Madness and Mental Health: 2023-4

Ethnic Inequalities in Experience of Mental Distress and Illness and Care

This lecture in the series Madness and Mental Health is presented by Kam Bhui.

Ethnic inequalities in experience of mental distress and illness and care: from ecologies of mind to eco-social and psychopolitical context

Over six decades of research confirm there are ethnic inequalities in the experiences and outcomes of severe mental illness. Notably, black and minority ethnic communities experiences a higher incidence of psychoses, as do migrants more generally. They experience more coercive care pathways, namely more crisis and emergency care, police contact, criminal justice system contact, and compulsory care under the powers of the Mental Health Act. These findings are replicated in Europe and North America. The reasons for these differences have been debated, some arguing they meet treatment needs, other they are manifestations of structural racism. Efforts to tackle inequalities are bedevilled by conflict, resistance, and direct opposition. I share my views on conceptual confusions, causes, and remedies by drawing on recent Lived Experience Data on compulsory treatment, other research and campaigns over three decades.

  • About the speaker

    Kam Bhui is a professor of psychiatry and Hon. consultant psychiatrist, undertaking eco-social, syndemic, and health and social systems research. Through his research, Kam seeks to improve policy and practice, reduce health inequalities and adverse health outcomes, such as persistent mental illness, suicide, and premature mortality due to chronic long-term conditions, and advance research methods and interdisciplinary dialogue.

    Kam has established an international Centre of Excellence on cultural psychiatry practice, research and teaching ( and led the Synergi Collaborative Centre ( a national partnership to understand and tackle ethnic inequalities in severe mental illness.