Accessing Mental Health Services for the First Time: The Black African and Caribbean Experience

Abstract

Background: Significant disparities and complex inequalities are experienced by individuals from black African and Caribbean communities and perpetuate the formation of barriers and the perception of poor outcomes from NHS mental health services. Aim: This dissertation explores the lived experiences of accessing mental health services for the first time by people of a black African and Caribbean background. Methods: Qualitative phenomenological research was conducted using semi-structured interviews with a sample of 15 adult male and female participants aged 18 years and over and who resided in the southeast region of England. The participants’ individual accounts were audio-recorded, transcribed and analysed using Interpretative Phenomenological Analysis (IPA). Results: Four superordinate themes were identified and these explored experiences in relation to: ‘Psycho-social exposition and vulnerability to psychiatric morbidity’ – which shows how individuals from these communities are predisposed to mentally strenuous and debilitating social disadvantage; ‘Coping mechanisms in dealing with adversities’ – which gives insights on how participants deployed strategies to manage psychological adversity; ‘Being hospitalised in a psychiatric ward’ – which speaks to the experience of being an inpatient in a psychiatric hospital; and ‘Dynamics of therapeutic relationship with clinicians’ – which characterises the quality of caring relationship that participants experienced with doctors, nurses and fellow service users. Conclusion: The study contributes to a scant evidence base of qualitative research into the first-time lived experiences of accessing mental health services by black African and Caribbean individuals. Findings suggest that while there are notable positive changes that have contributed to diversity and inclusion policies within services, disparities remain evident with far reaching implications on accessibility and satisfaction for these individuals. Implications: For clinical practice, there is need for services to embrace multiculturalism and to understand the socio-cultural aspects of these communities in order to provide universally responsive mental health interventions. Further participatory research that directly involves participants at various stages of the research process, and fosters ownership and solidarity may provide yet more insights about the subjective experiences of individuals from these communities.