Search

Introduction: The awarding gap between White and Black students in UK health curricula is well established. Critical race theory (CRT) is a lens to deconstruct pedagogic practice and consider the intersectionality of Black student lived experience to provide a realist critique of the phenomenon of Whiteness in higher education and the impact this has on Black attainment. Using one UK pharmacy programme as a case study, this paper aims to explore Black lived experience as a means of problematising and disrupting structural oppressions. Methods: Sixteen Black students from one UK pharmacy degree programme were purposively recruited to the study. Love and breakup letter methodology (LBM) was used to facilitate sharing experiences of intersectionality in relation to their undergraduate education, with data thematically analysed through the lens of CRT. Results: Two meta‐themes (identity and inclusion; and cultural capital) and four subthemes (social capital; access; family expectations; and help‐seeking) were identified. The intersectionality of Black students was articulated as not possessing the social capital and the 'language' to succeed within the White structures of the curriculum. The conflict of capital and the absence of Black culture gave rise to confined help‐seeking behaviours. Whilst Black students experienced equality of access to the curriculum, an absence of rights to legitimate involvement (inclusion) worked to diminish participation in the curriculum. Discussion: This is the first study to consider the intersectionality of Black pharmacy students in relation to academic awarding gaps and has found that oppressive educational structures marginalise and other Black experience. Black students experience the curriculum as a place where their social and cultural capital is undervalued, and as a White space where they lack the artefacts to succeed, leading to peripheral participation and detachment. The approach used in this study can be adopted across medical and health education as a means to problematise racial inequality through the exemplar of White:Black awarding gaps. In this article, @AndrewMawdsley1 et al. use critical race theory as a lens to understand Black student intersectionality and its role in awarding gap deficits [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is twofold: to explore the existing evidence around dementia services and interrogate the overarching UK policy development relating to service inclusion of black and minoritised groups. The paper will go on to identify the implications for the dementia wellness pathway and make recommendations regarding how services can be more inclusive. Design/methodology/approach: This paper examines the policy/practice landscape around dementia care provision and observes if lessons can be learnt to improve health outcomes for people living with dementia from black and minoritised communities. Findings: A review of dementia policy demonstrates how opportunities to improve the awareness, diagnosis and post-diagnostic support for minoritised communities are being missed. The outcomes of this mean that individuals are denied vital treatment and support, which could enhance quality of life and delay the progression of dementia. Practical implications: The authors' premise is that not meeting the dementia support needs of less-heard communities has negative financial as well as social and health-related outcomes and has wider resonance and implications for all stages of the dementia wellness pathway. Moreover, there is a legal responsibility for public services to provide culturally sensitive, responsive, appropriate and available care, to all people, without discrimination. Originality/value: This paper offers a valuable review of policy and practice around dementia care in the UK and makes recommendations to improve health outcomes for people living with dementia from black and minoritised communities. [ABSTRACT FROM AUTHOR]

This article explores the impact of the coronavirus disease 2019 (COVID-19) pandemic on racially minoritised children and young people. It draws on a study that investigated the factors that impacted the well-being and resilience of Black and Asian children and young people in the UK during the pandemic. The study employed a qualitative approach using semi-structured interviews and focus groups with Black and Asian children aged twelve to nineteen years, to explore their perspectives of the contributing factors that impacted the health, well-being and the coping strategies and support they were able to draw upon to navigate challenges. The thematic analysis highlighted themes of: (1) Support and well-being and (2) coping strategies and resilience to understand the layered elements of multiple intersecting identities and inequities. The findings revealed insights into the intersection of multiple disadvantages, namely economic stressors, food poverty, digital inequality, disrupted education and disproportionate losses that impacted family functioning, peer-to-peer support, friendships and social connection. Through the lens of community cultural wealth, this article seeks to examine key factors that need to be foregrounded when lived experiences are rooted in the cumulative effects of multiple intersecting inequalities. The findings provide insights into the challenges exacerbated by structural inequalities and racial disparities that disproportionately impacted youth experiences. [ABSTRACT FROM AUTHOR]

