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Book part
Publication date: 8 June 2020

Dawn Edge, Amy Degnan and Sonya Rafiq

Several decades of mental health research in the UK repeatedly report that people of African-Caribbean origin are more likely than other ethnic minorities, including the…

Abstract

Several decades of mental health research in the UK repeatedly report that people of African-Caribbean origin are more likely than other ethnic minorities, including the White majority, to be diagnosed with schizophrenia and related psychoses. Race-based inequalities in mental healthcare persist despite numerous initiatives such as the UK’s ‘Delivering Race Equality’ policy, which sought to reduce the fear of mainstream services and promote more timely access to care. Community-level engagement with members of African-Caribbean communities highlighted the need to develop culturally relevant psychosocial treatments. Family Intervention (FI) is a ‘talking treatment’ with a strong evidence-base for clinical-effectiveness in the management of psychoses. Benefits of FI include improved self-care, problem-solving and coping for both service users and carers, reducing the risk of relapse and re-hospitalisation. Working collaboratively with African-Caribbeans as ‘experts-by-experience’ enabled co-production, implementation and evaluation of Culturally adapted Family Intervention (CaFI). Our findings suggests that a community frequently labelled ‘hard-to-reach’ can be highly motivated to engage in solutions-focussed research to improve engagement, experiences and outcomes in mental health. This underscores the UK’s Mental Health Task Force’s message that ‘new ways of working’ are required to reduce the inequalities faced by African-Caribbeans and other marginalised groups in accessing mental healthcare. Although conducted in the UK (a high-income multi-cultural country), co-production of more culturally appropriate psychosocial interventions may have wider implications in the global health context. Interventions like CaFI could, for example, contribute to reducing the 75% ‘mental health gap’ between High and Low-and-Middle-Income counties reported by the World Health Organization.

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The International Handbook of Black Community Mental Health
Type: Book
ISBN: 978-1-83909-965-6

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Book part
Publication date: 25 August 2020

Jason O. Manaois, Chantal Ellis S. Tabo-Corpuz and Andrew G. Heise

This chapter reviews the empirical evidence for Psychological First Aid (PFA) in the context and experience of the Southeast Asian (SEA) region. First, this chapter…

Abstract

This chapter reviews the empirical evidence for Psychological First Aid (PFA) in the context and experience of the Southeast Asian (SEA) region. First, this chapter provides the definition and background of PFA and its core principles, to explain the basis for doing PFA as part of an integrated approach to disaster mental health. Second, the existing literature on the effectiveness of PFA is reviewed. Third, this chapter examines the application and adaptation of PFA in SEA. Implications and recommendations are provided at the end of the chapter.

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Resistance, Resilience, and Recovery from Disasters: Perspectives from Southeast Asia
Type: Book
ISBN: 978-1-83909-791-1

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Book part
Publication date: 8 June 2020

Nicholas Banks

Research suggests that African-Caribbeans are less likely than their white British counterparts to ask for mental health support (Cooper et al., 2013). This is despite…

Abstract

Research suggests that African-Caribbeans are less likely than their white British counterparts to ask for mental health support (Cooper et al., 2013). This is despite research identifying that minority groups as a whole, when compared to the white majority, report higher levels of psychological distress and a marked lack of social support (Erens, Primatesta, & Prior, 2001). Those who do request support are less likely to receive antidepressants (British Fourth National Survey of Ethnic Minorities, 1994; Cooper et al., 2010) even when controlling for mental health symptom severity, with African-Caribbeans less likely to make use of medication for depression even when prescribed (Bhui, Christie, & Bhugra, 1995; Cooper et al., 2013). Studies reporting on reasons for black people being less likely to attend for mental health consultation with their GP suggest a variety of explanations why this may be, focussing both on the suspicion of what services may offer (Karlsen, Mazroo, McKenzie, Bhui, & Weich, 2005) and the concern of black clients that they may experience a racialised service with stigma (Marwaha & Livingstone, 2002). Different understandings and models of mental illness may also exist (Marwaha & Livingstone, 2002). Different perspectives and models of mental health may deter black people from making use of antidepressants even when prescribed. Despite a random control trial showing that African-Caribbean people significantly benefit from targeted therapy services (Afuwape et al., 2010), the government, despite a report by the Department of Health in 2003 admitting there was no national strategy or policy specifically targeting mental health of black people or their care and treatment has not yet built on evidence-based success. One important aspect recognised by the Department of Health (2003), was that of the need to develop a mental health workforce capable of providing efficacious mental health services to a multicultural population. Although there were good strategic objectives little appeared to exist in how to meet this important objective, particularly in the context of research showing that such service provision could show real benefit. The Department of Health Guidelines (2003) focussed on the need to change what it termed as ‘conventional practice’, but was not specific in what this might be, or even how this could improve services to ethnic minorities. There was discussion of cultural competencies without defining what these were or referencing publications where these would be identified. There was a rather vague suggestion that recent work had begun to occur, but no indication that this had been evaluated and shown to have value (Royal College of Psychiatrists, 2001). Neither British Association for Counselling and Psychotherapy nor British Psychological Society makes mention of the need for cultural competencies in organisational service delivery to ethnic minority clients. This chapter will describe, explore and debate the need for individual and organisational cultural competencies in delivering counselling and psychotherapy services to African-Caribbean people to improve service delivery and efficacious outcomes.

