Why are you cast down, o my soul? Exploring intersections of ethnicity, gender, depression, spirituality and implications for Black British Caribbean women’s mental health

Abstract

Ethnic disparities in UK mental healthcare persist despite decades of policy and practice initiatives to eradicate them. Inequalities in access, care and outcomes are most evident among people of Black Caribbean origin. However, much of this evidence is derived from clinical practice and research among men with serious mental illness. Lack of evidence about common mental health issues in Black British Caribbean women is an important omission as reducing inequalities in mental healthcare and providing effective interventions require improved understanding of aetiology, epidemiology, symptom profile and ways of coping. In this paper, I explore the conundrum of apparently low levels of perinatal depression among Black British Caribbean women despite significant levels of psychosocial risk and against the backdrop of high prevalence of diagnosed mental illness among Black British Caribbean men. I posit that the intersections of ethnicity, gender and spirituality might provide at least a partial explanation for apparent underdiagnosis in this group of women. Understanding Black British Caribbean women’s mental health needs, coping styles, help-seeking strategies and their relationship with formal systems of care has important ramifications for research, policy and practice aimed at reducing mental health disparities in the context of the UK’s equity-based healthcare system.