Background: Youth mental health is a growing concern in research, practice, and policy. Practice standards, guidelines, or strategies provide an invisible infrastructure that fosters equity, quality, and safety, potentially addressing inconsistencies and more effectively attending to the mental wellness of Black youth as a particular population of concern. This scoping review aimed to address the following question: What standards exist for the delivery of mental health services to Black youth in community, primary care, and educational settings? Due to a limited initial search yield on publications about standards for the delivery of mental health services for Black youth population, our goal was then to identify and map mental health standards, recommendations, or guidelines for the delivery of mental health services using the same settings to all youth. Methods: Searches were conducted in various databases, including PubMed/MEDLINE, PsycINFO, Embase, SocINDEX, CINAHL, Gender Studies Database, Social Services Abstracts, Sociological Abstracts, Scopus, Web of Science, and Google Scholar. Screening was independently conducted by two reviewers, with disagreements resolved by a third. Information extraction was performed by two independent reviewers. Results: Out of the 2,701 screened publications, 54 were included in this scoping review. Among them, 38.9% were published between 2020 and 2023, with 40.7% originating from the United States of America, 20.4% from the United Kingdom, and 13% from Canada. Concerning the settings, 25.9% of the publications focused on primary care, 24.1% on health care services, 20.4% on educational settings, and 3.7% on the community. Additionally, 25.9% were classified as general because recommendations were applicable to various settings. Attention-deficit/hyperactivity disorder (11.1%) was the most frequently considered specific condition, followed by autism spectrum disorder (9.3%) and depression (9.3%). However, 31.5% of the included references addressed mental health in general. Only three references provided specific recommendations for the Black population. Conclusions: Recommendations, guidelines, or standards for Black youth mental health services in community, primary care, or educational settings are scarce and limited to North American countries. This scoping review emphasizes the need to consider ethnicity when developing guidelines or standards to improve racial equity and reduce disparities in access to mental health services. [ABSTRACT FROM AUTHOR]

Black people in the United Kingdom disproportionately acquire long-term health conditions and are marginalised from the labour market compared with other groups. These conditions interact and reinforce high rates of unemployment among Black people with long-term health conditions. To examine the efficacy, and experience, of employment support interventions in meeting the needs of Black service users in Britain. A systematic literature search was conducted focusing on peer-reviewed literature featuring samples drawn from the United Kingdom. The literature search revealed a paucity of articles that include analysis of Black people's outcomes or experiences. Six articles met the selection criteria of the review, of which five focused on mental health impairments. No firm conclusions could be drawn from the systematic review; however, the evidence suggests that Black people are less likely than their White counterparts to secure competitive employment and that Individual Placement and Support (IPS) may be less effective for Black participants. We argue for a greater focus on ethnic differences in employment support outcomes with an emphasis on how such services may remediate racial differences in employment outcomes. We conclude by foregrounding how structural racism may explain the dearth of empirical evidence in this review. [ABSTRACT FROM AUTHOR]

Introduction: Differential attainment is a well‐known phenomenon in medical education. Despite a strong impetus for institutions and researchers to move away from a 'student deficit model' when exploring the attainment gap, little attention has been given to understanding the experiences of Black, Asian and Minority Ethnic (BAME) medical students. Informed by the social construction of learning theory, this is the first national study to explore how multiple dimensions of the medical school environment impact academic performance of BAME undergraduate medical students across the UK. Methods: Using a sequential explanatory mixed‐methods approach, the authors conducted a survey and facilitated three focus groups across medical schools in the UK between 2020–2021. Participants self‐identified as being from BAME backgrounds. Quantitative analyses included descriptive statistics and bivariate analyses. Qualitative data were analysed using thematic analysis, subsequently identifying inductive themes. Results: Three hundred sixty‐two respondents completed the Phase 1 survey, and 17 participants participated in the Phase 2 focus groups. Although both survey and focus group participants identified facilitators to learning such as supportive relationships, students reported facing numerous barriers that they felt impeded their learning and performance. These barriers included limited access to educational resources, and undiversified curricula and medical school populations. Students also described both experiencing and witnessing various forms of racism throughout their educational journeys. Discussion: Students encountered various difficulties throughout their medical training that they felt impacted their learning and performance. This study offers novel insights into the experiences of BAME students and builds upon previous research. It also reveals the pervasive nature of racism within medical schools, highlighting the urgent need for institutional changes. Educators and institutions must go beyond merely recognising these barriers and facilitators; they must proactively innovate and adapt. In doing so, they pave the way for inclusive learning environments that truly foster a sense of belonging for BAME students. In this mixed‐methods study, @DrNariell, Machado and Blackburn explore UK BAME medical students‐ perspectives on the barriers and facilitators they experience during their training. #MedEd #MedTwitter [ABSTRACT FROM AUTHOR]

