Within mental health services, Black people tend to have poorer experiences of mental health services, in terms of access, treatment and outcomes. Institutional racism has been cited as one of the main causes for the differences.

There is much controversy about why some people have poorer life chances, and specifically poorer experiences of health and mental health. One explanation for ethnic inequalities seen in the mental health system, and in society in general, is racism. The place of racism as a cause of mental illness, or factor that leads to poor health, is contested. This is mainly as the evidence is emerging but also as there are strongly held views, both by people who do not want to talk about racism and those that do.