Cast in the shadow of yet another senseless knife rampage, this time on a Doncaster-to-London train, where Anthony Williams allegedly stabbed 11 people, Britain is once again grappling with a grim pattern. The suspect, a man of African-Caribbean descent with a history of mental health issues, echoes a chilling series of tragedies: unhinged individuals, often Black men battling schizophrenia or severe psychosis, slipping through the cracks of a system that's supposed to protect us all. From Zephaniah McLeod's 2020 Birmingham bloodbath to Valdo Calocane's 2023 Nottingham stabbings and Axel Rudakubana's 2024 Southport child murders, the victims pile up like unpaid bills in a bankrupt bureaucracy.
Paul Birch's recent essay nails it: these aren't isolated mess-ups. They're systemic failures, fuelled by chronic underfunding, bureaucratic inertia, and — yes — a creeping ideological cowardice. Health pros and coppers, trained to tiptoe around "racism" like it's a live grenade, hesitate to section dangerous patients. The result? More bodies in the streets. Is "woke" dogma, the relentless push for "equity" at the expense of reality, turning safeguards into suicide pacts?
First, the numbers. Black Brits are overrepresented in mental health crises, and that's not some figment of racist imagination. Schizophrenia rates are higher among African-Caribbean populations, up to five times the general rate, per longstanding studies, likely a toxic brew of genetic predispositions, migration stress, urban poverty, and cannabis use (which hits psychosis risk like a sledgehammer). But here's the rub: despite this elevated risk, the system's response has swung from overreach to underreaction.
Under the Mental Health Act (MHA), Black people were 3.5 times more likely to be detained than white folks in 2022/23, 228 detentions per 100,000 Black people versus 65 for whites. Fast-forward to 2024/25: the gap persists, with Black detention rates holding steady at alarming highs while white rates barely budge. Mixed-ethnicity folks saw a 6% spike, Asians 7%, and "other" groups even higher. Charities like Mind and the NHS Confederation are right to call this "shameful" and demand reform, coercive detentions traumatise communities, breed distrust, and smack of institutional bias.
But reform has morphed into a fetish. The 2021 push by then-Health Secretary Matt Hancock to tweak the MHA for "disproportionality" wasn't wrong in intent. Labour's 2024 manifesto doubled down: "targeted interventions" to slash black detention rates. Enter the Stevens Report and the Race Equality Foundation's playbook: embed "anti-racism" in every decision, from triage to tribunals. Sounds noble. Until you realize it's code for second-guessing clinicians who know a patient is a ticking bomb.
Take Valdo Calocane, the paranoid schizophrenic who eviscerated three innocents in Nottingham. A 2024 Care Quality Commission probe exposed a "catalogue of failures": ignored violence history, no enforced injectables (he "didn't like needles"), and a revolving door of community care despite red flags waving like semaphores. Calocane, of African heritage, wasn't sectioned aggressively because... well, the report dances around it, but whispers of ethnic disparities loom large. NHS brass fretted over "over-policing" Black patients, per internal audits, leading to a chilling effect: docs opting for "watchful waiting" over wrist-slaps.
Or Axel Rudakubana, the 17-year-old who turned a Taylor Swift dance class into a slaughterhouse. His headteacher, Joanne Hodson, clocked the menace early: "sinister, cold, calculating," she emailed colleagues in 2021, after he'd been expelled for packing heat and later confessed to Childline his urge to kill. Her gut screamed intervention. But a mental health worker slapped back: racial profiling of a black boy with a knife. Hodson, gut-punched, self-censored, erased "sinister" from reports, silenced her "visceral dread." The Southport Inquiry in October 2025 laid it bare: that accusation gagged her, and three little girls paid with their lives.
Birch, a 24-year Met vet, saw it firsthand: Black men, known psychotics, sectioned only after near-misses because inspectors eyed promotion-killers like the College of Policing's Race Action Plan. It mandates pondering "disproportionate contact" with distressed Black folks — translation: hesitate, or risk the scarlet R. This isn't hyperbole; it's policy as prophylaxis against Twitter mobs.
Here's the politically radioactive core: anti-racism, wielded as a blunt instrument, is inverting the disparity. Where once Black patients faced undue coercion, now they're undertreated, not from neglect, but from overcompensation. The Persistence of Racism in Mental Healthcare report (2025) admits as much: "racial inequalities persist," but so does the backlash, with clinicians paralysed by DEI checklists. A BMJ analysis warns that MHA reforms, obsessed with "decolonising" care, ignore how racism fuels psychosis while handcuffing responses.
It's a feedback loop. Black communities rightly distrust a system that's warehoused them disproportionately, echoes of Windrush and stop-and-search. But when that distrust morphs into doctrine, e.g., "sectioning is inherently racist" — it greenlights release for the violent. McLeod, fresh from jail, hallucinating demons, built shivs unchecked. Byer, delusion-riddled, got five days' freedom before gutting O'Halloran. Funding's the scapegoat (fair), but ideology's the accelerant.
Critics cry "Right-wing scaremongering!" Yet the Lampard Inquiry into Midlands midwifery scandals (tangentially linked via ethnic health gaps) flags the same: "anti-racist" training that prioritises feelings over facts erodes candour. And post-Southport riots? They weren't just thuggery; they stemmed from suppressed truths, festering into conspiracy.
No one's advocating a return to the bad old days of casual over-sectioning. Black mental health deserves tailored care: culturally competent therapists, community outreach that builds trust, upstream fixes like slashing inequality. But equity isn't equality of outcome if it means equal opportunity for carnage. Decisions must hinge on evidence, psychometric risks, violence histories, not ethnic checkboxes.
Policymakers: Audit those "targeted interventions" for unintended body counts. Clinicians: Log the hesitations, anonymise the fears. And us? Demand transparency. Lives hang on it.
Birch ends his piece with a plea: "Progressive dogma should have no place where psychotic individuals are concerned." Correct. In a nation reeling from too many memorials, it's time to section the sacred cows. Public safety isn't racist, it's human.