Racism, mortification and carcerality: Three concepts needed to understand the experiences of racially minoritised people diagnosed with severe mental illness.

This paper argues to understand racially minoritised people's experiences of mental illness and mental healthcare, we must expand the focus from inpatient stays to understanding a series of interactions with state institutions. We extend Goffman's concept of mortification beyond the inpatient unit to demonstrate how carceral practices are routinely used by state institutions, contributing to the worsening of racially minoritised people's mental health. Drawing upon 22 in-depth interviews from participatory action research (PAR) with racially minoritised people diagnosed with severe mental illness in the UK, we show mortification and carceral practices experienced by racially minoritised patients are related to their racialised identities. This is shown in our data by: institutions' failure to act on reported incidents of racism; controlling and withholding information and services related to patients' mental healthcare; and the assumed criminality and threat of racially minoritised people, often resulting in increased police involvement and surveillance. Specifically, we show (1) mortification is not a process that happens solely inside the physical psychiatric hospital. It happens in a series of interactions with state institutions with harmful effects and (2) mortification is not a discrete event that takes place within one period, in one type of institution. Instead, degrading, racist experiences are interspersed throughout the life course compounding the feelings of identity loss and erosion. We conclude it is vital to bring together the concepts of racism, carcerality and mortification to develop a thorough understanding of the experiences of racially minoritised people diagnosed with severe mental illness.