The problem with the Mental Health Act
The recent passage of the Mental Health Act 2025 is a welcome step in tackling the racial disparities long associated with 1983 Act. For decades, Black and minoritised communities have experienced disproportionately high rates of detention, coercive interventions and unequal treatment within mental health services. Seeing these inequalities acknowledged within legislation matters as it reflects years of advocacy from communities and organisations who have persistently called for reform and greater accountability from the mental health system.
However, while this moment of reform was meant to be an opportunity to reshape a system long criticised for inequality and injustice, for Black and minoritised victim-survivors of violence against women and girls (VAWG), the new law still carries many of the same shadows as the Mental Health Act 1983 it replaces. Recognition is important, but without deeper structural change, the patterns of harm that communities have fought to expose risk continuing within the very system meant to provide care and support.
When you look more closely at what the reforms actually do, a troubling gap emerges. The experiences of Black and minoritised survivors of VAWG are still largely absent. The legislation speaks about inequality in broad terms, while the reality for many survivors sits at the sharp intersection of race, gender and trauma.
One of the most significant omissions is the lack of any clear recognition of VAWG as a driver of mental ill-health. According to Imkaan’s ‘Why Should Our Rage Be Tidy’ report, many survivors come into contact with mental health services carrying the psychological impact of abuse. Yet for Black and minoritised women, these experiences are too often interpreted through racialised assumptions about risk, aggression or instability. Trauma responses that should be understood in the context of harm can instead be treated as symptoms that require control or containment. While the Act introduces safeguards around detention and decision-making, it stops short of requiring services to systematically recognise or respond to violence and abuse as a central factor shaping mental health crises.
For Black and minoritised victim-survivors of VAWG, this means navigating institutions that frequently fail to recognise the context of their trauma. By failing to embed an intersectional understanding of racism and VAWG into mental health reform, policy once again renders these women invisible.
The launch of Imkaan’s Out of Sight, Out of Mind campaign
New research from Imkaan reveals a profound gap in how specialist services are funded and supported. As part of the organisation’s Out of Sight, Out of Mind campaign, analysis of data obtained through Freedom of Information requests shows that Integrated Care Boards (ICBs) across England are failing to commission specialist support for Black and minoritised survivors of VAWG.
Of the 41 ICBs that responded (out of a possible 42) not one reported commissioning a specialist “by and for” VAWG service to deliver mental health or therapeutic support to survivors between 2022 and 2025.
This finding is striking. Specialist “by and for” organisations are those designed and led by the communities they serve. They are widely recognised as vital for delivering culturally appropriate, trusted and effective support. Yet across all ICBs, not a single one reported commissioning such services for mental health provision.
This raises serious questions about whether ICBs are meeting their legal obligations under the Health and Care Act 2022, which requires health systems to reduce inequalities and promote integrated care. It also calls into question compliance with the Public Sector Equality Duty, which obliges public authorities to actively address discrimination and advance equality.
The absence of commissioning tells a wider story. It suggests that specialist Black and minoritised VAWG organisations are not only underfunded but also excluded from shaping local health strategies and responses. The research also highlights weak coordination between ICBs and other public bodies in how services are commissioned and funded. Without clear accountability, support systems remain fragmented and inconsistent. In practice, this means survivors encounter institutions that do not see them, do not hear them, and do not respond to their needs.
Mental health reform cannot succeed while ignoring the intersecting realities of racism and gender-based violence. If the Government is serious about tackling VAWG and addressing racial inequality in mental health care, then specialist “by and for” services must be recognised, funded and embedded within the system. Without them, reform risks being little more than rhetoric.
Until these structural gaps are addressed, far too many survivors will remain exactly where the campaign’s title suggests: out of sight, and out of mind.
Fleur Boya is Parliamentary and Campaigns Coordinator at Imkaan, the UK’s only umbrella organisation representing violence against women and girls (VAWG) services led ‘by and for’ Black and minoritised women.
