Progress to tackle racism in psychiatry, but there’s more to be done
30 October, 2025
Discrimination and racism are embedded in society, and as a product of society, medicine is no exception.
- People from a Black or Black British background are almost four times more likely to be detained under the Mental Health Act than White people - an increase from 3.5 times in 2023/24.
- Black of Black British people are over eight times more likely to be placed under Community Treatment Orders (CTOs) than their White counterparts.
- Despite experiencing higher rates of mental illness, Black adults receive the lowest treatment rates of any ethnic group—just 6%, compared to 13% among White adults.
- Black women are more than twice as likely to die during pregnancy or in the year after childbirth compared to White women.
- Minoritised ethnic people are 40% more likely to access mental health care via the criminal justice system than White people.
- Prevalence of psychotic disorders remains significantly higher in Black men compared to Asian and White men. The evidence indicates that this is not simply related to genetic factors, but rather environmental and psychosocial factors.
These disparities are not just numbers - these are individuals whose lives and families are profoundly impacted by a system that remains unfair but is also inefficient and costly.
Some years ago, the College recognised this issue and endeavoured to explore the reasons why these disparities exist. The increasing evidence is that social factors drive much of the excessive rates of illness seen in Black people; impact presentation and affect outcome. This is a challenge, but also an opportunity, an opportunity to change things going forward.
Equity delivery systems
These equity delivery systems are designed to improve access, experience and outcomes for marginalised groups of people who suffer significant health inequality because of race and ethnicity, but also because of other protected characteristics.
'Racism affects retention of psychiatrists'
And, of course, we developed guidance to Tackle Racism in the Workplace supported by our Act Against Racism campaign). This was not because we are “woke”, this is because racism affects retention of psychiatrists and frankly, the UK cannot afford to lose any more psychiatrists to other parts of the world.
'Structural racism remains'
The RCPsych recognised this as an issue a number of years ago and endeavoured to do something. We are proud of the work we've done, being at the forefront of equity, diversity and inclusion (EDI) efforts amongst the medical royal colleges and in the charity sector. It is too easy, perhaps lazy, for people to label psychiatry and therefore psychiatrists, as no less racist or discriminatory than 50 years ago, because of ongoing disparities in mental health care, but over the last 8 or 9 years, the College is one of the only mental health organisations that has actually developed practical initiatives to tackle racism and discrimination, not just condemned it and talked about it.
More to be done
The journey toward racial equity in psychiatry is far from over. But by acknowledging the past, celebrating progress, and committing to continued action including encouraging the next generation of Black psychiatrists through our Aggrey Burke Fellowship, we can work towards a future where mental health care is truly inclusive for all.
Blog Author
Dr Lade Smith CBE
President
Dr Shubulade (Lade) Smith was elected President in 2023. She holds this role until 2026 and leads the RCPsych on behalf of its members and associates.
Question Time with the Officers
Each month, our President Dr Lade Smith CBE is joined by one or more of the College’s Officers to respond to questions and feedback from members and affiliates.
This is your opportunity to put forward suggestions about to how to improve things in mental healthcare, ask about some of the initiatives being undertaken and decisions being made, and learn more about the College and what it does.