SCIE Resource guide 10: Commissioning and providing mental health advocacy for African and Caribbean men

Background: Key messages from research

SCIE Knowledge Review 15 includes a systematic review of the relevant literature. The key messages from this are:

• There is demonstrable need for mental health advocacy with people from black and minority ethnic (BME) communities. For African and Caribbean men, the pathways into mental health services, anomalies in care and treatment compared to their white counterparts, experience of racism and discrimination within services and greater dissatisfaction with mental health services indicate that high-quality mental health advocacy is needed to ensure that these men receive appropriate services.
• While there is scant research on this subject, there is a consensus that access to mainstream mental health advocacy for people from BME communities is seriously limited. Such organisations typically do not proactively seek clients, and this serves to disadvantage African and Caribbean men and members of other BME communities. In addition, there can be a fundamental mistrust of established mental health services and confusion over the meaning of advocacy, which gets in the way of anticipating its value or potential benefits.
• There are clear differences between standard approaches to mental health advocacy and those developed by and for black and minority ethnic communities. Underpinning these are key differences in the way that advocacy is conceptualised.
• BME definitions emphasise interdependence with families and communities. Concepts of the self or individual may not match individuals’ values and beliefs and their expectations and preferences to be part of a community or cultural group (11).
• The need for advocacy is framed in terms of inequalities and exclusion. For BME communities, advocacy is not only concerned with addressing the power inequalities in the relationship with mental health services but more broadly with achieving equality and social justice within UK society.
• The focus and organisation of advocacy services can operate to limit the extent to which African and Caribbean men are able to access and make effective use of advocacy.