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Experience of accessing mental health support
Saf: Another common barrier is the historic context of Black communities accessing mental health support. Getting professional support with mental health challenge has, until more recently been uncommon. There are a number of reasons this might explain. According to statistics from NHS Digital, Black men are four times more likely to be sectioned under the Mental Health Act than their white counterparts. For many young Black men, engaging with a service creates a fear of being sectioned, and so they’re more likely to prolong reaching out for help.
Obi: It is important for professionals to understand that because of this experience, many young Black men and the communities they are a part of associate mental health crisis with being sectioned.
Stuart: Sectioning for me translated to isolation or being admitted. And it sounded more like a threat every time I spoke to health professionals about it. I would have questions, internal questions and questions I would ask professionals like what happens next, and who knows I have been sectioned? In my mind, it was an additional label on top of the existing long term health condition that I have, and the mental distress, mental health distress, which is a barrier to accessing jobs and even services.
Saf: This has created a stigma around mental health and the lack of confidence in the effectiveness of mental health services. Whilst a lot of work is being done to break down the stigma around mental health within Black community, there are not enough visible success stories for others like them who have accessed crisis support and recovered. We need crisis support services to reassure us that being sectioned is not the only solution.
Obi: The young men we spoke to talked about crisis being the straw that broke the camel’s back because they are often not used to reaching out to professionals for help with their mental health. The circumstances of life begin to wear them down over a period of time and it reaches a crisis point.
Saf: One young man we spoke to, J, talked us through the events leading to him experiencing mental health crisis. He said, “I lost my granddad, who I was really close to, and then like five, six months later, or so, my gran died, too. And it was my gran who brought me up. And at first it was fine. Even when everyone was looking at me at the funeral thinking I was mad because I accepted it. Like, yeah, she’s gone. And I was calm. And it was like a week or two later, I was with all my boys, chilling, playing games, and it just hit me. My boy could see I was under and I just said, “I’m going for a walk because I don’t want to be around anyone. I went for my walk. And I thought about everything I’d been through. And I literally broke down.”
Obi: Sometimes they will not even know that they are experiencing a crisis because they have felt this way before and found a way to manage it on their own, or with the help of a friend or family member.
Saf: One young man, D, said, “Once you go under, it’s hard because you’re used to doing things your own way. I don’t want your help, if you get me. You carry your own stress, and even if it’s say, money that’s stressing you out and your friend says hold that and you could solve all your money problems to help you crack on, how I deal with things in my own way, I still have to go through the stress in my own way. Like if you help me now how would it be different when you’re not around to help me?”
Obi: Being a young Black man and gay or a young Black man with a learning difficulty or an additional label means that you’re constantly navigating and fitting into so many spaces. This adds an additional barrier to accessing and engaging services.
Saf: By accessing crisis support, a young Black man has potentially overcome one or more of the barriers we’ve just highlighted. We need professionals to acknowledge how much courage it has taken for us to take this step. We need professionals and services to accommodate our language in their practice and services.
Akram: In summary, language, sexuality, fear driven by historical context, stigma and previous experiences are some of the barriers faced by young Black men when accessing crisis services. This is not an exhaustive list. We encourage you to conduct further research using resources available to you, including your peers to enhance your understanding of the barriers faced by young Black men.
[END OF VIDEO]
Whilst a lot of good work is being done to break down the stigma, as a cultural barrier, around mental health within the Black community and to address inequalities in services, it is vital to acknowledge the historical context of Black communities when they interact with the system.
Negative interactions with health services and other parts of the ‘system’ such as education, the justice system, and employment are well known in our communities.
Recently, the Public Health England (2020) Beyond the data: Understanding the impact of COVID-19 on BAME groups review ‘found that the highest age-standardised diagnosis rates of COVID-19 per 100,000 population were in people of Black ethnic groups (486 in females and 649 in males), and the lowest were in people of White ethnic groups (220 in females and 224 in males)’ (Public Health England, 2020).
