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The most recent research on the prevalence of young caring in secondary school–age children (Joseph et al., 2019) suggests that one in five 11–16 year olds have a caring role. There are inherent challenges with identifying children and young people (CYP) who have caring responsibilities; they find themselves in the role because of love for a family member, as well as the lack of provision to meet the needs of the person they are caring for (Keith & Morris, 1995), not because they have consciously chosen to become a carer, and so do not identify with the concept (Smyth, Blaxland, & Cass, 2011). School can be both precarious and a place of sanctuary for young carers (Becker & Becker, 2008). Experiences of education, as with many aspects of caring, exist on a continuum with no young carers’ educational experience being the same (Dearden & Becker, 2003). Schools have a pivotal role in identifying, understanding and supporting young carers to prevent their education from being adversely affected.

At the heart of health and social care services is the pursuit of safety and dignity. Legislation and organizational policies are the main way in which statutory and independent organizations’ are tasked with enabling adults with mental health services along the road to recovery. Safety is an intrinsic motivator and basic need.

There is increased political recognition that social policy including the Mental Health Act 2007, which is a cornerstone, is in need of reform. A Conservative Manifesto pledge to reform mental health legislation is based upon the need to mitigate discrimination.

The chapter will explore the interrelationship between “poor outcomes” within the black community and safety; consider the opportunities to move from organizational complacency as a result of new policy and legal frameworks; and promote the view that developing a new discourse around safety is an integral part of improving outcomes for service users, particularly those who are poorly served currently.

A literature review plus reference to case studies will form the basis of the chapter ent and modern racism?

Several decades of mental health research in the UK repeatedly report that people of African-Caribbean origin are more likely than other ethnic minorities, including the White majority, to be diagnosed with schizophrenia and related psychoses. Race-based inequalities in mental healthcare persist despite numerous initiatives such as the UK’s ‘Delivering Race Equality’ policy, which sought to reduce the fear of mainstream services and promote more timely access to care. Community-level engagement with members of African-Caribbean communities highlighted the need to develop culturally relevant psychosocial treatments. Family Intervention (FI) is a ‘talking treatment’ with a strong evidence-base for clinical-effectiveness in the management of psychoses. Benefits of FI include improved self-care, problem-solving and coping for both service users and carers, reducing the risk of relapse and re-hospitalisation. Working collaboratively with African-Caribbeans as ‘experts-by-experience’ enabled co-production, implementation and evaluation of Culturally adapted Family Intervention (CaFI). Our findings suggests that a community frequently labelled ‘hard-to-reach’ can be highly motivated to engage in solutions-focussed research to improve engagement, experiences and outcomes in mental health. This underscores the UK’s Mental Health Task Force’s message that ‘new ways of working’ are required to reduce the inequalities faced by African-Caribbeans and other marginalised groups in accessing mental healthcare. Although conducted in the UK (a high-income multi-cultural country), co-production of more culturally appropriate psychosocial interventions may have wider implications in the global health context. Interventions like CaFI could, for example, contribute to reducing the 75% ‘mental health gap’ between High and Low-and-Middle-Income counties reported by the World Health Organization.

The practice of transracial adoption often triggers strong emotions, effecting views on its ethical validity, both from individuals who are pro transracial adoption and those who strongly resist transracial adoption. This chapter will consider transracial adoption of children of African-Caribbean origin and its psychological impact along a continuum of psychological wellbeing, psychological adjustment and aspects of mental health. The chapter will draw on literature from the USA and, where available, from the UK.

One of the earliest publications on transracial adoption by Grow and Shapiro (1974) explored the psychological adjustment of African-American children placed within white American families. This study along with later studies (Silverman & Feigelman, 1981) concluded that the children were adjusting well in placement. Further early research appeared to suggest that transracial placements have little negative impact on issues of self-esteem, racial or self-identity or intellectual development (Curtis, 1996; Hayes, 1993; Hollingsworth, 1997, 1998; McRoy, 1994; Simon, Altstein & Melli, 1994; Vrogeh, 1997).

The undermining impact on mental health for transracial adoptees appears to be an argument related to the disconnect between the child’s developing racial identity and lack of preparation for racism and the cultural and ethnic group social devaluation likely to be experienced in a white racist society. The impact of loss of ethnic identity is said to be a key issue in the research on transracial adoption. Ethnic identity is the connection or recognition that one is a member of a specific ethnic or racial group and coming to adopt those associated characteristics into the group associated cultural and historical connections into oneself identity (Rotheram & Phinney, 1987). The establishment of a secure and accurate racial identity is said to be a protective factor in psychological adjustment. This chapter will explore issues and narratives related to this argument.