We use an art-based approach to engage and involve members of African, African Caribbean and Muslim communities' in exploring barriers to accessing and using mental health services in the co creation and co-production of mental health communication material. A creative practice approach underpinned by the principles of participatory action research was used. Seven community-based interactive workshops were held between February and June 2022 at three community centres in Nottingham, UK Attendees were invited to take part in open discussions around the conceptualisations of mental health, well-being and emotional health and to draw or describe their experiences of accessing mental health services. Attendance was higher than anticipated, with 72 individuals from African, African Caribbean and Pakistan communities taking part in the workshops. What emerged was the low level of understanding of the services available in addressing mental health. In addition, it was felt that health professionals in the National Health Service (NHS) do not sufficiently acknowledge or consider the ethnic, social, cultural and economic factors influencing the mental health and emotional well-being of minoritised communities. Attendees critiqued and provided feedback on service providers' posters and leaflets. They commented on the lack of key information provided, the inclusion of what was viewed as irrelevant content and the use of unfamiliar terminology. Some attendees created mock-ups of what they believed a good poster should look like. A creative practice approach that follows the principles of participatory action research can play an important role in engaging members of minoritised communities in the co-production and co-design of services. This approach highlighted the need to establish trust and shared ownership among marginalized communities affected by inequities of mental health service provision. [ABSTRACT FROM AUTHOR]

In the United Kingdom, people with non-white ethnicities are more likely to report being in worse health conditions and have poorer experiences of healthcare services than white counterparts. The voices of those of Black ethnicities are often merged in literature among other non-white ethnicities. This literature review aims to analyse studies that investigate Black participant experiences of primary care in the UK. We conducted a systematic literature review searching Medline, Web of Science, EMBASE, SCOPUS, Social Policy and Practice, CINAHL plus, Psych INFO and Global Health with specific search terms for appropriate studies. No publish date limit was applied. 40 papers (39 articles and 1 thesis) were deemed eligible for inclusion in the review. A number of major themes emerged. Patient expectations of healthcare and the health seeking behaviour impacted their interactions with health systems in the UK. Both language and finances emerged as barriers through which some Black participants interacted with primary care services. (Mis)trust of clinicians and the health system was a common theme that often negatively impacted views of UK primary care services. The social context of the primary care service and instances of a cultural disconnect also impacted views of primary care services. Some papers detail patients recognising differential treatment based on ethnicity. The review included the voices of primary care professionals where descriptions of Black patients were overwhelmingly negative. Views and experiences of Black groups may be radically different to other ethnic minorities and thus, should be teased out of broader umbrella terms like Black and Asian Minority Ethnic (BAME) and Black Minority Ethnic (BME). To address ethnicity-based health inequalities, culturally sensitive interventions that engage with the impacted community including co-designed interventions should be considered while acknowledging the implications of being racialised as Black in the UK. [ABSTRACT FROM AUTHOR]

The impact of racism on health is undeniable. However, undergraduate nurse education in the UK is not adequately addressing the racism within the profession. Literature on anti-racist nursing education was reviewed to uncover the most effective strategies for nurse educators to develop this approach. The literature describes a climate of denial and defensiveness among nurse educators. It urges nurse educators to develop racial literacy, and explores nursing curricula, recommending intersectionality as a way to teach about health disparities, with a move away from a culturalist perspective. There is growing recognition that institutions need to address issues around the retention of Black students, and robust reporting systems are required to respond to allegations of racism. Institutions also need to provide evidence-based anti-racist training for staff. The conclusion here is that, without institutional support, there is little nurse educators can do alone to change the culture of racism in nurse education. Thus, this review is a starting point for nurse educators interested in anti-racist nursing education. [ABSTRACT FROM AUTHOR]

