The Meanings of Mental Health Recovery for African and Caribbean Men in the UK An Intersectionalities Approach

Main Article Content

Kris Southby
Frank Keating
Stephen Joseph

Abstract

Racial disparities for African and Caribbean men are nowhere as stark as in mental health services and outcomes. Men from these communities who have been in contact with mental health services seemed to be stuck in a stalled cycle of recovery. This paper reports the findings from a study that aimed to explore how African and Caribbean men and their supporters conceptualise mental health recovery at the intersections of masculinity, racialised identities and mental distress. It illuminates the perspectives of service users,
family, carers and practitioners on recovery in relation to ethnicity and culture.
Owing to the exploratory nature of this study, a qualitative design using a phenomenological approach was adopted to capture the dynamics of recovery processes and outcomes for African and Caribbean men across two study sites. Interviews were conducted with African and Caribbean men, their supporters and service providers. Interpretive Phenomenology Analysis (IPA; Smith J, Flowers P, Larkin M. Interpretative phenomenological analysis: Theory method and research. London: SAGE; 2009) was used to offer insights into how recovery was understood and experienced by study participants.
Seven overarching themes emerged from the data in relation to the meanings of recovery: recovering from social suffering, leading a normal life, (re)gaining control and agency, a sense of hope, (re)gaining identity, reduced medical involvement, and recovery being a healing journey.
The paper concludes that recovery is an ongoing process, not merely a narrow outcome to be achieved for men. The paper advances previous understandings by conceptualising mental health recovery for African and Caribbean men as a journey towards addressing individual and collective “social suffering” that occurs at the intersections of masculinity, “race” and mental distress, and moving to a better social location.

Downloads

Download data is not yet available.

Article Details

Section
Articles
Author Biographies

Kris Southby, Leeds Beckett University; Leeds, UK

Leeds Beckett University; Leeds, UK

Frank Keating, Royal Holloway, University of London

Department of Social Work, Royal Holloway University of London, Egham Hill, Egham, Surrey, UK

Stephen Joseph, Royal Holloway University of London

Department of Social Work, Royal Holloway University of London, Egham Hill, Egham, Surrey, UK

