Experiences of mental health services for ‘black’ men with schizophrenia and a history of disengagement: A qualitative study

Abstract

Whilst mental disorders can be disabling they are also treatable, yet engagement with services is often poor and disengagement from treatment is a major concern for mental health nurses. Participants were service users typically perceived as the most disengaged from mental health services, yet they were willing to engage in the research interviews. The seven participants were all male with a diagnosis of schizophrenia, a history of disengagement from mental health services and described their ethnicity as ‘black’. Participants were under the care of Assertive Outreach Teams and were recruited after the researcher was introduced to them by clinicians who were working with them. After ethical approval, in‐depth, semi‐structured interviews were used to elicit the experiences of participants. Through interpretative phenomenological analysis, themes were developed. Interpretative Phenomenological analysis generated four themes: (i) “People just keep hounding me”, (ii) Antipathy to Medication, (iii) Choice and the value of services, (iv) Stigmatisation and identity. By rigorously examining how service users with schizophrenia make sense of their experience of their relationship with mental health services, there is potential to give voice to the experiences of the recipients of mental health services. This study uncovered the complex nature of disengagement and in view of this there may never be a straightforward mechanism developed to engage all people with schizophrenia with mental health services. When the participants’ experiences are considered in a broader social context it may be possible to reflect on how services can be adapted to facilitate better engagement.

Perspectives of cannabis use in the life experience of men with schizophrenia

“…There were two components of the larger study; study one consisted of individual semi‐structured interviews with seven male service users who described their ethnic identity as ‘black’ and had a diagnosis of schizophrenia and a history of disengagement from mental health services (Wagstaff et al . ). Study two involved two focus groups with clinicians who worked in assertive outreach teams in the West Midlands, UK (under review).…”

“…This research reports on findings from a part of a larger study (Wagstaff et al . ) which was conducted amongst people affected by SMHP with a history of disengagement from mental health services. A research question of the larger study sought to understand, from the perspective of both service users and clinicians, cannabis use within the experience of men with a diagnosis of schizophrenia (Table ).…”

Research watch: people of Black African and African Caribbean heritage in the UK and USA – psychosis, racism and inclusion

“…Black men with schizophrenia often seen as disengaging Wagstaff et al (2018) tell us that according to research in a range of countries, people with a diagnosis of schizophrenia often stop cooperating with their treatment and are seen as disengaging. Wagstaff et al (2018) say there was a need to understand why this happens.…”

“…Black men with schizophrenia often seen as disengaging Wagstaff et al (2018) tell us that according to research in a range of countries, people with a diagnosis of schizophrenia often stop cooperating with their treatment and are seen as disengaging. Wagstaff et al (2018) say there was a need to understand why this happens. Initially, they had not focused exclusively on Black men, but when they started recruiting their sample of people with a diagnosis of schizophrenia who were defined as disengaging, the first four were all Black men.…”

“…Rosen et al (2017) have extended research on traumatic life events and psychosis to Black Americans. Wagstaff et al (2018) report on their in-depth interviews with seven Black men in the UK about their experience of mental health services, shedding important light on why professionals often see them as disengaging. Edge and Grey (2018) carried out participatory action research to adapt family intervention to increase its cultural relevance to people of Black African Caribbean heritage in the UK.…”