Background: People of Black, Asian and minority ethnic (BAME) heritage have a higher-than-average incidence of, and mortality from hypertension and stroke. Therefore, it is important to identify new settings for engaging people at risk of high blood pressure (BP). Aim: This feasibility study aimed to evaluate if barbers in a London borough can support and educate men of BAME heritage to manage their BP. Following UK Medical Research Council guidance, the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework was used to guide study objectives and feasibility outcomes. Methods: We collaborated with 8 barbers who were part of an existing BAME barber network. Barbers were trained online (1.5 h) and face-to-face (3 h) to provide BP healthcare advice and take customers BP readings. Qualitative field notes were collected to assess how best to recruit and train barbers, and to understand how to maintain motivation and retention of barbers. BP readings were recorded between June 2021 and March 2022. Results: Both online and face-to-face training were effective, however, greater focus on how to start conversations about BP with clients was needed. We found that motivation, incentivization and regular contact with barbers were important for recruitment, retention, and sustained BP measurement. Obtaining BP readings was challenging due to client concerns about recording their data and the impracticalities of recording results. We captured 236 BP recordings, of which 39 (16.53%) were over 140/90 mmHg; of these, 5 were over 180/100 mmHg. Conclusion: The combined data showed that educating barbers to take BP readings and deliver healthcare advice about BP is a viable intervention for rollout in a large-scale study. It has demonstrated the need to identify strategies to motivate barbers for sustained recruitment and retention, as well as further efforts to build trust among customers for long-term BP surveillance. [ABSTRACT FROM AUTHOR]

Objective: People from a Black ethnic (BE) background in England and Wales are disproportionately detained as inpatients under the United Kingdom's Mental Health Act (MHA). Qualitative research into the lived experiences of this group is sparse. This study, therefore, aims to explore the experiences of people from a BE background detained under the MHA. Method: Semistructured interviews were conducted with 12 self-identified adults from a BE background who were currently detained as inpatients under the MHA. Thematic analysis was used to identify themes across the interviews. Results: Four themes emerged from the interviews: "Help is decided by others, not tailored to me"; "I am not a person—I am a Black patient"; "Mistreated or neglected instead of cared for"; and "Sectioning can be a space for sanctuary and support." Conclusions and Implications for Practice: People from a BE background report inpatient detention to be a racist and racialized experience, inseparable from a wider context of systemic racism and inequality. Experiences of detention were also discussed in terms of stigma within BE families and communities, as well as social support that appeared to be lacking outside of the hospital. Systemic racism must be addressed across mental health care, led by the lived experiences of BE people. Impact and Implications: This study found that people from a Black ethnic background have lived experiences of racism in inpatient detention under the UK Mental Health Act (MHA), in addition to the statistical racial disparity. Lived experiences from the study also show systemic challenges, including societal racism, stigma, and access to support. These experiences are not routinely monitored, leaving a significant shortcoming in the development of policies and practices that ensure the quality of care for people from a Black ethnic background, including in psychiatric rehabilitation services. [ABSTRACT FROM AUTHOR]

Childhood sexual abuse (CSA) can result in devastating and long lasting consequences. Differences in the nature of the abuse differ for males and females and this difference potentially influences recovery. However, studies of recovery from CSA, especially among men, are relatively few, especially for ethnic minority men. The study explored the lived experience of recovery from CSA among African-Caribbean Black male survivors of CSA living in Canada, the United Kingdom and the United States. The theoretical framework was the transactional model of stress and coping, which proposes that stress is an ongoing transaction between the demands of life and a person's psychological ability to address those demands. The study was qualitative in design, using an interpretive phenomenological approach, involving purposeful sampling, in-depth semi-structured interviews, and interpretive phenomenological analysis of the data informed by a critical race theory lens. The results showed that Black male survivors are situated in unique historical/sociocultural interrelationships that complicate recovery from CSA, including institutional racism and discrimination, restrictive narratives of masculinity, and other cultural norms. These findings can be used to influence policy makers, service providers, and communities, to more effectively support and address the needs of CSA survivors and their affected families. [ABSTRACT FROM AUTHOR]

