Engaging communities to improve mental health in African and African Caribbean groups: a qualitative study evaluating the role of community well-being champions.

Nadia Mantovani,Steve Gillard,Micol Pizzolati

doi:10.1111/hsc.12288

Nadia Mantovani, Steve Gillard + Show 1 more

Open Access

https://doi.org/10.1111/hsc.12288

Copy DOI

Abstract

Over the last decade, Britain has undergone reforms to promote engagement in local structures of governance. These reforms have encouraged the promotion of active citizenship and have been central to the government's public service modernisation agenda. This article presents the findings from a study evaluating a pilot outreach intervention which adopted a community engagement model to address the mental health needs of African and African Caribbean groups, which entailed a partnership between faith-based organisations, local public services and community organisations to co-produce the pilot project. Lay people were trained to raise awareness about mental health among these communities in South London. Between 2012 and 2013, a qualitative participatory approach was used to evaluate the pilot project, which enabled a researcher to take part in the engagement phase of the pilot project, and the project co-ordinators to be involved in the research process. Semi-structured, one-to-one interviews were carried out with 13 community and well-being champions (CWBCs) recruited from African and African Caribbean communities (seven male and six female). This study examines the impact of the relationship between the intervention and community through the participants' engagement in the pilot outreach project and the action undertaken as champions. We found that although CWBCs used circles of influence to share ideas about mental health and well-being and to encourage change, they encountered resistance on the part of the people they engaged with, which resulted from a lack of knowledge about mental health, taboos and ascribed stigma. We argue that CWBCs acted as healthy examples to communicate mental health knowledge to those approached, but that they needed to be equipped with bespoke communication skills to be able to talk about such sensitive issues as mental health.

Highlights

Mental health is more than the absence of mental health problems; it is the foundation for well-being and effective functioning for an individual and for a community
Inequalities in mental health in African and African Caribbean groups. Social determinants such as poverty, inequality, lack of education and unemployment have an impact on mental health (Patel & Kleinman 2003, Lund et al 2010), with research demonstrating a relationship between income inequality and prevalence of mental health problems in developed countries such as the US and UK (Picket et al 2010)
One strength of the design was the in-depth interviews with the participating community and well-being champions (CWBCs), which allowed a comprehensive view of the champion role and the mechanisms underlying the empowerment model

Summary

Introduction

Mental health is more than the absence of mental health problems; it is the foundation for well-being and effective functioning for an individual and for a community. Inequalities in mental health in African and African Caribbean groups. Social determinants such as poverty, inequality, lack of education and unemployment have an impact on mental health (Patel & Kleinman 2003, Lund et al 2010), with research demonstrating a relationship between income inequality and prevalence of mental health problems in developed countries such as the US and UK (Picket et al 2010). African and African Caribbean communities favour mental health resource centres staffed with individuals from the same ethnic groups who look ‘at the world from their clients’ perspective’ and share ‘something of themselves’ African and African Caribbean communities favour mental health resource centres staffed with individuals from the same ethnic groups who look ‘at the world from their clients’ perspective’ and share ‘something of themselves’ (Secker & Harding 2002a, p. 275), over traditional types of services such as inpatient services (Secker & Harding 2002b)

Methods

Discussion

Conclusion