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Redefining Black Men’s Mental Health Support

Ontonio Dawson

There is a colossal problem affecting Black men in the UK and around the world. This article offers useful context to some of the challenges faced by Black men and shares some examples of the work to improve Black men’s access and outcomes to psychological therapies.

Challenges faced by Black men

As a teenager growing up in Jamaica, I often heard the phrase “Black men are endangered species” but never really understood what it meant. After seven years of living and working in the UK, now it all makes sense. It is no secret that racial disparities exist within our society, despite legislation, healthcare policies, research and social justice campaigns.

Within the UK, Black people are nine times more likely to be stopped and searched by police (Dearden, 2019). Black people make up 3% of the overall population of UK, However, since September 2021, 15% of those remanded in prison are Black and sadly if you are a young Black man born in London you are more than 19 times more likely than their white counterparts to be stopped and searched by the police (Gidda et al., 2022).

In relation to mental health care Black people experience more incarceration and detention under the Mental Health Act than any other group (UK Government, 2022). The evidence suggests that Black men are significantly more likely than others to be diagnosed with severe mental health problems such as schizophrenia and experience longer compulsory hospital care (Keating, 2020). Even when they access services, one in three experience stigma and discrimination from health care professionals (Iacobucci, 2022) and the sad reality is that we are more likely to experience psychological support through the criminal justice system (Mind, 2019). Black, Asian and minority ethnic men have reported a significant decline in mental health and wellbeing than White British men since the global pandemic’s onset (UK Government, 2021).

We live in a society in which Black people are much more exposed to many of the common risk factors for poor mental health, such as poverty, poor living conditions, unsafe neighbourhoods, reduced access to education and employment opportunities. To make matters worse, Black people in Britain continue to be subjected to nationalised racism, inequality and constant violence (Bleich, 2006). All of which may influence the development and maintenance of mental health difficulties. With people identifying as Black more likely than average to have experienced a common mental problem (Baker & Kirk-Wade, 2023). Despite such levels of need, the IAPT Positive Practice Guide (Beck et al., 2019) summarises how people from diverse backgrounds often have poorer mental health, poorer quality of life and more difficulty in accessing psychological therapies than much of the population.

These barriers often prevent Black men from considering or accessing mental health support. As a result, some young Black men become overwhelmed with stress, anxiety, and low mood. Some may turn to self-medicating on illegal drugs and alcohol to suppress the overwhelming emotions they are experiencing. These factors also contribute to an increasing number of Black men who are taking their life by suicide. Despite, the overall suicide rates in the USA reducing by three percent in 2020, the rate of suicide increased for Black men, during this time. Moreover, between 2011 and 2020, the suicide rate among Black men was three times that of Black women (SPRC, N.D.). This colossal problem is not unique to the United States and is also affecting us here in the UK.

Government and services are aware of the mountain of challenges affecting Black men, yet many of the interventions to support us are not meeting our needs. To address this the IAPT Positive Practice Guide (Beck et al., 2019) makes recommendations around service level changes, adapting therapy, outreach, supporting staff and service audits.

Some examples of improving access and outcomes

In 2017, I joined the Lewisham IAPT as a trainee Psychological Wellbeing Practitioner (PWP) and quickly realised that Black men were the least likely to access psychological support, and if they did, they were more likely to drop out compared to their white counterparts. I inquired about the available treatment options specifically for men, particularly Black men. Later, I discovered that there was no Men's Group in my service at the time. With the support of my service manager and the team, we established a group aimed at supporting men dealing with symptoms of stress, depression, and anxiety. This group exemplifies the work done within the context of IAPT, where we can adapt the treatments offered to better support men. To promote these groups, my team and I engaged with the local community by visiting shops, bus stops, and barbershops in Lewisham, informing people about our group and the services our organisation provides. Instead of relying solely on referrals from GPs or online applications, we adopted alternative outreach approaches to reach out to men.

In addition to this, more generalised outreach and promotion is still needed. As sadly many young Black men I speak with are not aware of IAPT or the free support offered. Which highlights the fact that some services are in the community but not a part of the community. For services such as IAPT to significantly support Black men we must adopt a different approach to reach Black men. To bridge the gap between the community and service there needs to be more integration. Also, for individual therapists, we can work to bridge the gap. For instance, I have made it my mandate to support people within my community by actively having and normalising everyday conversations about mental health within my community.

There are also a number of community groups and organisations doing similar work. These include Black Lives Matter UK, Speak Black Man, The Empowerment Group, Black Minds Matter UK, MIND UK and Islington Council. Wouldn’t it make sense for NHS services to collaborate more with such groups, maybe even consider working together to raise awareness of mental health problems, where to seek support and even co-create treatment options. For an example of this, is the Young Black Men and Mental Health Programme by Islington Council in partnership with the NHS. Part of this programme involves training Black barbers in mental health issues. This programme aims to deconstruct barriers to mental health support and create safe pathways into mental health services.

