The experience of Black service users within forensic psychiatric services in the UK has remained largely unchanged over the past decade. It is similar to that of Black patients in secondary mental healthcare services, as summarised in a Department of Health publication Inside Outside (Sashidharan, 2003). This document brought together evidence from clinical and epidemiological research, clinical observations, anecdotal accounts and testimonies of service users and carers. It summarised the problems of mental healthcare as experienced by Black and minority ethnic groups to be:

Institutional racism

Despite the conclusion reached by Professor Sashidharan in Inside Outside, the Department of Health disagrees with the existence of institutional racism (also called structural or systemic racism) in mental healthcare services. Retired judge Sir John Blofield, in the independent report following the death of David Bennett in a medium secure unit, reported that institutional racism was present throughout the National Health Service (NHS) and that greater effort was needed to combat it. He noted that until that problem is addressed, people from Black and minority ethnic communities will not be treated fairly. He described the experiences of patients poignantly: ‘the black and minority ethnic community have a very real fear of the Mental Health Service.