Marcel Vige of mental health charity Mind says we must look to new approaches to overcome the disproportionately high number of African-Caribbean men subjected to compulsory mental health treatment

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NOT FOR REUSE

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African-Caribbean men are overly subjected to compulsory treatment under the Mental Health Act, and it is a longstanding challenge – one that’s linked not only to the healthcare system, but also the corrosive impact of living in a society where racism influences life chances.

‘We use a range of engagement activities from sports to informal befriending, group discussion and one to one key working’

Reasons for the higher incidence of such treatment range from stereotypes of African-Caribbean men’s dangerousness, which has an influence on risk assessments, to individuals being disconnected from support services, meaning they tend to come to the attention of services when at the point of crisis.

Reducing this overrepresentation requires a range of measures that impact on, though also go beyond, typical approaches.

In mid-2013, Mind’s equality improvement team launched a series of local 12-18 month projects focused on prevention tactics and increasing the capacity of young African-Caribbean men to support their own mental wellbeing.

Working in partnership with youth initiatives in Manchester, Birmingham and London, the projects use youth work approaches such as goal setting and self-reflection.

Developing resilience

The idea is to use a range of engagement activities from sports to informal befriending, group discussion and one to one key working to enable young men to build mental health resilience; this helps them to develop insights into their own mental/emotional state, as well as effective life management skills.

‘The lesson is the value that flows from greater understanding among staff and young African-Caribbean men of each other’s position’

The projects also engage the local community in discussions about how best to support the mental health of young African-Caribbean men.

Alongside the projects is an evaluation programme that tracks the impact on the young men. Developed and delivered by HS Consultancy, it involves drawing on standard resilience measuring tools and developing new ones that are more closely matched to the group.

While these projects focus on young African-Caribbean men who are not in contact with mental health services, another Mind equality improvement project, called 300 Voices, looks at the interface between young African-Caribbean men and statutory services.

Rebuilding relationships

Funded by the anti-stigma campaign Time to Change, and initiated as an 18 month project in September 2013, 300 Voices is a partnership between Time to Change, Birmingham and Solihull Mental Health Foundation Trust, West Midlands Police and Birmingham City Council.

‘The format may include interviews, poetry, rap, song, drama, dance, art and conversation’

It was inspired by Breaking the Circles of Fear, a report that reveals how the relationship between African-Caribbean service users and mental health staff is often one of mutual distrust, even hostility. This feeling limits the benefit of therapy or other types of support.

The 300 Voices project is delivered through a series of guided management sessions; they are flexible workshops that bring together young African-Caribbean men, mental health staff and other agencies, such as the police, who have a role in managing people in mental distress.

The core of the project is a dynamic model comprising four components: hearing service users’ stories, hearing staff stories, dialogue and planning.

Sessions start with hearing individuals’ stories. The format will depend on the setting, time and wishes of the participants, and may include live interviews, pre-recorded interviews, poetry, rap, song, drama, dance, art and conversation.

In a facilitated setting, staff also share their experiences of working with young African-Caribbean men.

Case study: Lived experience consultants

When it comes to providing improvements to care and services in mental health, it is essential that someone with their own experience is involved.

As a ‘lived experience consultant’, I have the skills and knowledge to add value to the 300 Voices project.

I am one of three such people working on an engagement model called “Better must come: towards hope’” for the 300 Voices project. The engagement model will be developed into a practical toolkit that will form a key part of 300 Voices.

It is hoped that it will facilitate meaningful discussion between young African and Caribbean males and statutory professionals, resulting in more positive outcomes and experiences for young African and Caribbean men.  

There is a common misconception that people who have experienced mental health problems are weak-minded and unable to cope with the pressures of a demanding role. As people co-developing and co-piloting the model, we are demonstrating the exact opposite.

Our role has included developing an understanding of the theoretical models we are using, contributing to the engagement model and design of the programme for the pilot sessions, delivering presentations and jointly run pilot sessions. 

I think that our contribution to 300 Voices as lived experience consultants gives it integrity because it has been designed through the eyes of people who truly understand the reality of life with a mental health problem.

I have greatly appreciated the opportunity to use my lived experience and interactions with statutory staff in a positive way, to produce something that will help improve outcomes and experiences for other young African and Caribbean men.

Steven Gilbert, a consultant for 300 Voices, with personal experience of mental health problems.

Opening a dialogue

There is an aspect of dialogue that draws on three theoretical frameworks:

  • “appreciative inquiry”, which focuses on the capacity of people in the engagement sessions to create a positive vision;
  • “dialogue model”, which develops consensus based on appreciation of the views of others; and
  • “restorative practice”, which underpins the other two frameworks by emphasising a collective commitment to appreciate the impact of one’s behaviour on others. This stage is about facilitating healthy and transformative conversations.

There is also a focus on actions that can be taken to generate ongoing transformation of the relationship between young African-Caribbean men and mental healthcare professionals.

The emphasis here is on actions within the control of the individual or team. Typically, this will also mean influencing those with authority to change organisational strategy.

‘Our aim is to scale up this work based on learning from the projects’

Currently 300 Voices is gathering together organisations and individuals to participate in the engagement sessions, and by April 2015 we’ll have a clear picture of the overall impact.

Though the various projects outlined here are at a relatively early stage, already there are lessons for the NHS and other providers of mental health support. The approach taken by the reliance programme is to forge close partnerships with other sectors, in this case youth work, which typically have more effective engagement with young people than mental health services do.

The lesson from 300 Voices is the value that flows from greater understanding and appreciation among staff and young African-Caribbean men of each other’s position, and the need for specific interventions to make this happen.

Our aim is to scale up this work based on learning from the projects. Our hope is that we’ll be able to bring lasting improvement in the areas we’re working in, which serve as a forerunner to improvements in supporting the mental health needs of young African-Caribbean men across the country.

Find out more

  • For more information on Mind’s work on equality, email equality@mind.org.uk
  • If you are experiencing mental health distress, contact Mind’s info line on 0300 123 3393

Marcel Vige is head of equality improvement at Mind

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