References

1. Memon A, Taylor K, Mohebati LM, Sundin J, Cooper M, Scanlon T, et al. Perceived barriers to accessing mental health services among black and minority ethnic (BME) communities: A qualitative study in southeast England. BMJ Open. 2016;6(11). https://doi.org/bmjopen.bmj.com/content/bmjopen/6/11/e012337.full.pdf
2. Synergi Collaborative Centre. The impact of racism on mental health. Briefing paper. London: Synergi Collaborative Centre; 2018. https://doi.org/synergicol-laborativecentre.co.uk/wp-content/uploads/2017/11/The-impact-of-racism-on-mental-health-briefing-paper-1.pdf.
3. Department of Health. Delivering race equality in mental healthcare: An action plan for reform inside and outside services. London: Department of Health; 2005. http://doi.org/research.bmh.manchester.ac.uk/ ReACH/resources/keypaper4.pdf.
4. Care Quality Commission. Monitoring of the Men-tal Health Act in 2018–19. London: APS Group; 2020. https://doi.org/www.cqc.org.uk/sites/default/ files/20200206_mhareport1819_report.pdf.
5. Cabinet Office. Race disparity audit. London: Cabinet Office; 2017. https://doi.org/assets.publishing.service.gov. uk/government/uploads/system/uploads/attachment_data/ file/686071/Revised_RDA_report_March_2018.pdf.
6. Robinson M, Keating F, Robertson S. Ethnicity, gender and mental health. Diversity Health Care. 2011;8(2). https://doi.org/d1wqtxts1xzle7.cloudfront.net/40507436/ BMe_men_paper_Diversity_in_Health_and_Care. pdf?1448898253=&response-content-disposition=in line%3B+filename%3DEthnicity_gender_and_men-tal_health.pdf&Expires=1604595089&Signature=DH QiobZOamlOfHl~8ST889IB-4zoZ~cF6zIp9Nv0eK6P GIoMsy~e1yEkn41M0dmapIBgzuA2kVviw7hAEBX kuOho0JS8Sh6ivyDHc13fo1PZgB-VDu34lGy5DPkC-sV~HO77oEwdhl9J98pBs6xXX1U6Ep1XWmf6-lT6cyuCrKJIEHeWnQKWxwUoFyIQ1izBe-lhNHA sYmz~LvlRWvh2fqj9gNpABa14WACNPVI7OYLKofUhNUtQG29TBxFxnrEkI~nCdQjWELQaPLyqPb-kmkVQeLTmS1yzsOEetM1R62wrX9lVeAeZVnE-O6tWB4g3vU-sB5rhxASbrkLQ8kcVZEJA__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA.
7. Crenshaw K. Demarginalizing the intersection of race and sex: A black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics. u Chi Legal f. 1989:139.
8. Gilbert KL, Ray R, Siddiqi A, Shetty S, Baker EA, Elder K, et al. Visible and invisible trends in black men’s health: Pitfalls and promises for addressing racial, ethnic, and gender inequities in health. Ann Rev Public Health. 2016;37:295–311.
9. McKeown M, Robertson S, Habte-Mariam Z, Stowell-Smith M. Masculinity and emasculation for black men in modern mental health care. Ethn Inequal Health Soc Care. 2008;1(1):42–51. https://doi.org/d1wqtxts1xzle7.cloudfront.net31932303MascEmasc
BlackMen_MentalHealth.pdf?1379850837=&response-contentdisposition=inline%3B+filename%3DMas culinity_and_emasculation_for_black_m.pdf&Ex pires=1604595141&Signature=b8oeSTW8Gq3J w51x1rPq5uCZX~UTVgt8CLNICcMbKhwTXw bKh0jyz5n2IbGbSyk6tYgEhtUsn35ThYlvOKILr969
sNAehlF9c8ffpVlM77QNuGPHqxDuALobPeRSLlm 7sKLK~6nlMBjciKNvRHCvAPad3Enm5c5gzkh1 Ih0wFYqAyUQVUG3wQEI1aAknGtXpksfNeThytB ozuaqqWh6pv-NU5i0drFyBWeW~VXBZREfD5QhO--rrNMBAEDijw6QWOaglzbCDLN3L5qNFF5zcgL-w3poWZWx2hKsXnT6HKT2bDVC59lPE-H3KqwuqH-y8wAj8IUp0d4TWr7Q__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA.
10. Bourdieu P, Accardo A, Emanuel S. The weight of the world: Social suffering in contemporary society: Stanford, CA: Stanford University Press; 1999. http://doi.org/www.sup.org/books/title/?id=1275
11. Wilkinson I. Health, risk and “social suffering.” Health Risk Soc. 2006;8(1):1–8. https://doi.org/ www.tandfonline.com/doi/abs/10.1080/13698570500532256.
12. Chamberlin J. On our own: patient-controlled alternatives to the mental health system. New York, NY: McGraw Hill; 1978.
13. Anthony W. Recovery from mental illness: The guiding vision of the mental health service system in the 1990s. Psychosoc Rehab J. 1993;16(4):11.
14. Clarke C, Lumbard D, Sambrook S, Kerr K. What does recovery mean to a forensic mental health patient? A systematic review and narrative synthesis of the qualitative literature. J Foren Psych Psychol. 2016;27(1):38–54.https:doi.org.www.tandfonline.com/doi/full/10.108014789949.2015.1102311.
