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Mafuba, L, 2024. Barriers to mental health service access and utilisation: a case of Black sub-Saharan Africans in the West Midlands of England, UK. PhD, Nottingham Trent University.
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Abstract
Mental health problems have been identified as the leading cause of disease burden worldwide. In high-income countries, they are more common among global majority populations and in the UK, individuals of Black heritage are over-represented in their experiences as well as not accessing mental health services. Sub-Saharan Africans are the worst affected. This study aimed to understand the factors that influenced their decisions to seek help for poor mental health. The qualitative study was guided by The Silences Framework (TSF) and Critical Race Theory (CRT). It drew upon the Interpretative Phenomenological Analysis (IPA) methodology to engage with the lived experiences of 21 Black sub-Saharan African individuals, n=13 males and n=8 females, aged 23 – 60 years old, from diverse backgrounds. Semi-structured interviews were used to collect data and transcribe verbatim. IPA was used to analyse and interpret the data collated. In addition, CRT was employed to critically analyse the findings, examining how race and racism influenced their decisions to seek help for poor mental health. The findings revealed a complex landscape of barriers deeply rooted in historical, cultural, social, economic, and political contexts. Two significant superordinate themes: Struggle and Oppression and Medical Colonialism were revealed. Struggle and Oppression outlined the experiences of participants while navigating their social terrain and highlighted how these negatively influenced their decisions to seek help for poor mental health. Medical Colonialism outlined the experiences of participants while navigating mental health services. The application of CRT to the findings highlighted systemic biases rooted in historical legacies of colonialism and Eurocentrism which are perpetuated through policies and legal frameworks. This is the first time TSF and CRT were combined to investigate barriers to accessing mental health services among Black sub-Saharan Africans in the UK. In conclusion, the study showed that systemic racism ingrained in policies and legal frameworks, as well as dominant cultural narratives shaped by racial hierarchies, negatively influenced their decisions to seek help for poor mental health, calling for the inclusion of their voices in the development of mental health services.
| Item Type: | Thesis |
|---|---|
| Creators: | Mafuba, L. |
| Contributors: | Name Role NTU ID ORCID |
| Date: | September 2024 |
| Rights: | This work is the intellectual property of the author. You may copy up to 5% of this work for private study, or personal, non-commercial research. Any re-use of the information contained within this document should be fully referenced, quoting the author, title, university, degree level and pagination. Queries or requests for any other use, or if a more substantial copy is required, should be directed in the owner of the Intellectual Property Rights. |
| Divisions: | Schools > School of Social Sciences |
| Record created by: | Jeremy Silvester |
| Date Added: | 11 Jul 2025 12:32 |
| Last Modified: | 11 Jul 2025 12:32 |
| URI: | https://irep.ntu.ac.uk/id/eprint/53937 |
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