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The chapter begins by discussing an official report that highlighted institutional racism in London’s Metropolitan Police and stimulated many organisations to examine their own processes. It describes the evolving literature in the 1980s, which was critical of psychiatry and mental health practice and which was often grouped under the umbrella of ‘transcultural psychiatry’, advocating anti-racist strategies and cultural-sensitivity training for staff. The chapter discusses the contribution of the black voluntary sector to supporting black people; work that led to a strategy intended to deal with racial inequalities in the mental health system, but which eventually failed; and events and happenings, some involving the author personally, that illustrate the extent to which institutional racism is embedded in the mental health system and in government departments. A theme that runs through the chapter is the struggle against racism in mental health services on the part of UK’s black and ethnic minority communities, and it ends by considering race matters in professional bodies involved in psychology and psychiatry.

This chapter focuses on the persistence of racism in a changing ethno-social scene in the UK, in the context of a developing multiculturalism. It discusses the interplay in the disciplines of psychiatry and psychology between diagnosis, discrimination and power; racism evident in so-called ‘ethnic issues’ in psychiatry; and the failure of psychology services to provide acceptable talking therapies for many ethnic minority people. The chapter considers the concept of the racialisation of various social groups, and how racism is embedded in aspects of psychiatric and psychological research, often without the people carrying out the research being fully aware of the fact. It also includes two sections on the excessive use of the schizophrenia diagnosis for black people. The discussions are illustrated by real-life stories and experiences of which the author has close knowledge or which involved him personally.

Once the USA and much of Europe became gripped by so-called ‘war against terrorism’, newer variations of racism became evident as well as exacerbations of old ones. Anti-immigrant/anti-foreigner sentiments, Islamophobia and an increase in overt expression of traditional racism emerged. The chapter discusses issues of identity among Britain’s minority ethnic communities; critically examines the impact of the presidency of Barack Obama on race matters; and considers briefly the rise of the political right.

In mid-2016, the UK voted to leave the European Union after a campaign characterised by racism voiced in terms of xenophobia and nativism (‘take our country back’); and soon afterwards, the USA elected Trump as its president after a campaign characterised by misogyny, white supremacy and nationalism (‘America first’). Hostility towards the racial ‘Other’ appears to be sweeping the UK and USA. The future is difficult to predict with much certainty, except that racism is back with a vengeance.

The chapter begins by discussing the failure of the hopes for the elimination of racism, voiced after the end of the Second World War, to live up to expectations. It goes on to discuss how the mental health system is part of controlling racialised groups in various settings; and how racism operates in employment in the National Health Service and in the Department of Health. It draws on personal experience in discussing the position of black people in a racist mental health system and how black people can try to influence policy in institutions although these are essentially dominated by white people. It ends by considering the issues of power and privilege associated with racism; and the restrictions that result from academic disciplines, including clinical psychology and psychiatry, being informed by limited sources—what is called white knowledge.

In the years following the end of the Second World War unashamed racism was replaced by new forms of racism, exemplified to some extent in American social studies. The expression of racism became subtle and less overt but its power underpinned racial inequality in many facets of British and US society. The chapter discusses racist IQ studies, debates about race and madness and racist notions of black mentality. It then goes on to discuss the racist nature of psychological and psychiatric observations on alleged defects in the mentality of black people in British and French colonies in Africa; and in the alleged ‘deficiencies’ of ethnic minority groups, such as their inability to differentiate emotions, tendency to deny symptoms and alleged unusual ways of being depressed. It concludes with a summary of race matters from the 1960s onwards.

The first part of this chapter explores the origins of ‘race thinking’ in European culture and literature; and then outlines how this led to racism as a dominant ideology in European culture with which to explain diversity of human physical appearance and cultural differences. It describes how race-based slavery (the white-on-black Atlantic slave trade and the plantation cultures of America and the West Indies) and subsequent race-based colonialism established racism as an important part of Western culture over the next 300 years. The second part of the chapter traces the emergence of (Western) clinical psychology and psychiatry (the main ‘psy’ disciplines), as they developed in tandem, through a study of madness in a positivist framework of the post-Enlightenment thinking of the seventeenth and eighteenth centuries. The chapter discusses the confinement of the ‘mad’ and the construction of mental illnesses; how an earlier notion of a positive value of non-reason (of ‘mad’ people) changed to one where madness was seen as ‘illness’; and then how the ‘illness model’ was applied to explain the causes of a variety of human problems, leading finally to the biomedical psychiatry of today. It uses a table listing historic events against events in the development of the ‘psy’ disciplines to illustrate how racism permeated those disciplines.

This chapter considers the overt, unashamed nature of white supremacist thinking that characterised the Victorian age and the years leading up to it, as European power came to dominate most of the world. It traces how racist thinking carried over to become a driving force in the colonial project in Asia and Africa, following on the tradition set during the era of the Atlantic slave trade. Thus racism informed the work of psychologists and psychiatrists during the latter part of the nineteenth and at least the first half of the twentieth centuries, persisting to the present in a variety of ways. The chapter covers ways in which race matters were dealt with in nineteenth-century sociology, psychology and psychiatry. It describes the intimate connections between eugenics and psychology, and the racist ideologies evident in the work of eminent psychiatrists and psychologists. Examples are given of race-specific (mental) illnesses diagnosed among enslaved Africans and racist theories about racial diversity of mental health and mental illness, especially the excessive labelling of black people with the schizophrenia diagnosis.