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The International Handbook of Black Community Mental Health
Type: Book
ISBN: 978-1-83909-965-6

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Article
Publication date: 20 March 2020

Sue Holttum

This paper aims to examine three recent papers on psychosis and social inclusion in relation to people of Black African and African Caribbean heritage in the UK and the USA.

Abstract

Purpose

This paper aims to examine three recent papers on psychosis and social inclusion in relation to people of Black African and African Caribbean heritage in the UK and the USA.

Design/methodology/approach

A search was carried out for recent papers on psychosis and social inclusion in relation to people of Black African and African Caribbean heritage in the UK and the USA. I selected three papers addressing this theme from different angles.

Findings

The first paper extends previous findings (that psychosis can follow traumatic events) to Black Americans and includes the contribution of societal inequalities and racism. The second paper illustrates Black men’s experiences of mental health services for psychosis in the UK. It finds, not surprisingly, that a lack of listening combined with coercive use of medication reduces trust in services. The third paper offers hope in reporting collaborative work with people of Black African Caribbean heritage in the UK to culturally adapt family intervention for psychosis. The first and third papers both place importance on valuing people’s spiritual beliefs.

Originality/value

All three papers highlight the on-going need for increased equity and social inclusion in mental health services for people of Black African and African Caribbean heritage, in terms of recognising the role of childhood trauma and later stresses, addressing the potential harm of over-reliance on medication, offering therapy that is collaborative and culturally adapted and respecting valued spiritual beliefs.

Details

Mental Health and Social Inclusion, vol. 24 no. 2
Type: Research Article
ISSN: 2042-8308

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Book part
Publication date: 25 August 2020

Ma. Regina M. Hechanova and Lynn C. Waelde

Advances in disaster prevention and mitigation in Southeast Asia (SEA) have increasingly included plans for mental health and psychosocial support. However, substantial…

Abstract

Advances in disaster prevention and mitigation in Southeast Asia (SEA) have increasingly included plans for mental health and psychosocial support. However, substantial challenges remain, particularly in the areas of (a) disaster communication and preparedness, (b) institutionalized disaster education, (c) culturally adapted and evidence-based tools and interventions, (d) developing capacities and caring for disaster responders, and (e) enabling collective resilience. In addition, the impacts of poverty, lack of access to education, and other forms of marginalization result in less resources to prepare for hazardous event and increased vulnerability to environmental hazards for SEA countries. These issues highlight the need for SEA governments to address deeply rooted human development issues that put communities at risk and heighten vulnerabilities of SEA populations.

Details

Resistance, Resilience, and Recovery from Disasters: Perspectives from Southeast Asia
Type: Book
ISBN: 978-1-83909-791-1

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Article
Publication date: 4 June 2018

Maria Regina Hechanova, Pierce S. Docena, Liane Peña Alampay, Avegale Acosta, Emma E. Porio, Isabel E. Melgar and Rony Berger

The purpose of this paper is to evaluate the effect of a community-based resilience intervention for Filipino displaced survivors of Super Typhoon Haiyan.

Abstract

Purpose

The purpose of this paper is to evaluate the effect of a community-based resilience intervention for Filipino displaced survivors of Super Typhoon Haiyan.

