The Mental Health Act: the impact of age and race

In this second blog on the Mental Health Act, following its omission from the King's Speech, Policy and Public Affairs Officer Tara Harris explores how reform to mental health policy is especially vital for young women and girls and Black, Asian, minoritised and migratised women and girls.

Girls and young women, and Black, Asian, minoritised and migratised women and girls, are disproportionately impacted by mental health challenges.

However, they lack access to tailored or specialist support which can meet their needs. It has been repeatedly noted that one of the key reasons to reform the Mental Health Act was to improve the disproportionate use of restraint against Black patients and so it is especially disappointing to see this opportunity missed by neglecting to prioritise this urgent legislative reform. Similarly, young women and girls are more likely to experience certain mental health conditions than men and boys, yet much of the support on offer is generic and underfunded – something which Agenda believes must urgently change.

Girls and young women face specific challenges when it comes to mental health. Our project, Girls Speak, found that:

• over a quarter of young women aged 16 to 24 have symptoms of depression or anxiety, experiencing this at three times the rate of their male counterparts and at higher rates than older women.
• Girls are more likely to be detained under the Mental Health Act than boys and young men. In 2016, 65% of young people placed in secure hospitals were girls.
• One in five women aged 16 to 24 reports having self-harmed at some point in their life.

Mental health issues are particularly prevalent for girls and young women in touch with the criminal justice system. Our recently released Call to Action briefing for our Young Women’s Justice Project, highlights some of the specific mental health challenges girls and young women face across criminal justice agencies.

• In 2022, the number of self-harm incidents in custody amongst 21 to 24-year old women surpassed all other female age groups. This number has been rising consistently over the past four years.
• In 2022, 138 young women aged 21 to 24 self-harmed while in prison. On average, these young women self-harmed 34 times during the year.
• We also found that 80% of young women in custody report having mental health problems.

It’s clear that mental health services and prisons are not designed with girls and young women mental health care in mind, and do not have the appropriate training or resources to support their needs. There needs to be clear guidance and training to specifically meet the needs of girls and young women, as well as ring-fenced funding for women’s and girls’ services to provide age appropriate community based mental health and wellbeing support.

Black, Asian, minoritised and migratised women and girls face more severe negative consequences when interacting with mental health support.

• Shockingly, our research found that over the five-year period between 2012/13 and 2016/17, Black and minoritised women were over-represented in the thirty-two women who were detained under the Mental Health Act and died after being restrained.
• Studies also show that rates of self-harm are highest amongst young Black women, but they are less likely to receive support for this.
• Further research also indicates that South Asian young women (aged 16 to 24) are significantly more likely to self-harm than young white women.

• Specialist gender-, trauma-, age-, and culturally-responsive care in in-patient and community mental health services, so that women and girls can access the support they need, when they need it.
• Women and girls to be asked about their experiences of abuse and violence by trained professionals and to receive appropriate therapeutic follow up support.
• An end to the use of face-down restraint, and other forms of physical restraint used only as a last resort.
• Data collection that demonstrates women and girls’ experiences of and outcome under the Mental Health Act, including a disaggregated break down by gender and other characteristics, which would help to develop focused support for these groups.

All of this is possible if policymakers take seriously the need to review the Mental Health Act. As mental health across the country worsens, addressing this through tailored, specialist support is essential for the groups most disproportionately affected.

We recently voiced our concern to the Prime Minister alongside a number of other mental health organisations regarding the lack of reform to the MHA included in the King's Speech; read our letter here.