Black Mental Health and Wellbeing Alliance
A Manifesto for Radical Change
23 recommendations for structural change across government, NHS, education, and civil society.
Download PDFAbout the Alliance
The Black Mental Health and Wellbeing Alliance is a collective of individuals with lived experience and grassroots organisations in the mental health sector, with a primary focus on tackling racial inequities that disproportionately impact Black people.
The Manifesto serves as a point of reference for the Government, healthcare professionals, those working in education, practitioners, policymakers and anyone involved in or accountable for instigating change.
Through collaboration, we can dismantle systemic barriers and develop a mental health system that genuinely meets the needs of Black communities, which benefits everyone.
When community members speak, it’s essential that we listen.
Part 1
Structural inequities contribute to poorer mental health outcomes. Black communities in Britain are disproportionately impacted by known risk factors — lower-income households, overcrowded housing, higher unemployment, and school exclusions. Racism and discrimination are at the heart of these inequities. Action can be taken to break these cycles.
Why? There is currently no coherent strategy to combat racism in the UK despite wide-ranging disparities and calls from civil society.
Why? Traditional clinical mental health services have not achieved good outcomes for Black communities; community-based models have proven benefits.
Why? Associated suicide risks are demonstrably higher in low and middle-income areas, with young Black men aged 13 to 24 most at risk.
Why? Refugees and asylum-seekers report greater levels of anxiety, depression and PTSD, worsened by over a decade of hostile environment policies.
Why? Victims have endured forced detention, loss of employment and housing, and separation from families, contributing to severe mental trauma.
Why? Black-led organisations have solutions but are held back by a lack of sustainable funding; 9 in 10 were at risk of closure at the start of the pandemic.
Why? ICSs have a legal duty to address health inequalities under the Health and Care Act 2022 and the Advancing Mental Health Equalities strategy.
Why? Black people are nearly four times more likely to be detained under the Mental Health Act and report worse outcomes during care and treatment.
Part 2
Racism permeates the key structures and systems that Black people interact with. To ensure long-standing change, we must address the systems, the strategies that govern them, and the practice of actors within them — including anti-racist commissioning, decision-making, accountability, and cultural competency.
Why? PCREF provides a systematic, transparent anti-racism framework to drive service improvements for racialised communities.
Why? Racism causes trauma that contributes to mental ill-health, yet actionable anti-racist recommendations from 50 years ago remain unimplemented.
Why? Mental health response vehicles have reduced A&E admissions to 16%, compared to 50% with regular ambulance responses.
Why? Colonialism has established racial hierarchies of knowledge that perpetuate racism through research and policy sectors.
Why? Current approaches reinforce beliefs that Black communities do not know what is best for them, stripping them of agency and self-determination.
Why? Higher education curricula are rooted in colonialism and racism, making it impossible for practitioners to be truly culturally responsive.
Why? Regulators are in a unique position to rebuild trust with Black people and rectify systemic inequities through frameworks like PCREF.
Why? The detention rate was 3.6 times higher for Black people in 2022/23; Advance Choice Documents give patients a voice in their future care.
Part 3
Our current understanding of mental health is rooted in white, Eurocentric norms. To eliminate racial disparities, we must reimagine how we understand mental health and build support systems that allow for different ways of knowing and being. We must learn from the past and build on community strengths to create sustainable change.
Why? The current WHO definition negates the reality of Black people who face racism and discrimination impacting their wellbeing.
Why? Retrofitting existing interventions not designed for or with Black people perpetuates harm; new approaches must centre reparative justice.
Why? Research shows relationships between gut health and depression, with variations in gut microbiomes based on race and ethnicity.
Why? Black people are almost nine times more likely to be stopped and searched; negative police interactions increase risks of PTSD and depression.
Why? Less than a third of teachers have received training on racism, yet 94% believe it should be given to all school staff.
Why? Black Caribbean children are nearly twice as likely to be excluded; exclusions predict the onset of new mental health problems.
The Black Mental Health Manifesto is freely available to download, share, and reference. Distribute it to colleagues, elected representatives, commissioners, and anyone in a position to act.
Download PDFApril 2024 · Black Mental Health and Wellbeing Alliance
Whether you are a policymaker, practitioner, commissioner, educator, funder, or community member, there are concrete steps you can take to advance these recommendations.
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