Sewell in Mad or Bad? A Critical Approach to Counselling and Forensic Psychology discusses the topic and intersectionality of race. It introduces Victor, a black male of African origin whose parents were originally from Nigeria but moved to. Victor has had multiple issues with criminality, the justice system (after being convicted of grievous bodily harm and robbery) and experienced mental health issues.
Data from reliable analysis tools such as the census that regularly records population changes, plus the gathering of feedback reports from service users in the mental health system help to support Sewells argument that a persons ethnicity negatively impacts the mental health care services they receive. On pages 70-73, Sewell highlights and partitions the inequalities that occur in mental health into five sections. In the first of these sections, Sewell describes how individuals from black and minority ethnic groups (BAME) will experience a high level of social inequalities, such as racism abuse trauma, poor housing and unemployment. In addition, he adds that migration and the impact of moving to another country can also negatively impact a persons mental health. In the second section, Sewell describes how members of the BAME group, in particular black African individuals, are more likely to be what he calls overrepresented in mental health care. He adds that BAME members will have statistically higher than a
verage detention rates in hospitals, have more referrals by other agencies such as the courts, and will more likely receive a diagnosis of psychosis and receive more formal community treatment orders from the mental health team. In his third section, Sewell argues that research conducted by Glover and Evison (2009) identified that men and women from BAME backgrounds (Bangladeshi, Chinese, Indian and Pakistani origins) were less likely to utilise psychological therapy services and therapies such as cognitive behaviour therapy (CBT). The fourth section describes how data gathered suggests that BAME members who accessed mental health care services were more likely to ultimately receive poorer outcomes such as repeated admittance and longer on the hospital ward than their white counterparts and were more likely to drop out when accessing talking therapies such as CBT. In the fifth and final section, Sewell describes how several researchers have identified significant issues between BAME communities and their satisfaction with their therapists and mental health care services. One study was the Breaking the Circles of Fear research in 2002. It found that African Caribbean communities reported very unsatisfactory levels of mental health services. Another study conducted by the Mental Health Commission in 2006 also reported that black and mixed-race groups reported high rates of dissatisfaction in mental health inpatient stays.