Exploring barriers and facilitators to recovery among Afro-Caribbean mental health service users

Introduction: Evidence suggests that minorities with mental distress underuse mental health services compared with the majority population. Such under-utilization, combined with other socio-cultural factors, can impede recovery from mental illness. The Afro-Caribbean community in Canada is a fast-growing population, but their mental health service experience has been under-researched. As such, we set out to examine perspectives and experiences among Afro-Caribbean service users, exploring (i) self-identified barriers and facilitators towards recovery; (ii) experiences within the official mental health care system; and (iii) use of alternative treatments and remedies outside the official system.

Methods: To meet these aims, we employed a qualitative community-based approach, conducting in-depth semi-structured interviews with 18 Afro-Caribbean service users with a variety of mental disorders. Data was analyzed using thematic analysis.

Results: Analysis revealed three themes. First, participants pointed to their Christian faith as a vital source of comfort and solace, which helped their recovery. Practices such as prayer, consulting scripture and church attendance were considered particularly helpful. Second, participants reported that some people in their social circle (especially older relatives, e.g. parents) held stigmatizing views of mental illness, including sceptical views about the reality of mental illness. This was a barrier to recovery, as it inhibited disclosure and delayed help-seeking. Third, many participants reported common issues within clinical services including (i) lack of understanding of Afro-Caribbean cultural norms; (ii) avoiding discussion of religion and spirituality, which was central to many participants’ lives; and (iii) an overemphasis on medication as a solution. Subsequently, many participants reported seeking out alternative activities including Reiki, herbal medicine, dance, exercise and other naturopathic remedies. Participants typically praised these activities as facilitators of recovery, while downplaying the role of medication.

Conclusion: The results suggest an urgent need for religious and cultural competence for Canadian clinicians to better engage minority patients and facilitate recovery.