Sir: It is well known that people who experience mental health services and many people from black and ethnic minority communities have grave reservations about the clinical practice of psychiatry.
The implementation of compulsory powers under present circumstances (ie the 1983 Mental Health Act) is riddled with racism and cultural insensitivity resulting in inequality and injustice - a fact evident from reports of the Mental Health Act Commission and I believe well known to ministers.
Basically, the system of (Western) psychiatry used in the mental health services is both insensitive to the cultural diversity of our society and fails to counteract problems arising from institutional racism. And there is as yet no indication that the government has either the political will or the strategy to remedy these difficulties.
Frank Dobson's letter to Dr Graham Thornicroft does not indicate that he is looking to the committee headed by the latter for anything like a radical examination of psychiatric practice and of course he would not have given the chairmanship of the committee to a psychiatrist from the mainstream of institutional psychiatry if he had!
My fear is that unless the problems inherent in current pyschiatric practice are tackled first, the proposed changes (round-the-clock crisis teams, extra hostels etc) would have little effect - and in some cases may make matters much worse both for people diagnosed as "mentally ill" and the general public. And worrying to me as a psychiatrist is that the already tarnished reputation of pyschiatry as a racist and insensitive discipline that is merely a front for social control would be worsened.
DR SUMAN FERNANDO
Senior Lecturer in Mental Health
University of Kent and CanterburyReuse content