‘It Just Feels Like an Invasion’: Black First-Episode Psychosis Patients’ Experiences With Coercive Intervention and Its Influence on Help-Seeking Behaviours

Abstract

Studies from the United States and United Kingdom show that Black patients are disproportionately diagnosed with psychosis and receive excess coercive medical intervention. There has been little discussion of this topic in Canada, and of how coercive interventions may have influenced Black patient attitudes towards mental health services. To address these issues, semi-structured interviews were administered to five Black men with first-episode psychosis (FEP) to (a) explore their experiences with coercive interventions and (b) describe how these experiences may have influenced help-seeking behaviours. Interpretative phenomenological analysis (IPA) was used to analyze the data. Four core themes and four additional themes emerged from the interviews. Patients described loneliness, not being heard, police contact and forced medication as influencing their attitudes towards mental health care. Further research is needed to develop reparative strategies to encourage reflection about and awareness of coercive intervention among Black FEP patients.

Racialised staff–patient relationships in inpatient mental health wards: a realist secondary qualitative analysis of patient experience data

“…The outcomes related to poor staff–patient rapport (eg, mistrust), worsening mental health outcomes (eg, retraumatisation) and less patient feedback. These findings align with previous research20 which revealed ethnic minority patients’ mistrust towards mental health professionals, particularly due to ethnic disparities in the use of coercive practices.…”

“…Some racial biases may have been activated as a response to physical/verbal abuse, neglect and dominance from ward staff directed towards patients—as one patient described, ‘the doctors play God’. These findings are aligned with previous research on coercive practices among ward staff including forced medication21 and a failure to provide culturally sensitive explanations of mental illness 20…”

“…These findings are aligned with previous research on coercive practices among ward staff including forced medication 21 and a failure to provide culturally sensitive explanations of mental illness. 20 …”

The Burden of Psychosis in Black Communities in Canada: More than a Feeling, a Black Family Experience

“…Lastly, there is a sentiment within Black communities that the care received is often culturally inappropriate, racist, not tailored to individual needs and of poor quality. 9 These sentiments reinforce the belief among many that provincial healthcare and justice systems are racist and perpetuate the social and health inequities Black individuals face within Canadian society. These situations have significant consequences for Black communities.…”

“…6,8 Feelings of injustice about how Black people with psychosis are treated further aggravate this situation. 9 First, there is a sense of insecurity within Black families regarding how these cases are handled by the police and the justice system. In recent years, acts of violence by the police against Black individuals with psychosis have multiplied, and some of them resulted in the deaths of several Black men.…”