‘Boys from Black Caribbean backgrounds experience a higher rate of exclusion than White pupils, but Black African pupils, both male and female, have lower exclusion rates than White pupils. The literature does not always distinguish between groups of Black pupils’ – (Department of Education, 2019)
In the justice system,
‘Evidence demonstrates there are critically high proportions of this group (young Black and Muslim) at all stages of the Criminal Justice System and reporting the least positive outcomes and perceptions of prison life compared to all other groups.’ – (Youth Justice Board, 2009)
In Mental Health services,
‘Black men are four times more likely to be sectioned under the Mental Health Act than their White counterparts.’ (NHS Digital, 2019)
‘Doctors are far more likely to diagnose Black people with schizophrenia than White people. But there’s no biological evidence that being Black makes you more prone to it.’ (Mind, 2020)
‘Legitimate concerns raised by members of the Black community are often dismissed’ (Omonira, 2014), which results in missed opportunities for early intervention and lack of confidence in being believed.
‘Some communities accept the idea that mental illnesses are health problems that require treatment. But in other communities (such as Black communities), there’s a serious stigma that implies a mental health problem is a sign of weakness and should be kept hidden from others.’ – (Mind, 2020)
‘There is a lack of research about the experience of people from Black, Asian and minority ethnic (BAME) groups. This means it can be even harder for autistic people in the BAME community to get the support they need.’ – (National Autistic Society)
It is essential to be aware of our experiences when we interact with other parts of the ‘system’ because we sometimes view health services, education, and the justice system as one. Therefore, a negative experience with one means a negative experience with all and vice versa.
Try to put yourself in our shoes and consider that it might be difficult for us to trust you or be open with you. We have a natural fear of engaging with crisis services, an additional system, due to the aforementioned reasons and a fear of being stuck in the system. Therefore, crisis services are usually our last resort.
As we heard, some young men view ‘sectioning’ as a threat and not an acknowledgement of needs and a way for them to receive the support they need at the time.
Sectioning is a tricky subject to discuss with young people, but don’t avoid it if necessary. We expand on how to approach the conversation about sectioning in our learning guide, What we need crisis services and practitioners to know.
Services and professionals should work with Black community role models or peer workers with lived experience to ensure enough visible success stories of others who have accessed crisis support and recovered (42nd Street, 2017). This will help build confidence in the effectiveness of crisis services, change the narrative on being black and having a mental health diagnosis and encourage early access to interventions for mental health conditions
- Young black men in crisis use different language and phrases to describe their feelings or experience. Ask for clarification if there are any phrases used which might be vague or ambiguous.
- Language or jargon commonly used in mental health settings may not be familiar to young black men in crisis.
- Black men are 4 times more likely to be sectioned under the Mental Health Act than their White counterparts – therefore they often associate mental health crisis with sectioning.
- Acknowledging the courage required for young black men in crisis to reach out for mental health support is vital.
- Public Health England (2020) Beyond the data: Understanding the impact of COVID-19 on BAME groups review, Available: assets.publishing.service.gov.uk (Retrieved 17th February 2022)
- Department of Education, (2019) School exclusion: a literature review on the continued disproportionate exclusion of certain children, Available: assets.publishing.service.gov.uk (Retrieved 22nd February 2022)
- NHS Digital (2019). Mental Health Act Statistics, Annual Figures 2018-19.digital.nhs.uk (Retrieved 18th February 2022)
- Youth Justice Board, (2009) Exploring the needs of young Black and Minority Ethnic offenders and the provision of targeted interventions, Available: assets.publishing.service.gov.uk , (Retrieved 22nd February 2022)
- Mind, (2020) What is Schizophrenia?, Available: www.mind.org.uk (Retrieved 22nd February 2022)
- Omonira, R (2014) Black and dangerous? Listening to patients’ experiences of mental health services Why are black people with mental health problems still more likely than whites to be heavily medicated, restrained and detained against their will?, Available: www.jstor.org (Retrieved 22nd February 2022)
- 42nd Street (2017) Perceptions: Peer research into the needs and perceptions of young black men on mental health and wellbeing, Available: manchestercommunitycentral.org (Retrieved 22nd February 2022)
- National Autistic Society, Autism and BAME people, Available: www.autism.org.uk (Accessed 23rd February 2022)