Racism and mental health within humanitarian and development organisations: perspectives from in-house mental health professionals.

INTRODUCTION: Racism is recognised as a concern within humanitarian and development (HD) organisations, yet little research has examined its implications for staff mental health. Notably, the perspectives of in-house mental health professionals (MHPs)-a key but understudied group-have remained absent from the literature. This study addresses this gap by asking three questions: First, how do MHPs perceive and personally experience racism within HD organisations? Second, in what ways does racism affect the mental health of staff, and how do MHPs navigate their role in addressing these impacts? Third, how do MHPs evaluate existing organisational responses to racism, and what changes do they consider necessary to strengthen anti-racism efforts and link these to staff well-being? METHODS: Semi-structured interviews were conducted with ten currently employed or recently retired MHPs across United Nations entities and an organisation belonging to the Red Cross/Red Crescent Movement. Participants were recruited via organisational circulation and snowball sampling. Data were analysed using inductive thematic analysis. RESULTS: Three themes identified. (1) Experiences and impacts of racism among HD staff: MHPs described racism as pervasive yet rarely discussed, manifesting in inequities between national and international staff, donor-related privilege, exclusion, and substantial mental health consequences. Staff often coped privately, seldom using formal in-house psychosocial support. (2) Roles and professional boundaries of MHPs: Racism frequently appeared as a latent factor behind other complaints. MHPs employed a range of strategies, such as validating clients' experiences and outlining available response pathways. They recognised that aspects of their own identity may initially shape staff members' help-seeking behaviour. (3) Organisational responses and constraints: MHPs acknowledged progress, yet anti-racism efforts were viewed as insufficient and disconnected from staff-care systems. Recommendations included a shift from reactive to preventive action and training. DISCUSSION: Racism in HD organisations emerges as widespread yet insufficiently addressed, with its mental health impacts largely managed in private. Findings indicate the need for integrated approaches that link anti-racism and staff-wellbeing strategies, recognise racism as an occupational health issue, and include MHPs in organisational transformation efforts. This study provides evidence from a hard-to-reach and rarely examined group, and highlights critical directions for institutional change.