Socially oriented approaches to recovery for African and Caribbean men

Introduction

Despite several initiatives, notably the Department of Health and Social Care’s 2005 ‘Delivering Race Equality’ national policy, designed to reduce persistent racial disparities in mental health services, people from African and Caribbean, Asian, and Minority Ethnic (BAME) communities continue to have poorer experiences and outcomes. This disparity is most significant for African and Caribbean men. The recent review of the Mental Health Act was specifically focused on addressing the disparities for African and Caribbean communities in the use of the Act.

Recent approaches to supporting individuals with mental health difficulties shifted to the concept of recovery. African and Caribbean men, however, can often become stuck in a stalled cycle of recovery if the services and support they receive are not tailored to their unique needs as both individuals of African and Caribbean heritage and as men.

Objectives

This study sought to examine what socially-oriented approaches to recovery in mental health mean for African and Caribbean men, and what was felt to help to support such recovery. It explored the perspectives of African and Caribbean men, their supporters/carers and care providers on socially-oriented recovery and mental health care.

Methods

Fifty-nine in-depth interviews were conducted with African and Caribbean men with experience of mental ill-health (n=30), supporters/family-carers (n=15) and non-statutory service providers (n=12) and (n=2) statutory providers, across two sites (London and Leeds). Participants were recruited with the assistance of community partner agencies. Data were analysed following interpretative phenomenological analysis.

The research team also held a co-creation event at each site, in which service user participants were invited to reflect on emerging findings as well as an expert symposium in London. In the participatory research tradition, the research was guided by a steering group of relevant stakeholders, including ex-service users, carers, citizen-activists, and service providers.

Findings

• Social recovery is intimately linked to the re-negotiations of what it means to be an African or Caribbean man.
• African and Caribbean men should be able to define recovery in their own terms as part of a much more inclusive dialogue.
• There was some divergence in how recovery was conceptualised between men, supporters and care providers.
• Mental health experiences contained accounts of the role of culture in their emotional wellbeing, overly medicalised and depersonalised approaches to care and lack of discharge planning.
• Mental health services need to consider how they can move towards the co-production of services with African and Caribbean men.
• Safe spaces are required to support social recovery, and are needed before men can develop relationships of equality, authenticity and trust.