Exploring the Challenges of Commissioning Mental Health Services for Black Men

Abstract

This research explored the challenges for commissioning services for Black men in Mental Health Services in the UK National Health Service (NHS). More specifically, the focus was on how commissioners conceptualised the structural and social issues in developing services for Black men with the aim of understanding how these issues might translate into service development. The context of commissioning was the focus of the study due to the influence this has on service provision and consequently on supporting the mental health of Black men. The study involved individual in-depth interviews with eight commissioners who had a role in commissioning adult NHS Mental Health Services. Interviews were analysed using thematic analysis drawing on an Intersectionality framework within a critical realist epistemology. Three main themes were identified, ‘Challenges to Commissioning Mental Health Services’, ‘Reframing Mental Health Services’ and ‘Black Men and Power Dynamics’. Key findings from the analysis highlighted various intersecting locations such as maleness, ‘race’, and social context in understanding factors that contribute to the mental health of Black men. These issues were drawn upon to discuss the constrains of service provisions available and explain why Black men were excluded from commissioning processes, leaving them with little power to influence decisions regarding mental health provisions. Based on the analysis, the limitations of current mental health provisions and processes involved in commissioning are discussed and considered in relation to supporting Black men’s mental health. This research indicates that more inclusion and support is required to empower Black men to be involved in commissioning processes in order to address some of the structural and social issues relevant to addressing mental health needs. The implications and suggestions are discussed in relation to considering ways that Clinical Psychologists in particular can facilitate this.