Mental health inequality is real – as a Black woman, I’ve lived it

Imagine begging and begging for help, finding yourself drifting on and off A&E crisis hotlines, and the only remedy is being dosed higher and higher on mind-numbing antipsychotic medication

Sylvie Carlos
Monday 10 October 2022 10:00 BST
Chris Kaba death: Relatives of 24-year-old killed by police share tearful embrace

Once again, World Mental Health Day is upon us. Unfortunately, our world remains an unequal one – and this disparity is clearly demonstrated in mental health, both in matters of race, gender and among diagnoses.

For starters, Black people are five times more likely to be sectioned than white people. Women are three times more likely to develop a common mental health disorder than their male counterparts.

There is bias even amongst mental health charities. Chris Kaba, an unarmed Black man, was killed by the Metropolitan Police in September, and this is currently being investigated by the IOPC. Mental health charity Mind published various tweets about it. They highlighted what a lot of people I’ve spoken to have touched on in terms of the sheer frustration the Black community felt during a time when news coverage was solely focused on the Queen’s death – while this incident needed our attention.

I was proud of Mind, because they did what it feels like various mental health organisations miss. They publicly validated Black people’s experiences with four words on Twitter, a platform where they have over half a million followers: “Racial trauma is real.” But then, a mere day later, they backtracked.

They apologised for their tweet and replied to individual tweets of outraged people. I’m going to bet money on it and say the outraged people had one thing in common – an interesting friendship with the quote: “All lives matter.” I expect those comments from what I refer to as “online gangsters”, but because of the original tweet from Mind, I was disappointed. I felt let down as someone who regularly refers people to Mind. Pressure didn’t make Mind a diamond, it made them crumble. I’m not sure about signposting people to them anymore.

It’s also worth noting that Black people are substantially overrepresented at inpatient facilities, yet less likely to receive support until they are in crisis. I am not surprised at all. I can’t even pretend to feign lukewarm shock. Imagine begging and begging for help, finding yourself drifting on and off A&E crisis hotlines, and the only remedy is being dosed higher and higher on mind-numbing antipsychotic medication. That’s my experience, as a Black woman who lives with borderline personality disorder (BPD).

I waited on a list for three years while sedated on medication. It got to the point where I couldn’t even pinpoint my favourite colour anymore, let alone any hobbies that I enjoyed. I felt in a constant zombified state, and after taking the medication, I could sleep for 14 hours straight.

I often feel that there is a threshold for acceptable mental health conditions. Let me take you a bit deeper and walk you past the good side of the mental health neighbourhood. This isn’t the struggle Olympics, but we do need to have a transparent conversation about why there are “acceptable disorders” like depression and anxiety, and why there are more stigmatised, frowned-upon ones, such as bipolar, schizophrenia and borderline personality disorder.

People with borderline personality disorder are 50 times more likely than the average person to contemplate suicide. And for every 10 people with BPD, one of us dies by suicide. These aren’t just words to me – this is personal. It’s life or death, which feels even more painful when you add racial inequality into the mix. I want my life and the lives of others with BPD to be more than just a number, but I can’t help but think about people that I’ve been in therapy with. Sometimes 10 is that magic number in the group, and I panic.

While on an NHS waiting list for Dialectical Behavioural Therapy (DBT), I would have a generic psychology appointment every three months – and this was before the Covid-19 pandemic of 2020. They did six-month rotations and the first out of the two appointments was always painful, as I would have to rehash my whole medical history to professionals who never seemed to read my notes in advance. And with the end of each rotation came the news that my referral had been misplaced.

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What could I do? I did what I needed to get by and hoped I would get proper help before my attempts of needing a “long break” became irreversible. When I speak to others, they recount strikingly similar accounts.

The Independent even reported back in 2018 that “nine out of 10 NHS Commissioning Groups (CCGs) didn’t record any waiting times for talking therapies in severe mental illnesses”. A close friend of mine was told to join an online group therapy and that she wouldn’t be put on the referral list for DBT until she completed the sessions.

She’s terrified of going and her mental state keeps deteriorating, but she is effectively being blackballed from treatment unless she complies. When I don’t hear from her in a couple of days I fear the worst, and it’s not irritational when you know the suicide statistics for BPD sufferers.

I want this to change. I want the racial inequality within the mental health sphere to be eradicated. In the grand scheme of things, I’m not special. What I am is Black, female and living with a serious mental health disorder. It feels quite surreal knowing that I’m living in an unequal world with horrifying mental health statistics that deeply impact the lives and life chances of people like me.

If you are experiencing feelings of distress and isolation, or are struggling to cope, The Samaritans offer support; you can speak to someone for free over the phone, in confidence, on 116 123 (UK and ROI), email, or visit the Samaritans website to find details of your nearest branch.

If you are based in the USA, and you or someone you know needs mental health assistance right now, call National Suicide Prevention Helpline on 1-800-273-TALK (8255). The Helpline is a free, confidential crisis hotline that is available to everyone 24 hours a day, seven days a week.

If you are in another country, you can go to to find a helpline near you

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