‘I Don’t Think There’s Many Black African Caribbean Men That Talk Positively about Mental Health Services’ : Mental Health Professionals’ Perspectives on Distrust Amongst Black Men Detained in Psychiatric Hospitals

A growing body of literature has highlighted the importance of establishing and maintaining trust between people with mental health problems and mental health services. However, trust is a challenging concept within mental health care. Mental health laws in most jurisdictions, allow mental health professionals to detain people with mental health problems against their will, which can promote distrust between these groups. Quantitative research has consistently shown that African Caribbean men are disproportionately detained under mental health laws, contributing to a lack of trust between them and mental health services. In this presentation we explore how mental health professionals believe that trust can be established with African Caribbean men drawing on sociological theories of risk and trust within mental health work.

Our qualitative study used experienced-based co-design and thematic analysis to explore how the experiences of African Caribbean men detained under the Mental Health Act might be improved. In this presentation, we focus on the views of 13 mental health professionals, including psychiatrists, psychologists, social workers, and police officers who were interviewed in 2023.

Professionals in the study identified that African Caribbean men commonly distrusted mental health services. This distrust was seen to be driven by stereotypical views within services about this group being ‘risky’ and ‘dangerous as well as assessments and interventions not being culturally adapted. These factors were viewed within the context of socio-cultural and political factors, namely African Caribbean men experiencing higher levels of poverty, substance-misuse, trauma and discrimination. Participants identified that risk language was more frequently deployed in professional descriptions of Caribbean men and identified tensions between inter-agency policies when working with such risks. Research participants suggested several strategies for building trust. Issues relating to the mental health workforce were identified, including the lack of diversity in the workforce and inadequate training relating to black people’s perspectives.