When my mental health dipped during a period of immigration stress and financial precarity, I did what the leaflets say: called the GP, filled the online form, waited. By the time the service replied, I had already taught myself to “mask” at work.
I am British South Asian. I speak fluent English and still found myself translating my experience into a narrow clinical accent during the appointment. I have seen friends refused interpreters or told to “bring a relative.” Miss one call because you are juggling shift work or bad Wi-Fi and the file reads “did not engage.” The problem becomes the person, never the design: nine-to-five lines, forms that punish long stories, targets that reward quick discharges. In a system built for speed, those who need time get labelled difficult.
The assessment focused on symptoms inside my head, not the eviction notices on the table or the racism I had met that week. I was not “complex”; I was unsafe in the world. My distress was not a disorder. It was a response.
You learn the choreography quickly: six sessions, a workbook, a discharge letter. I was advised to build “resilience,” as if the real work was not forcing my landlord to fix mould, or appealing a benefits decision that froze my bank card. Poverty, immigration status, and racism are not “background factors”, they are the treatment plan. When I raised these, the room fell quiet: outside scope, outside budget, outside the service.
Once, a crisis visit brought the police to my home in place of a clinician. Nothing violent happened, but I left more frightened than when I called. Colleagues have had welfare checks turn into searches; Black friends tell me about assumptions of risk that shadow them into every room. Surveillance is not support. The message is clear: comply with our pathway or we escalate. For racialised people, “risk management” often feels like behaviour management.
I have been invited to co-produce mental health resources, institutional trust research, and translate patient leaflets, typically after most key decisions had already been made. Payment arrived months late; my edits were softened until risk-averse. True co-production starts at the problem-framing stage — budgets for interpreters and childcare, pays lived experience partners on time – and publishes what communities say even when it is uncomfortable. Co-production loses its integrity when it drifts into surveillance or policing; communities should have the authority to contest such shifts, not merely observe them.
What has helped is community: a user-led group where I did not have to justify distress; a small solidarity fund that covered travel to appointments; an advocate who sat with me on hold to housing; a faith space that let grief be loud. Peer support did not pathologise me for needing more time or cultural language. It named the real stressors and moved cash and companionship towards them. No assessments, no acronyms, just care that believed me.
I believe the following changes should be made to mental health services:
- Interpreter as a default provision rather than a favour, and ensure all interpreter use is tracked and transparently reported by both language and ethnicity.
- Non-police crisis options in every peer-run sanctuary, 24/7 safe spaces.
- Cash-first support alongside therapy: travel, food, data, housing advocacy.
- Stop calling it “DNA” as if absence is a flaw in the person. Ask instead what stood in the way — your timing, your tech, or their fear.
- Measure what matters. Ask whether people feel safer, believed, and less surveilled, not just whether they completed six sessions.
Mine is not a miracle recovery narrative. I still wobble. What has steadied me is being met as a full person: clinician and migrant, student and carer, someone navigating racism and bureaucracy while trying to stay kind to myself. The opposite of surveillance is not neglect; it is trust combined with resources. Racial justice in mental health is not a specialist add-on. It is the difference between being processed and being held. If you recognise yourself in this, you are not “hard to reach”, you were hardly reached.
Let us build the services that find us on our terms.