mental health in the UK before focusing on the specific risk factors for mixed-race people.

  4. Race Equality Foundation’s paper on better practice in mental health for Black and minority ethnic communities. This report provides a summary of the existing research base in relation to mental health of black and minority ethnic communities, outlines the current policy context for mental health in England and Wales, and also gives the results of a series of interviews and focus groups with voluntary and community sector groups providing mental health support with black and minority ethnic communities.

  5. Global Majority: Decolonising the language and Reframing the Conversation about Race – a thoughtful article making a case for the use of the term “global majority” instead of the myriad ways in which we refer to ‘BAME’ and ‘ethnic minority’ communities.

  6. An overview of how to best communicate the evidence-base around the five ways of well-being. We believe more work needs to be done to help adapt and message the five ways of well-being to racialised communities and ensure these are shared and contextualised appropriately so they don’t result in further shaming and/or put the sole onus of achieving good mental health back on individuals experiencing racism and discrimination.

  7. This is an NHS East London Trust report on improving the experience of community mental health services for BAME people in Tower Hamlets, Newham and City and Hackney by Samuel Ogunkoya. It includes a discussion about the impact of a lack of clinicians, poor cultural knowledge and insensitivity leading to poor patient experience.

  8. An evidence synthesis of literature on the concept of intersectionality and how it can be used to understand structural inequality in Scotland – this resource looks at what the concept of intersectionality means, and how it can be applied to policy making and analysis.

  1. Mental Health, Race & Culture by Suman Fernando
    This text offers a unique analysis of the impact of race and culture on contemporary issues in mental health; the author challenges the traditional ideas that have long informed practice in clinical psychology and psychiatry to promote new ways of thinking.

  2. Natives: Race and Class in the Ruins of Empire by Akala
    From award-winning musician and political commentator, Akala, Natives speaks directly to British denial when it comes to confronting issues of race and class that are at the heart of the legacy of Britain’s racialised empire.

  3. Brit(ish) by Afua Hirsch
    A helpful analysis by Guardian columnist Afua Hirsch on race, identity and belonging.

  4. Cracked by Dr James Davies
    Looks at the origins of the DSM and the unscientific roots of psychiatric diagnoses; also explores the relationship between psychiatry and the pharmaceutical industry. Though it’s not explicitly about race, it can be read in context to show that diagnoses in the DSM are based on unscientific gut feelings and whims from white European heterosexual cisgendered men.

  5. Black Skin, White Masks by Frantz Fanon
    Provides an exploration of some of the nuanced ways in which racism is experienced and internalised by colonised peoples; illustrates the destructive nature of racism, not only physically, but culturally, politically, and psychologically.

  6. Internal Racism by M. Fakhry Davids
    An interesting perspective on racism as a normal part of the human psyche; you may not agree with the perspectives offered here but hopefully reading it can encourage lifelong critical self-examination.

  7. Taking Up Space: The Black Girl’s Manifesto for Change by Chelsea Kwake and Ore Ogunbiyi
    Authors of this powerful book explain how for certain individuals from minority backgrounds in predominantly white institutions, taking up space is an act of resistance.

  8. Mixed Experiences: Growing up mixed race – mental health and well-being by Dinah Morley and Cathy Street
    The fastest growing population group of children and young people in England and Wales happens to be mixed race. This guide offers practitioners insight into the experiences of racism, discrimination, and identity confusion that mixed-race children and young people encounter.

  9. Mixed/Other: Explorations of Multiraciality in Modern Britain by Natalie Morris
    Author explores the complexities of passing and code-switching to navigating the world of work and dating and explores the ways in which all these issues uniquely impact those of mixed heritage.

  10. Maybe I Don’t Belong Here by David Harewood, OBE
    Actor, Presenter, Documentary filmmaker and so much more – this memoir is a deeply personal exploration of the duality of growing up both Black and British and is a lived account of David Harewood’s life after psychosis. The author uncovers a devastating family history and investigates the impact of racism on Black mental health.

Our personal tips

Finally, we find ways to constantly look after our own health and mental well-being. Here are a few things you can also try:

  • Joden – Pilates, mindfulness, prayer, talking to my loved ones, long walks, baths, gym, setting boundaries
  • Yvonne – Time with family and friends, baking, playing guitar, going to the gym, reading
  • Anisah – Take time for myself, reflect, and connect with how I’m feeling; being still, spending time with my loved ones, having agency over how I spend my time
  • David – Quality time with my partner and Gertrude (our cat); also, cheese!
  • Anonymous contributions – Practice Vedic meditation, work out, practice self-compassion, connect with friends; take time out for myself, do things that fill me with purpose

Other general tips

  • Name your emotions
    Racism can leave people feeling belittled and insulted. No matter what you are feeling, labelling your emotion can be empowering and allow to work through it in a constructive way.
  • Talk about your experiences and connect with others
    Share with others what you’ve been through; it can help others empathise with what you are encountering, reduce the isolation you might be feeling and bring about some relief.
  • Identify what triggers you
    Narrowing down the specific people and situations that affect your mental health in a negative way can also help you understand what you might need to do to reduce your anxiety and help you process trauma.
  • Join organisations that fight racism and create meaningful change in society
    Due to the deep-rooted nature of racism, joining causes, movements and organisations that work on dismantling unjust systems, laws, practices and policies and work to support the most vulnerable groups can be immensely rewarding, empowering and give you a sense of control and help you find your voice!
  • Seek professional help
    If you’re struggling and instances of racism you’ve experienced are affecting your daily life, don’t be afraid to seek professional help. There are networks of Black and Minority Ethnic therapists that have lived experience of the issues you have encountered and can support you to get your mental health back in shape.
Children holding hands

If you are feeling like ending your life or feel unable to keep yourself safe, please call 999 or go to A&E and ask for the contact of the nearest crisis resolution team. These are teams of mental health care professionals who work with people in severe distress. If you feel affected by the content you have read, please see our get help page for support.

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