By Gracious Shonge, CARE Research Intern
When I started my internship at CARE, I thought I understood discrimination fairly well. I’m a law student who has interned with Amnesty International and cares deeply about human rights. What I didn’t expect was how much a summer reading academic papers on mental health law would change how I see fairness in this country.
My literature review examined how people with protected characteristics like race, disability, age, sex, and others under the Equality Act 2010 are assessed and detained under the Mental Health Act 1983. In plain terms: when someone is having a mental health crisis serious enough that a professional needs to decide whether they should be admitted to hospital, sometimes against their will, does that decision get made fairly, whoever the person is?
The person who is the legal applicant to make the application is an Approved Mental Health Professional, or AMHP — usually a social worker with extra training, who makes the decision with two doctors. Their role is to balance someone’s safety against their right to liberty. It’s one of the hardest decisions a professional can be asked to make, and, I’ve learned, one shaped by patterns going back decades.
The evidence on race was the hardest part to read. Black people in England are still around three to four times more likely to be detained under the Mental Health Act than White people, a gap that has barely moved in over forty years, across every reform that was meant to fix it. I read about Orville Blackwood, Michael Martin, and Joseph Watts — three young Black men who died in seclusion at Broadmoor Hospital in the 1980s and 90s — and about Olaseni Lewis, who died in 2010 after being restrained by eleven officers. These weren’t isolated tragedies. They were part of a pattern researchers have been documenting since before I was born.
What struck me the most was that the data did not lead to specific bad individuals. It speaks to a system: police are more frequently contacted instead of General Practitioners, referral routes silently divided by ethnicity, and professionals — even well-intentioned ones — make split-second decisions impacted by assumptions they may be unaware of. One research I studied includes a direct remark from a service user: a White man who throws a chair is told to calm down, whereas a Black man who does the same is restrained and sequestered. That single line has stuck with me more than any number.
I also found real gaps. For characteristics like sexual orientation, gender reassignment, and marriage and civil partnership, there’s almost no research at all. Wales-specific data is strikingly thin, too; most of what we know comes from English studies, and the last Welsh census on this topic ended in 2010 with no replacement.
The most significant aspect of this internship was, without a doubt, the direct presentation of these findings to a group of AMHPs. One AMHP informed me that Cardiff has a sizable Somali community, but very few of the area’s AMHPs are from it. This is the exact workforce gap I had discovered hidden in a national dataset, but they had personally experienced it, so the evidence stopped feeling abstract almost instantly. This kind of research is only significant if it reaches the individuals who make these decisions on a daily basis, and this internship ceased to feel academic to me when I witnessed that real-time acknowledgement. I anticipated learning about the law. The urgency with which I believe the law ought to be implemented surprised me.
