The murder of George Floyd has reinvigorated the call for anti-racism across the Global North, and mental health bodies have joined this political moment. Yet, discussions of racism in mental health are nothing new (Bailey et al., 2017; Fernando, 2017; Fernando et al., 1998; McKenzie & Bhui, 2007; Nazroo et al., 2020; Richards, 1997). Certainly, the COVID-19 pandemic has revealed the extent to which racial inequalities play a detrimental role in health outcomes (Nazroo et al., 2020). The point of this commentary is not to summarise the works on racism and mental health. Rather, the following is a reflection on the hurdles of anti-racism in mental health, as situated within a neoliberal order. It will outline the challenges in addressing racism as a dynamic process in allegedly post-racial world—racism without racists (Bonilla-Silva, 2017).

The psy-disciplines in the UK have a history of confronting the racism endemic in their fields (Fernando, 2017). More recent reviews have found that BME communities are generally at higher risk of mental illness and more likely to be impacted by social detriments; less likely to access mental health services and more likely to do so through crisis care; more likely to be medicated (rather than be offered talking therapy) for mental ill health, while external risk factors such as poverty and racism are overlooked (Bignall et al., 2019). The structural inequalities underlying discrepancies in mental health, between white and BME populations, have also been highlighted in relation to the discrepant mortality rates due to COVID-19 (Nazroo et al., 2020).

Given these structural inequalities, scholars increasingly underline how anti-racist praxis in mental health must consider macro-level policies (Came & Griffith, 2018; Nazroo et al., 2020). The focus in this commentary will be the Prevent policy, the UK's counter-radicalisation duty and a wing of the nation's counter-terrorism strategy. This duty has made it incumbent on health staff to report individuals they suspect are susceptible to radicalisation based on elusive ‘pre-criminal’ risk factors. Prevent's pre-crime strategy is increasingly entangled within mental health settings. First, extremism risk factors are now embedded within the comprehensive risk assessments of several mental health trusts across the UK. In other words, all patients are screened for ‘extremism’ (Younis, 2021). Second, Prevent training employs extensive ‘psychology talk’, whereby elusive discussions of ‘vulnerability’ predominate the logic of averting future catastrophe (Knudsen, 2020; Younis, 2021). Third, novel mental health hubs have recently been developed to embed NHS mental health services with counter terrorism police. The majority of patients referred to these hubs are Muslim (National Police Chiefs' Council, 2017). These developments are indicative of the government's increased investment in pre-crime as a public mental health strategy.

Politics cannot be disassociated from public health. To this, the notion of policy-based evidence, as opposed to evidence-based policy, showcases the explicit role of political agendas underlying health-care strategies (Gregg, 2010). It has been argued that the Department of Health has employed policy-based evidence for years, leading to hospital bed shortage despite escalating waiting lists for patients (Jones, 2017). Similarly, the Public Accounts Committee (2020) expressed concern that the Home Office's decisions behind the hostile environment—a set of policies introduced to make life for irregular migrants in the UK unbearable—were made on ‘anecdote, assumption and prejudice’, rather than evidence. Naturally, this same observation has been levied towards Prevent (Mythen et al., 2017). The significance of policy-based evidence in racism cannot be understated, given how political discourse both pivots and reproduces dominant, racialised moral panics. In strategies like Prevent then, the racialisation of ‘threat to national security’ in public consciousness gives prejudice institutional legitimacy (Younis & Jadhav, 2020). Herein lies the significance of colourblindness.

乔治·弗洛伊德 (George Floyd) 的谋杀案在全球北方重新激发了反种族主义的呼声，心理健康机构也加入了这一政治时刻。然而，关于心理健康中种族主义的讨论并不是什么新鲜事（Bailey 等人，2017年；Fernando 等人，2017 年；Fernando 等人，1998 年；McKenzie & Bhui，2007 年；Nazroo 等人，2020 年；Richards，1997 年）。当然，COVID-19 大流行揭示了种族不平等在多大程度上对健康结果产生不利影响（Nazroo 等，2020）。本评论的重点不是总结有关种族主义和心理健康的著作。相反，以下是对心理健康中反种族主义障碍的反思，因为它位于新自由主义秩序中。它将概述在所谓的后种族世界中解决种族主义作为一个动态过程所面临的挑战——没有种族主义者的种族主义（博尼拉-席尔瓦，2017 年）。

英国的心理学科有应对其领域流行的种族主义的历史（费尔南多，2017 年）。最近的评论发现，BME 社区通常面临更高的精神疾病风险，并且更有可能受到社会危害的影响；不太可能获得心理健康服务，更有可能通过危机护理来获得；更有可能接受药物治疗（而不是提供谈话治疗）来治疗精神疾病，而忽视贫困和种族主义等外部风险因素（Bignall 等人，2019 年）。白人和 BME 人群之间心理健康差异的结构性不平等也与 COVID-19 导致的死亡率差异有关（Nazroo 等人，2020 年）。

鉴于这些结构性不平等，学者们越来越多地强调心理健康中的反种族主义实践必须如何考虑宏观层面的政策（Came & Griffith，2018 年；Nazroo 等人，2020 年）。本评论的重点将是预防政策、英国的反激进化义务和国家反恐战略的一个分支。这项职责使卫生人员有责任根据难以捉摸的“犯罪前”风险因素报告他们怀疑容易受到激进化的个人。预防的犯罪前策略越来越多地与心理健康环境纠缠在一起。首先，极端主义风险因素现已嵌入英国多家心理健康信托机构的综合风险评估中。换句话说，所有患者都接受了“极端主义”筛查（Younis，2021 年）。其次，预防培训采用广泛的“心理学谈话”，其中关于“脆弱性”的难以捉摸的讨论主导了避免未来灾难的逻辑（Knudsen，2020 年；Younis，2021 年）。第三，最近开发了新的心理健康中心，将 NHS 心理健康服务与反恐警察结合起来。转诊到这些中心的大多数患者是穆斯林（国家警察局长委员会，2017 年）。这些事态发展表明政府增加了对犯罪前作为公共心理健康战略的投资。

政治不能与公共卫生脱节。为此，与基于证据的政策相反，基于政策的证据的概念展示了政治议程在医疗保健战略中的明确作用（Gregg，2010 年）。有人认为，卫生部多年来一直采用基于政策的证据，尽管患者的等候名单不断增加，但仍导致医院床位短缺（Jones，2017 年）。同样，公共账户委员会（2020) 表示担心内政部在恶劣环境背后的决定——一系列政策旨在让英国的非正规移民难以忍受——是基于“轶事、假设和偏见”，而不是证据。自然，同样的观察也适用于 Prevent (Mythen et al., 2017 )。考虑到政治话语如何围绕和再现占主导地位的、种族化的道德恐慌，基于政策的证据在种族主义中的重要性不容小觑。在当时的预防策略中，“威胁国家安全”在公众意识中的种族化赋予了偏见的制度合法性（Younis & Jadhav，2020 年）。这就是色盲的意义所在。