Design/methodology/approach

The researchers used a quasi-experimental and mixed-method design comparing a treatment group with a control group across three time periods: before, immediately after, and six months after the intervention.

Findings

Results showed significant improvements in survivors’ anxiety scores and resilience scores compared to those who did not undergo the program. However, although there was an increase in adaptive coping of participants immediately after the program, there was a reduction in adaptive coping behaviors for all groups six months after the program. Focus group discussions revealed this might be due to significant environmental challenges among displaced survivors.

Research limitations/implications

A limitation of the study was the lack of randomization and a small sample size due to attrition.

Practical implications

The study highlights the positive effects of culturally adapted group interventions.

Social implications

The results suggest the importance of a systemic approach to enabling the recovery of displaced survivors in developing countries.

Originality/value

This study provides evidence for a resilience intervention developed in a low-middle income country in Southeast Asia.

Details

Disaster Prevention and Management: An International Journal, vol. 27 no. 3
Type: Research Article
ISSN: 0965-3562

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Article
Publication date: 24 January 2020

Mariam Vahdaninia, Bibha Simkhada, Edwin van Teijlingen, Hannah Blunt and Alan Mercel-Sanca

Mental health disparities exist among Black, Asian and Minority Ethnics (BAME) populations. This paper aims to provide an overview of mental health services designed for…

Abstract

Purpose

Mental health disparities exist among Black, Asian and Minority Ethnics (BAME) populations. This paper aims to provide an overview of mental health services designed for the BAME population in the UK, both established BAME communities and refugee/asylum-seekers.

Design/methodology/approach

A range of electronic databases were searched for peer-reviewed studies conducted within the past decade in the UK. Using the Arksey and O’Malley methodology, data were extracted, analysed and summarised.

Findings

A total of 13 papers were identified, mostly non-randomised community-based. Studies were very heterogeneous in terms of their sample and service provided. After the initial appraisal, the authors presented a narrative synthesis. Overall, all studies reported positive mental health outcomes and beneficial effects.

Research limitations/implications

Because of the time limitations and quality of the papers, the authors only included peer-reviewed journal papers.

Practical implications

Mental health services provided for BAME people, both established and refugee/asylum-seekers are feasible and improve engagement with the services and mental health outcomes. Initiatives are required to facilitate the integration of these targeted services within mental health and community services for BAME in the UK.

Originality/value

This scoping review is a snapshot of the mental health services designed for BAME people in the UK, either established or refugee/asylum-seekers in the past 10 years and adds to the evidence-based knowledge from these studies.

Details

Mental Health and Social Inclusion, vol. 24 no. 2
Type: Research Article
ISSN: 2042-8308

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To view the access options for this content please click here
Book part
Publication date: 8 June 2020

Abstract

Details

The International Handbook of Black Community Mental Health
Type: Book
ISBN: 978-1-83909-965-6

To view the access options for this content please click here
Book part
Publication date: 25 August 2020

Abstract

Details

Resistance, Resilience, and Recovery from Disasters: Perspectives from Southeast Asia
Type: Book
ISBN: 978-1-83909-791-1

To view the access options for this content please click here
Book part
Publication date: 25 August 2020

Ma. Regina M. Hechanova, Lynn C. Waelde and Alicia N. Torres

Southeast Asia (SEA) is a region highly susceptible to earthquakes, volcanic eruptions, and tsunamis, though the region has been underrepresented in disaster mental health…

Abstract

Southeast Asia (SEA) is a region highly susceptible to earthquakes, volcanic eruptions, and tsunamis, though the region has been underrepresented in disaster mental health research. This chapter addresses risk factors for SEA, including its disaster-prone location, the psychological toll of frequent disasters, and stigma and shame and lack of psychoeducation about psychological help-seeking. Collectivism, strong family ties, and religious faith are among SEA’s resilience factors. Culture should be heavily accounted for in mental health and psychosocial support (MHPSS), considering the wide array of cultural differences in spirituality, affect and expression, power distance, and gender and masculinity in SEA. Because culture affects treatment satisfaction, treatment engagement, and treatment outcomes, future research should explore how aspects of SEA culture impact accessibility and engagement in MHPSS.

Details

Resistance, Resilience, and Recovery from Disasters: Perspectives from Southeast Asia
Type: Book
ISBN: 978-1-83909-791-1

Keywords

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