Doctors Discouraged From Sectioning Black Patients

NHS doctors are under pressure not to section psychotic black patients to avoid appearing racist.

The Telegraph has uncovered numerous examples of NHS policy documents and mental health bodies calling for detentions of black people to be reduced to tackle inequality.

Doctors have criticised the policies as “scientific illiteracy” and “jumping on bandwagons”.

Nine current and former NHS psychiatrists reported being encouraged to limit the number of black patients they section under the Mental Health Act to avoid them being over-represented.

Black people are 3.5 times more likely to be detained by mental health services than white people. In response to this, the NHS has rolled out positive discrimination policies.

However, doctors warned that higher rates were not the result of a racist mental health system, but linked to risk factors such as social disadvantage, living circumstances and migration.

Psychiatrists said restrictions on sectioning mentally ill black patients deprived them of the care they needed and increased the risk to themselves and the wider public.

One former NHS doctor said: “Once a patient has psychosis, we shouldn’t perform sociology, we should perform medicine.”

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A former NHS psychiatrist reported that team members questioned his decisions to section black patients on multiple occasions, warning it could be “construed as racism”.

The former head of a major London trust recalled arguing with an inspector over why the majority of the patients on his acute ward were young black men even though the hospital was located in a majority black area.

Several doctors compared the issue to the grooming gangs scandal, in which police in Rotherham failed to stop groups of mainly south Asian men systematically abusing mostly white working-class teenagers amid fear of being accused of racism.

Last year, Mind, the mental health charity, condemned racial disparities in detention as “shameful”.

When the new Mental Health Act became law in December 2025, Wes Streeting, the former health secretary, said it would help tackle “unacceptable disparities that have seen black people detained at disproportionately high rates”.

However, doctors argued the term over-representation is “morally loaded”, and pointed to numerous factors that contribute to high rates of black detentions besides NHS racism, including family breakdown, school exclusion, absent fatherhood, social deprivation and cannabis use.

Prof Sir Robin Murray, one of the world’s leading researchers in psychosis at King’s College London, said there is “political pressure” to reduce the number of black people being sectioned, but added the reality is that physical and mental health issues affect racial groups differently.

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For others, the pressure is a more subtle “sotto voce” or “background hum”.

“It’s a pervasive pressure,” said one senior psychiatry professor. “You are seen as failing a little bit if you admit a black person on a section, whereas if you admit a white person it’s clear they are very very ill and needed it.”

A retired psychiatry professor said there was a “lazy assumption” that psychiatrists were racist when in fact “we’re a profession of woolly-minded liberals”.

“There is this constant statement that ‘we must get the numbers down,’” he added. “My argument is that these people are ill and therefore should be getting more care, not less.”

Much of the difficulty stems from the fact that the root causes of psychotic disorders remain unclear.

Swaran Singh, an NHS consultant and professor of psychiatry at Warwick University, said: “Diseases do not spread themselves equally. They are related to risk factors.”

Prof Singh said he was branded persona non grata by the profession 20 years ago when he published a paper claiming that detentions of black men were not the result of a racist mental health system.

Rather, he argued, they were linked to risk factors such as urban upbringing, social exclusions, childhood trauma and poverty, to which ethnic minority populations are more susceptible.

He also claimed that “every good study” shows that migrants have higher rates of psychosis than indigenous populations, regardless of ethnicity.

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