A Thematic Analysis Exploring Young Black Men's Experiences of Accessing and Engaging in Psychological Therapy within Primary Care

Abstract

BACKGROUND: Despite the increase in initiatives to improve the accessibility of psychological therapy within the NHS, Young Black men’s (YBM) experiences of psychological therapy are under researched. Young Black men are more likely to access mental health services (MHS) through police intervention(s) or the criminal justice system. This is compared to their White counterparts, who are more likely to access services through less punitive and disempowering routes. METHODOLOGY: A critical realist research paradigm was used to qualitatively explore YBM’s experiences of accessing and engaging in individual psychological therapy. This study incorporated semi-structured interviews with a purposive sample of 13 Black African and Caribbean men between the ages of 24 and 31. FINDINGS: An inductive Thematic Analysis (TA) was used to interpret four themes: “Navigating socio-cultural barriers;” “It’s a big step asking for help;” “Being taken on a journey;” and “Building bridges of trust and collaboration.’ Participants situated their experiences of therapy within a social-cultural context that expects Black men to be strong, stigmatises mental health difficulties and discourages professional help-seeking. Problem acceptance, access to resources and perceived efficacy of therapy influenced decisions to seek therapy. Safety and trust within the therapy room were negotiated and underpinned by disclosures of the therapists’ background, having a safe space for exploration, and being empowered through collaboration. While some participants found it easier to relate to a Black therapist, it also raised concerns around confidentiality, suggesting the importance of offering choice. Assertive outreach, collaboration with local expertise, and culturally humble approaches that recognise Black men’s unique socio-cultural identities were identified as best practice to increase access and engage YBM in psychological therapy.

CONCLUSIONS & IMPLICATIONS: Young Black men should be given equitable access to psychological therapies. Policy makers and clinicians should be aware that YBM have unique experiences with psychological therapies and should be knowledgeable and skillful in responding to these. Policy and clinical implications are discussed.