‘I had no voice': black mental health patients on surviving a care system they say is racialised

The Guardian

13-03-2025

It has been more than four decades since Devon Marston, a 66-year-old community organiser and musician, was taken to a psychiatric hospital where he was restrained, injected and forced to take medication. He was diagnosed with paranoid schizophrenia.
'Everything was said around me and about me, but no one asked me how I was doing,' he said. 'I had no voice, and there was no one to say: 'Don't do that to him,' or: 'Listen to him, hear what he has to say.''
The experience had a profound impact on his life and put him on a path to campaign for better care for minority ethnic people experiencing mental distress. However, progress has been painfully slow.
'Nothing has changed. Everything is still the same – only it's more covered up now by clauses in the Mental Health Act that make it look fair but the equality and justice are not there,' he said.
The most recent data paints a frightening picture. Findings from the Care Quality Commission's (CQC) latest report show that the number of adults sent for very urgent mental health care from crisis teams more than doubled between 2023 and 2024.
The report, published on Thursday, also raised concerns about the overrepresentation of black people being detained under the act, finding they are 3.5 times more likely to be detained than white people.
The damning report warned people are becoming more unwell while waiting for help and are stuck in a 'damaging cycle' of hospital readmission.
Tiwa, 22, described her experience with mental health support services as 'incredibly traumatic'. Her struggle with her mental health began when she was 13 and began self-harming. She was diagnosed with depression, anxiety disorders, suicidal ideation, as well as an eating disorder. She still has nightmares about the time she spent in a children's mental health unit.
'It was a horrible experience that I wouldn't wish on anyone,' she said. She points to the use of restrictive practices, restraints, as well as the use of forced medication.
'There were nights where there were maybe four staff looking after 12 to 15 young people who were just constantly having very dangerous incidents of self-harm. So we would be the ones having to run into our friends' rooms, help them, save them, and scream for staff,' Tiwa said.
Her discharge from hospital was meant to be a significant milestone in her recovery. But, she said: 'Every single night, I was waking up sweating and so scared, having nightmares of being restrained and incidents on the ward.'
Both Devon and Tiwi believe their race influenced the care that they received. 'There were times when situations escalated so much quicker and unnecessarily – situations where maybe force was used when it wasn't necessary, or I was seen as being aggressive when I wasn't. In my opinion, it had a clear racial undertone,' Tiwi said.
Devon still vividly remembers the first night he was sectioned. He ended up in hospital after his mother, who was concerned about his wellbeing, but did not fully understand mental health, Devon says, called a doctor. The doctor arrived with the police and an ambulance to take him to a psychiatric hospital.
'I went over to the office where the night nurse was and I said: 'Excuse me, love, I think you've got the wrong person, I shouldn't be here,'' Devon said. 'All of a sudden I see two or four big white men come down the corridor after me, run me down on the ground … They injected me and I was knocked out for four days.'
His life had changed completely. 'I couldn't breathe. I was dribbling from my mouth. I couldn't eat properly. I saw people around me in a similar atmosphere. I thought, I'm going to heaven. I'm going to die. When I looked through the window, I could see the big ground where the ward was situated in the building and the flowers were growing and everything was serene. I never understood the experience but as the years passed by and looking back, I realised what happened. They gave me psychiatric drugs to quiet me down.'
He added: 'Anyone who's accused of having mental problems or becoming violent or being black and dangerous in community, they give you tranquilliser … These tranquillisers and drugs the professionals are giving to me and to us are different from the ones they give to the younger white guys. They don't get the same ones that a black guy gets.'
Dr Sarah Hughes, the chief executive of Mind, said: 'The common threads between Devon and Tiwa's stories, which span several decades and transcend generations and genders, show how far we still have to go on stamping out racism in mental health care.'
While Hughes welcomes Thursday's report from the CQC, saying it shows some positive early progress on implementing the Patient and Carer Race Equality Framework, she says: 'it is ultimately more damning evidence of the barriers that people from racialised communities face while trying to get help and recover.'
For Devon, recovery was possible thanks to music. A nurse who had recognised his talent arranged for him to start a music workshop for other black men struggling with mental health issues. In 1992 he co-founded Sound Minds.
When asked what needs to happen next, Tiwi, now a young campaigner who works with institutions on reforming mental health care, said discussions of change must centre on people's lived experiences. 'If anyone knows what it's like to be part of the system, it's the people who have experienced it … It wouldn't make sense for these people not to be a part of the change.'
Devon agreed: 'Listen to us. Ask what we need, and we'll tell you.'