From Preproduction to Coproduction: COVID-19, whiteness, and making black mental health matter

King, Colin Guthrie; Bennett, Michael; Fulford, K. W. M.; Clarke, Simon; Gillard, Steve; Bergqvist, Anna; Richardson, John M.

doi:10.1016/s2215-0366(20)30458-2

Cited by 8 publications

(6 citation statements)

References 4 publications

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“…In addition, studies highlighted a need for community and workplace interventions to tackle forms of societal oppression and enable empowerment of people from ethnic minority groups, particularly the black community where the impact of systemic racism was considered to be deeply ingrained [ 56 , 57 , 59 , 64 , 65 , 74 , 88 ]. Studies highlighted that strategies to tackle ethnic inequalities in mental healthcare need to go beyond increasing recruitment of ethnic minority staff and must include empowerment of existing staff and the introduction of anti-racist approaches to tackle racist practice and cultural misunderstandings in clinical care [ 56 , 114 ]. This includes building capacity of service providers to deliver culturally resonant and anti-racist treatment and care through training [ 55 , 56 , 60 , 77 , 81 , 82 , 88 , 92 , 98 , 111 ].…”

Section: Resultsmentioning

confidence: 99%

“…Our synthesis indicates a need for better alignment of statutory mental health services with the lived experience of ethnic minority communities. These epistemic shifts require authentic engagement with ethnic minority communities in the development and evaluation of clinical policies, training, and services that go beyond superficial methods of coproduction [ 114 ]. Perhaps most importantly, strategies to tackle ethnic inequalities in mental healthcare require an evaluation of individual, systemic, and structural obstacles to authentic and meaningful coproduction and implementation of existing research and community recommendations in services.…”

Section: Discussionmentioning

confidence: 99%

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Understanding ethnic inequalities in mental healthcare in the UK: A meta-ethnography

et al. 2022

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Background Evidence regarding the presence and persistence of ethnic inequalities in mental healthcare is well established. The reasons for these inequalities and lack of progress in diminishing them are less understood. This meta-ethnography aims to provide a new conceptual understanding of how ethnic inequalities are created and sustained; this is essential to develop effective interventions. Specifically, we sought to understand why people from ethnic minority groups are underrepresented in primary care mental health service provision and overrepresented in crisis pathways and detention. Methods and findings Following eMERGe guidelines for meta-ethnographies, we searched OpenGrey, Kings Fund, CINAHL, Medline, PsycINFO, and Social Care Online databases for qualitative articles published from database inception until October 2, 2022, using broad categories of search terms relating to “ethnicity AND (mental illness/mental health/emotional distress) AND (help-seeking/service utilisation/experience/perception/view).” We included all conceptually rich articles that used qualitative methods of data collection and analysis and excluded non-UK studies and those that focused solely on causation of mental illness. Our patient, public, and practitioner lived experience advisory group provided feedback and input on key stages of the project including search terms, research questions, data analysis, and dissemination. A total of 14,142 articles were identified; 66 met the inclusion criteria. We used reciprocal, refutational, and line of argument analytical approaches to identify convergence and divergence between studies. The synthesis showed that current models of statutory mental healthcare are experienced as a major barrier to the delivery of person-centred care to those in ethnic minority groups due to the perceived dominance of monocultural and reductionist frameworks of assessment and treatment (described as “medical” and “Eurocentric”) and direct experiences of racist practice. The lack of socially oriented and holistic frameworks of knowledge and understanding in medical training and services is experienced as epistemic injustice, particularly among those who attribute their mental illness to experiences of migration, systemic racism, and complex trauma. Fear of harm, concerns about treatment suitability, and negative experiences with health providers such as racist care and medical neglect/injury contribute to avoidance of, and disengagement from, mainstream healthcare. The lack of progress in tackling ethnic inequalities is attributed to failures in coproduction and insufficient adoption of existing recommendations within services. Study limitations include insufficient recording of participant characteristics relating to generational status and social class in primary studies, which prevented exploration of these intersections. Conclusions In this study, we found that the delivery of safe and equitable person-centred care requires a model of mental health that is responsive to the lived experiences of people in ethnic minority groups. For the people considered in this review, this requires better alignment of mental health services with social and anti-racist models of care. Our findings suggest that intersections related to experiences of racism, migration, religion, and complex trauma might be more relevant than crude ethnic group classifications. Strategies to tackle ethnic inequalities in mental healthcare require an evaluation of individual, systemic, and structural obstacles to authentic and meaningful coproduction and implementation of existing community recommendations in services.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Understanding ethnic inequalities in mental healthcare in the UK: A meta-ethnography

et al. 2022

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“…Such approaches need to move beyond traditional mental health promotion strategies to consider historic inequities in mental healthcare delivery and promote racial/ethnic minority voices, including those who identify as gay and bisexual. 40 For heterosexual men and sexual minority women, the rates of all the 3 outcomes declined with age but not consistently among gay/bisexual men. These findings stress the need for suicide prevention resources across the life course.…”

Section: Discussionmentioning

confidence: 99%

Suicidality Among Sexual Minority Adults: Gender, Age, and Race/Ethnicity Differences

Ramchand

Schuler

Schoenbaum

et al. 2022

American Journal of Preventive Medicine

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“…Furthermore, these discourses may have much to offer psychiatry if is willing and able to engage with them in a spirit of humility and receptivity (Bibeau and Corin 2010). • Engagement with research and service development that involves individuals with lived experience, survivor networks and grassroots BAME organisations (King et al 2021): A de-colonised curriculum will shed light on the dominant mental health research hierarchy that continues to devalue the voices of those with lived experience of mental illness and the mental health system (Faulkner 2017). Journal clubs should include research and narratives from the lived experience community, including those whose distress relates to racism and other intersectional discrimination (King 2016;Kalathil et al 2011).…”

Section: Towards a De-colonised Curriculummentioning

confidence: 99%

Decolonising the medical curriculum: psychiatry faces particular challenges

Bracken¹,

Fernando

Alsaraf

et al. 2021

Anthropology & Medicine

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Colonial thinking runs deep in psychiatry. Recent anti-racist statements from the APA and RCPsych are to be welcomed. However, we argue that if it is to really tackle deep-seated racism and decolonise its curriculum, the discipline will need to critically interrogate the origins of some of its fundamental assumptions, values and priorities. This will not be an easy task. By its very nature, the quest to decolonise is fraught with contradictions and difficulties. However, we make the case that this moment presents an opportunity for psychiatry to engage positively with other forms of critical reflection on structures of power/knowledge in the field of mental health. We propose a number of paths along which progress might be made.

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From Preproduction to Coproduction: COVID-19, whiteness, and making black mental health matter

Cited by 8 publications

References 4 publications

Understanding ethnic inequalities in mental healthcare in the UK: A meta-ethnography

Understanding ethnic inequalities in mental healthcare in the UK: A meta-ethnography

Suicidality Among Sexual Minority Adults: Gender, Age, and Race/Ethnicity Differences

Decolonising the medical curriculum: psychiatry faces particular challenges

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