Organisations’ Contributions to the 2018 Review of the Mental Health Act: Social Processes, Racial Disparities and the Role of Stakeholders

Aims: The aim of the present research was to study stakeholders’ experiences of the written and verbal consultations during the 2018 review of the Mental Health Act, in particular how issues of race were explored.
Background: There are longstanding racial inequalities within the mental health system. One of the most concerning areas of inequality is the disproportionate use of the Mental Health Act. There have been several policies and legislative attempts to address racial inequities in society and the mental health system, however many have failed to change the material condition for people from ethnic minority backgrounds within mental health services. The 2018 review of the Mental Health Act aimed to address the disproportionate detention rates for people from ethnic minority backgrounds. The Government appointed an independent advisory panel to conduct consultations with key stakeholders to advise on recommendations for review.
Rationale: Due to previous policy failures to adequately reduce racial inequality within mental health services and in the application of the Mental Health Act, the study aimed to explore stakeholders’ experience of the Mental Health Act review process, with particular attention to how race was addressed within consultations.
Methodology: Semi-structured interviews were conducted with eight key stakeholders based in the UK. A critical realist thematic analysis was used to analyse participants’ experiences.
Results: Three main themes were identified, “It’s a charade”: power and influence in the review process; “This is how the political system works”: power enacted in the design of the review and Elements in an ideal consultation.
Conclusion: Stakeholders highlighted how power operated within the review process. This impacted their ability to consult, how issues of race were subsumed and ignored and how organisational and structural changes were needed to improve the stakeholder consultations. The study identifies key implications for future policy development, professional training and further research.