15. Leamy M, Bird V, Le Boutillier C, Williams J, Slade M. Conceptual framework for personal recovery in mental health: Systematic review and narrative synthesis. Br J Psych. 2011;199(6):445–452. https:// doi.org/www.cam-bridge.org/core/journals/the-british-
journal-of-psychiatry/ article/conceptual-framework-for-personal-recovery-in-mental-health-systematic-review-and-narrative-synthesis/9B3B8D6EF823A1064E9683C43D70F577.
16. Young SL, Ensing DS. Exploring recovery from the perspective of people with psychiatric disabilities. Psych Rehab J. 1999;22(3):219. https://doi.org/psycnet.apa.org/doiLanding?doi=10.1037%2Fh0095240.
17. Byrne L, Happell B, Reid-Searl K. Lived experience practitioners and the medical model: World’s colliding? J Mental Health. 2016;25(3):217–223. https://doi.org/ www.tandfonline.com/doi/full/10.3109/09638237.20 15.1101428.
18. McCabe R, Whittington R, Cramond L, Perkins E. Contested understandings of recovery in mental health. J Mental Health. 2018:1–7. https://doi.org/doi.org/10.1080/09638237.2018.1466037.
19. Farkas M. The vision of recovery today: What it is and what it means for services. World Psych. 2007;6(2):68–74. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2219905/.
20. Slade M, Amering M, Farkas M, Hamilton B, O’Hagan M, Panther G, et al. Uses and abuses of recovery: Implementing recovery-oriented practices in mental health systems. World Psych. 2014;13(1):12–20. https://doi. org/onlinelibrary.wiley.com/doi/abs/10.1002/wps.20084.
21. Tang L. Recovery, hope and agency: The meaning of hope amongst Chinese users of mental health services in the UK. Br J Soc Work. 2018:bcy033-bcy. http:// dx.doi.org/10.1093/bjsw/bcy033.
22. Keating F. Racialized communities, producing madness and dangerousness. Intersectionalities Global J Soc Work Analy Res Polity Pract. 2016;5(3):173–185. https://doi.org/journals.library.mun.ca/ojs/index.php/
IJ/article/view/1664.
23. Brown M, Essien P, Etim-Ubah P, Ezenwa B, Gabriel M, Hobbs T, et al. Community engagement project: The National Institute for Mental Health in England mental health programme. Report of the community-led research project focussing on male African and African Caribbean perspectives on recovery. London: Southside Partnership Fanon Care; 2008. https:// doi.org/library. recoverydevon.co.uk/items/show/17.
24. Outside the Box. Recovery and minority ethnic men in Edinburgh. Summary report. Glasgow, UK: Outside the Box; 2008.
25. Abimola D. BME recovery scoping study in Liverpool. Liverpool: Inclusion Matters; 2014.
26. Armour MP, Bradshaw W, Roseborough D. African Americans and recovery from severe mental illness. Soc Work Mental Health. 2009;7(6):602–622. https://doi.org/www.tandfonline.com/doi/full/10.1080/15332980802297507.
27. Myers NAL, Ziv T. “No one ever even asked me that before”: Autobiographical power, social defeat, and recovery among African Americans with lived experiences of psychosis. Med Anthropol Quart. 2016;30(3):395-413.https://doi.org/anthrosource.onlinelibrary.wiley.com/doi/full/ 10.1111/maq.12288.
28. Smith J, Flowers P, Larkin M. Interpretative phenomenological analysis: Theory method and research. London: SAGE; 2009. https://doi.org/books.google.co.uk/books/about/Interpretative_Phenomenological_Analysis.html?id=WZ2Dqb42exQC.
29. Robertson S. ‘I’ve been like a coiled spring this last week’: Embodied masculinity and health. Soc Health Illness. 2006;28(4):433–456.
30. Griffith DM, Cornish EK. “What defines a man?”: Perspectives of African American men on the components and consequences of manhood. Psychol Men Mascul. 2018;19(1):78.
31. Taylor C. The politics of recognition. In: Heble A, Palmateer Pennee D, Struthers J, editors. New contexts of Canadian criticism. 98. Ontario, Canada: Broadview Press, 1997; pp. 98–131.
32. Williams R. Marxism & literature. Cambridge, UK: Cambridge University Press; 1977. https://doi.org/books. google.co.uk/books/about/Marxism_and_Literature.