Understanding mental health and experience of accessing services among African and African Caribbean Service users and carers in Birmingham, UK

This paper examines understanding of mental health and the extent to which statutory and voluntary mental health services in Birmingham are meeting the needs of members of a range of black African and African Caribbean communities. Qualitative data were collected through nine focus groups and four individual in-depth interviews. Using a purposive sampling strategy, 25 service users and 24 carers were recruited. Interviews were recorded, transcribed and analysed using Krueger's framework. The participants understood mental illness as a social problem linked with material and social deprivation, racism, and an inappropriate response to the treatment of mental and physical illness. Lack of respect and understanding in relation to religious and spiritual beliefs was a crosscutting theme. While appreciating the positive aspects of medication, the participants raised concerns about interaction with recreational drugs, the dosage of prescribed medication, and equity with regard to accessing talking therapies. Engaging users and carers in a care pathway, acknowledging users' health beliefs and the importance of spirituality in healing, the provision of alternative interventions and working closely with voluntary organisations and spiritual leaders are recommended for improving clinical outcomes and patient-centred care