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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?

This chapter discusses the experiences of black men who encounter the phenomena of a mental health diagnosis, detention and death in a forensic setting in England. Although there are black women with mental health issues who have also died in forensic settings, the occurrence is significantly higher for men who become demonised as ‘Big, Black, Bad and dangerous’. The author discusses the historical over representation of mental ill health amongst black people in the general community and the plethora or reasons attributed to this. The author then discusses the various points of entry into the criminal justice system, where black men with mental health issues are over represented. The author explores some inquiries into the deaths of black men in custody and the recommendations that were subsequently made, which successive governments have failed to act upon. The author argues that the term ‘Institutional Racism’ is insufficient to explain this phenomenon; and offers her own theoretical interpretation which is a combination of systemic racism influenced by post-colonial conceptualisation

The aim of this chapter is to explore changes since the COVID-19 pandemic in welfare policies and services for people with learning disabilities and autism in England, focusing mainly on educational and health and social care sectors.

A review of official policy documents published on GOV.UK from January 2020 to May 2021 has been conducted using keywords on the topic in question, and semi-structured interviews took place in 2022 with four key informants/stakeholders working in health and social care or education sectors of people with learning disability or autism in England.

The main findings indicate a need to shift practices online due to the pandemic, for both education and health and social-care practice. It is also clear that reforms and adjustments were implemented in guidance, policies and frameworks for the support of persons with learning disabilities and autism. It has been increasingly difficult for people with disabilities to access healthcare services and medication during the pandemic, and this has had an impact on their overall health and wellbeing too. Experts suggested that smoother changes and more support are required, in terms of provision of services, research, access to healthcare, educational services, mental health, employment, as well as more public funding on such services for people with learning disabilities and autism.

The main lessons learned were focusing on the use of online resources, digitalisation of services and access to them, but also difficulty of the system to adapt fast to major changes required in order to support people with disabilities.

This chapter offers a prospective and naturalistic study of the impact of a risk-assessment and risk-management program on mentally abnormal young offenders admitted to a medium secure adolescent psychiatric inpatient unit in the United Kingdom (U.K.) because of violent, dangerous or self-harming behaviour. As a result of the risk assessment, there was a reduction in their violent, dangerous or self-harming behaviour that was significantly associated with a reduction in the number of risk factors. About 80% were discharged directly back into the community.

Since the demise of Delivering Race Equality strategy in 2010 under the last Labour government and with the Coalition (2010–2015), and now the Conservative government at times have adopted a “color blind” approach to race and health. This raises the fundamental question why is race equality off the political agenda and how black mental health issues can be part of a future strategy. The 2015 Care Quality Commission (CQC) annual monitoring report of the Mental Health Act (MHA; which has also incorporated the learning since the inception of the Act in 1985) further highlighted the overrepresentation of African and Caribbean men and women who are sectioned in secure wards or on Community Treatment Order (CTO) in the psychiatric system over the last 30 years. The CQC have revised the code of practice which recognizes issues around race equality as part of wider perspectives and principles of human rights.

In October 2017, the government established an independent review of the 2007 MHA as a way of providing more safeguards for patients and service users. The review, under the leadership of Sir Simon Wessely which is reported in 2018, provided an opportunity for an informed public debate on the historical and contemporary roles of psychiatry and the experiences of mental health in Britain’s African and Caribbean communities. The review did examine community anxieties about the proportionally larger numbers of black ethnic minorities receiving inpatient care and CTOs, or in the criminal justice system. However, after 30 years of Black History Month in the UK, we still need to ask the question: Are those of African descent overrepresented in these systems? If so, is serious mental illness over diagnosed among these groups due to the persistence of stereotypes rooted in the experiences of slavery, or do they in fact experience distinctive patterns of mental health and illness, perhaps due to the wider fallout of historical enslavem

The processual ordering branch of symbolic interaction has long recognized the importance of rhetoric and power to the social constitution of reality. However, little systematic effort has been devoted to probing their intertwined effects in the public policy arena.

The purpose of this paper is to employ the processual ordering perspective to examine the dramaturgical styles used in shaping public policy – expressed in terms of the “public administration” and “realpolitik” forms of rhetoric – among contending political factions as they negotiate mental health public policy. A latent content analysis of the minutes of key U.S. congressional debates, augmented with secondary archival material from the press is employed. It is concluded that both forms of rhetoric play a role in shaping public mental health policy and that both factions modify their rhetorical form as the debate progresses. Those modifications strengthen the position of one faction while weakening that of the other. Theoretical implications are discussed.