Blacks are more violent than whites because of culturally determined behaviour patterns
and black patients tend to become more involved in criminal activity seemingly more
readily than their white counterparts ([1991] ch5 p 140).

Richard Tilt, Director General of HM Prison Services, gave his views in a recent interview in
The Voice(March 30 1998) on death after restraint and claimed recently that:

Afro-Caribbean people are more likely to suffer positional asphyxia than white

for reasons of biology, not taking into account the fact that black men as perceived as 'big, black
and dangerous' (Prins [1993]) and are often subjected to heavy doses of drug cocktails and
restrained by excessive force which has led to deaths in HM prisons and Special Hospitals.

Judgements like these have 'political, psychological, social and economic' consequences on the
lives of black people (Fatinilehin [1989]). We are judged about who we are, what we can achieve,
what we cannot do, where we can live, and how best to manage us.

In September 1997, Mind issued a report, Raised Voices, which summarized the experiences of
black mental health users. They concluded that;

It is clear that different types of treatment can be helpful at different times and to different
people. But the experience of African-Caribbean patients seems to indicate a bias towards
the use of drugs rather than other treatments.

Paul Boateng, the then Minister of Health, summarized the report at a seminar organised by the
High Security Psychiatric Services Commissioning Board. His remarks were reported in the
Guardian, under the headline 'Young Blacks in Fear of Mental Health Services'.

Young black people regard mental health services as 'very dangerous'. They are at high
risk of being diagnosed schizophrenic, put on powerful sedatives and detained
compulsorily.

Boateng is calling upon health professionals to recognize and challenge the 'double
stigma' attached to black people with mental health problems.

He said that the widespread perception was that mental health care was 'a system that is
very dangerous for young black people to get involved with'.

He wanted to see 'many more' black and ethnic minority people in positions of
responsibility in the NHS.

2. Questioning diagnosis and treatment

Black users of mental health services have complained about discrimination before Raised
Voices. In 1995, 41 black mental health users were interviewed about the quality of the mental
health services provided by Sandwell Health Authority, Midlands (Jamdagni [1996]).

This is what they did not like:

1. The tendency to prescribe medication

2, The lack of appropriate counselling services

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