Is the NHS approach to mental health helping the African community overcome it’s mental health difficulties or is it reinforcing stigmatisms and failing to catch the most vulnerable of members of our African community?
I would argue that the medical approach to mental health neglects one of the most important aspects people’s lives, the past. The fact that evidence based therapy (CBT) concentrates purely on the here and now, and uses the past to gain an understanding of past risking behaviours and to identify a possible (arbitrary) trigger to your mental health issues means that the NHS continues to make the same mistakes.
Psychological traumas are like any other physical wound; although they vary in depth and severity, sometimes a bespoke approach is need to treat the wound. This doesn’t mean you throw away the manual to CBT but adapt it to the patient and consider if it’s appropriate. The psychological wounds of the African community stem from slavery and oppression, yet the importance of how this makes us view the world and mental health is completely omitted from any NHS assessment. I wonder how many IAPT workers ask if and individual has be a victim of discrimination? I wonder how many IAPT workers ask how their client’s families view mental health? Something as simple as this can allows the therapist to redress and reassure any preconceptions or stigmatisations the client may have on an individual and family level.
This brings me to my second point that western society and thus medicine is very individualistic, yet that is not how the African people live. Although western society promotes the importance of the ‘I’ it is the ‘WE’ that must be harnessed to fully engage our communities. Thus I believe we as African people should sitting at the table discussing what is salient to our people. Community based discussions about mental health directly linked to communities issues is what I believe is required.
Would love to hear other people’s thoughts on this.