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The aim of this article is an analysis of the links between race and psychotic illness, psychiatric diagnosis and treatment, as well as psychiatric, police and prison violence against people with mental health problems. The analysis focuses on Black men who are more frequently diagnosed with schizophrenia and other psychotic disorders and who face more brutal treatment than other people with such diagnoses. We have adopted a multidisciplinary approach which draws insights from psychiatry, psychology, and sociology and challenges the biologistic interpretation of “mental illness.” We take into account the United States and Britain – two countries with large Black minorities and an established tradition of research on these groups. Among the crucial findings of this study are the facts that racial bias and stereotypes heavily influence the way Black men with a diagnosis of psychotic illness are treated by the psychiatric system, police and prison staff, and that the dominant approach to psychosis masks the connections between racism and mental health.

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.

Schizophrenia is a profoundly disabling chronic mental disorder with an estimated annual prevalence rate of about 1.3% for the U.S. population age 18 to 54 (USDHHS, 1999). One reason it is so disabling is that onset typically occurs in early adulthood, impacting on a range of life experiences that influence later employment, such as completion of schooling, and early-career experiences at work. For most people, successful navigation of these experiences creates a solid foundation for later career advancement through the development of work skills and social supports.

This chapter briefly summaries research over the past four decades (and prior) associated with black men and mental health in the UK. The chapter also examines some responses to the research. This is because we unfortunately remain in a situation where black men in Britain are 17 times more likely than white counterparts to be diagnosed with a psychotic illness. Research into the mental health needs of black men has been conducted repeatedly in the UK, with each new generation hopeful for change. By briefly exploring some policies that have emerged to address this inequality, this chapter highlights the barriers to change.

In face of global deinstitutionalization policy, some aging parents find themselves confronting violence and crime in the family due to abusive behavior from their adult child with mental disorder. The aim of this paper is to explore and understand the meaning given by aging parents to this deviant behavior and the different ways in which they cope with a lifetime in the shadow of violence.

Data collection was performed through in-depth semi-structured interviews with 16 parents, followed by content analysis.

Three themes that expressed the meaning attributed to life with ACMD in the shadow of violence: (1) constructing parental identity in a shared reality of violence, (2) social and family networks as a resource in coping with ACMD, and (3) keeping a daily life routine as an anchor in a vulnerable, abusive relationship

Intervention with such families should focus on the life review process as a therapeutic tool. Interventions should also provide a “safety belt,” including health services, public social networks, and knowledge regarding their right for self-protection.

Old age becomes an arena for redefined relationships combining increased vulnerability, needs of both sides, and its impact on the well-being of the ageing parents. This calls for better insights and deeper understanding in regard to intervention with such families.

Estimates of the prevalence of AS in children throughout the entire population of the United States are highly limited and greatly variable. Ozonoff, Dawson, and McPartland (2002) stated that estimates of AS range from 0.2 to 0.5% (or 2–5 individuals in 1,000), while Volkmar and Klin (2000) cited studies reporting rates of 36 in 1,000 to approximately 1 in 10,000. The Diagnostic and Statistical Manual of the American Psychiatric Association (2000), fourth edition (DSM-IV-TR), states that “definitive data about the prevalence of Asperger Syndrome does not exist.”

The last several decades have brought about a paradigm shift in the conceptualization of disability (Fougeyrollas & Beauregard, 2001; Williams, 2001). The traditional medical model considers disability to be a characteristic of the person, situated within the body. In the medical model view, disability, or difficulty functioning in major life domains, results from bodily impairments associated with a medical diagnosis or disorder, and a medical intervention or treatment is required to “correct” the problem of the individual. Alternatively, contemporary social models argue that disability is a social construction. In the social model view, disability is created by social policies, stigma and other barriers within the social and physical environment. Changes in attitudes and policies and the removal of barriers are needed to “correct” these environmental problems.

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

Mental health is an underdeveloped service to the population generally and to African-Caribbean in particular. There is a need for more sensitive diagnosing, treatment and care. African-Caribbean people are asking for a more culturally competent mental healthcare system.

This chapter aims to address the following issues: how African-Caribbean people reflect on mental health and mental ill health. Their reflections are drawn from interviews done with African-Caribbean people who are involved with Hagar, a mental health charity in Lewisham, London. Mental health and mental illnesses will be examined, followed by the Psychiatrists’ use of the diagnostic tools that do a disservice to Black people. The Trans-Atlantic slave trade and its contribution to the mental ill health of Black people will be addressed, thus providing a historical underpinning for much of Black people’s struggle with mental ill health. Racism and its contribution to mental health issues will be presented. The views of the Black Psychiatrist Franz Fanon will be argued as a way of understanding oppression, alienation and mental ill health in Black people, and going on to open up ways of providing treatment and care. Finally suggestions will be made about how to provide a culturally competent mental health service to African Heritage peoples.