Mental Illness and Black Communities: Experiences of Treatment within the Afro-Caribbean Population of Montreal

Background and purpose: Black community members are over-represented within mandatory mental health services and underrepresented within voluntary services, despite Blacks being over-represented within most risk factors for mental well-being. This discrepancy between psychological distress and service seeking behavior raises concerns about the potential impact of racial stereotypes and ethnocentric practices contributing to discriminatory interventions within social services.

The objective of this research is to display the diverse experiences of mental illness and treatment within the Black community. It is expected to provide a better understanding of how social representations of mental illness influence help-seeking behavior and treatment perspectives within the targeted population and allow for others to recognize their shared experiences within these narratives; to raise awareness and decrease stigma along with returning power to the community, so it can advocate and develop services more appropriate to its needs.

Methods: This study used eight semi-structured interviews to elicit life story narratives, allowing participants to share their understanding of their illness, and the help-seeking and treatment process. Participants are adults (age 25 to 64) who identified as Afro-Caribbean, diagnosed with a mental illness, and provided with a treatment plan. 50% of the sample were first-generation immigrants. Participants were recruited via posters and emails distributed to pertinent community organizations and through social media. The interviews were all transcribed verbatim and analyzed thematically, through inductive reasoning, using the NVivo software.

Findings: Regardless of generational differences, the social representations of mental health include a combination of biomedical, traditional, and spiritual perspectives influencing participants’ help-seeking behavior. The intersection of race and illness influences the experience of psychological distress within the Afro-Caribbean community, as they experience or fear the experience of racial discrimination within a predominantly white and western focused social service settings along with facing discrimination and exclusion from their own ethnoracial group for being mentally ill, with the latter being a greater source of distress.
The narrative approach provides the space needed for Afro-Caribbean descendants to contextualize their illness and voice their concerns in their own words and without judgment, which influences the treatment process and further recovery. This space is too often denied to Black community members, especially when it does not comply with the dominant narrative.

Conclusions and Implications: Findings demonstrate the lived reality of mental illness within the Afro-Caribbean community. It highlights the need to work within the community to decrease the stigma surrounding this social issue, to improve prevention and interventions in situations of psychological distress. It also demonstrates a need for service providers to expand their understanding of mental health and illness when working with people of Afro-Caribbean descent and that the western biomedical perspective is but one way of conceptualizing illness. In fact, the ethnocentrism that surrounds the normative framework of service offerings as well as diagnostic and treatment guidelines, only continues to maintain a divide in access to services. It is imperative for social services to work closely with organizations and institutions that are important to Afro-Caribbean community members to improve the potential for collective well-being.