Since then, Lewisham IAPT continues to think of different ways to support Black men. We currently partnered with Partisan, a small, Black-led Community Interest Company; born out of a pull from the community for accessible and culturally sensitive mental health and wellbeing support. Partisan specialises in supporting marginalised, stigmatised, and excluded communities.

In our current partnership we are creating a safe space to support young men exposed to gang violence. The space we offer gives us the opportunity to learn from these young men and then utilise the space to share psychological knowledge with them as well as challenging their thinking to see things different. Using this approach gives these young men experiencing depression and anxiety an opportunity to access psychological support. In addition, by integrating this within Partisan it helps to take away the stigma from therapy, removes some of the potential expectation of therapy and gives the opportunity to express themselves in a natural way without suppressing their emotions. For instance, in our recent feedback from the young people we support they related to us that they find the weekly space as a very welcoming, comforting, warm, good vibes and found the relationship to be relaxed. They also reported that they have found the us supportive with when dealing with school work and helping with mental health challenges.

In terms of improving access, this approach means we are seeing young people who may be reluctant to access psychological therapy more open and now accessing therapy in IAPT. Without this intervention many of these young people would have been classified as ‘hard to reach’. This project is effective and different because we are meeting the young people in their natural environment, engaging in their everyday activities and we use a curious stance to learn from them and then seize any opportunity given to us to introduce psychological tools without forcing it upon the young people.

In sharing this article, hopefully I have provided useful context to some of the challenges faced by Black men and shared some examples of the work to improve black men’s access and outcomes to psychological therapies. Given the overwhelming struggles affecting Black men mental health, more needs to be done to support Black men. Whilst much work needs to be done by the government to support NHS to tackle this problem. I believe all of us as Psychological Therapist and Practitioners should make it our duty to support those from deprived communities. We can think of ways to support our local communities and partner with them to offer psychoeducation, basic tips and techniques or signposting people to services that can support them.

Like Marcus Garvey, I want to see Black men be liberated from mental slavery. Like Martin Luther King, I have a dream of seeing Black men accessing the mental health support they need without experiencing racism or feeling discriminated against. Like Malcolm X, I desire to see Black men being empowered and motivated to be agents of change in this difficult world. My greatest desire is that this dream of mine will become the dream of mental health professionals, policy makers and government officials all over the UK. Afterall our mental health is our greatest wealth.

For more information about Partisan, go to http://www.partisanuk.org/

Ontonio Dawson is a BABCP-Accredited Cognitive Behavioural Therapist, Founder of #SpeakBlackMan Movement, and a Minister Of Religion

References

Bleich, E. (2006). Institutional continuity and change: norms, lesson-drawing, and the introduction of race-conscious measures in the 1976 British Race Relations Act. Policy studies, 27(3), 219-234.

Dearden, L. (2020, October 2020). Stop and search is not reducing knife crime, says police watchdog. The Independent. https://www.independent.co.uk/news/uk/home-news/stop-search-uk-black-white-racial-police-increase-england-wales-b1367956.html

Iacobucci, G. (2022). Most black people in UK face discrimination from healthcare staff, survey finds. BMJ, 378, o2337. https://doi.org/10.1136/bmj.o2337

Mind. (2019). Discrimination in mental health services. Mind. https://www.mind.org.uk/news-campaigns/legal-news/legal-newsletter-june-2019/discrimination-in-mental-health-services/

Beck, A., Naz, S., Brooks, M., Jankowska, M. (2019). Improving Access to Psychological Therapies (IAPT) Black, Asian and Minority Ethnic service user positive practice guide. https://babcp.com/Therapists/BAME-Positive-Practice-Guide

Baker, C., & Kirk-Wade, E. (2023). Mental health statistics: Prevalence, services and funding in England. House of Commons. https://researchbriefings.files.parliament.uk/documents/SN06988/SN06988.pdf

Gidda, M., Rose,E., & Syal, R. (2022, March 17). Proportion of remand prisoners who are minority ethnic rises 17% in six year. The Guardian. https://www.theguardian.com/society/2022/mar/17/proportion-of-remand-prisoners-who-are-minority-ethnic-rises-17-in-six-years

Suicide Prevention Resource Center. (N.D.). Racial and Ethnic Disparities – Black Populations. SPRC. https://sprc.org/about-suicide/scope-of-the-problem/racial-and-ethnic-disparities/black-populations/

UK Government. (2021, November 18). Ethnicity Spotlight. Gov.UK. https://www.gov.uk/government/publications/covid-19-mental-health-and-wellbeing-surveillance-spotlights/ethnicity-covid-19-mental-health-and-wellbeing-surveillance-report

UK Government. (2022, June 23). Detentions under the Mental Health Act. Gov.UK. https://www.ethnicity-facts-figures.service.gov.uk/health/mental-health/detentions-under-the-mental-health-act/latest

This article was originally published in CBT Today magazine September 2023.

While we have checked the links in this article at the time of publication, BABCP is not responsible for any subsequent changes to these.

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