This study examines the cultural, social, and religious contexts of African-Caribbean women ageing without children. Drawing on in-depth biographical interviews with ten African-Caribbean women, the study aimed to develop insight into the experiences of women who were growing older without children. Thematic analysis highlighted the implications of early socialization and the complex intersections between childlessness, cultural and religious identity, and gender. The findings suggest that culture and religious beliefs were key factors in shaping the women's earlier socialization and views on family life, children, gender and marriage. However, there was variation in the extent to which some women's earlier socialization was retained into adulthood. Some women let go of earlier beliefs and practices, whereas others chose to keep the ones that they felt were important to them, which often influenced their decisions, choices and pathways regarding having children. [ABSTRACT FROM AUTHOR]

Black women are underrepresented in the research on compulsive sexual behavior (CSB). The absence of research poses questions for therapists supporting Black women who present with CSB as they have unique specificities, which can also influence how CSB is formulated in this population. This paper recommends a thorough assessment for CSB following the ICD-11 diagnostic criteria and also explains and provides guidance on the usefulness of assessing for racism and discrimination. The paper discusses the specificities experienced by Black women, such as Adultification, Invisibility, Microaggressions, Colorism, and Intergenerational Trauma and how they can influence Black women in the United Kingdom. This article will present a case study to illustrate the importance of understanding the specificities of Black women with CSB. [ABSTRACT FROM AUTHOR]

Objective: Black women in the United Kingdom are more likely than White women to be diagnosed with advanced breast cancer and have lower survival rates. We consulted women of Black Caribbean and Black African descent in the United Kingdom on how the Promoting Early Presentation (PEP) booklet and intervention could be adapted for Black women to promote early presentation with breast cancer symptoms. Methods: Focus groups with 22 women of Black African and Black Caribbean descent, of whom five had been treated for breast cancer. The participants were recruited from a large UK breast cancer charity and community settings. Data were analysed using Framework Analysis. Results: Four themes summarised the participants' views on how the booklet and intervention could be adapted: Justify the focus on Black women, Black people do not talk about cancer, Make interventions inclusive and engaging, and Engage Black communities to deliver interventions. Conclusion: Breast cancer behaviour change interventions need to be more inclusive, illustrate how breast cancer symptoms manifest on black skin, and emphasise that breast cancer is curable to increase awareness and reduce cancer fear. Researchers should involve Black communities in the design and delivery of interventions to address appropriately cultural barriers to early presentation. [ABSTRACT FROM AUTHOR]

Compared to other ethnic groups in the UK, Black people have the highest rates of psychosis. This may partly be explained by both assessment bias and structural racism. Mental health services often find it difficult to develop therapeutic relationships with Black people with psychosis. Attachment theory posits that the quality of previous caregiving experiences influence current interpersonal functioning and emotional regulation. In this study, we applied the theory to improve the understanding of therapeutic relationships with people with psychosis. This is the first study to examine associations between attachment difficulties, therapeutic alliance, and service engagement in a Black sample with psychosis. Fifty-one participants completed self-report measures of attachment and alliance. Staff completed measures of alliance and service engagement. Higher attachment avoidance was related to poorer alliance ratings. These significant findings were not upheld in a regression model controlling for total symptom scores and perceived ethnic/racial discrimination in services. Attachment anxiety was generally not associated with alliance ratings. Neither attachment anxiety nor attachment avoidance was significantly associated with service engagement. Staff should be supported to better understand the needs of service users with avoidant attachment behaviours and to develop mutually-agreed treatment goals and therapeutic bonds. [ABSTRACT FROM AUTHOR]

What Is New and Objectives: Older people from ethnic minorities experience the intersectionality of age and ethnicity in relation to complex medication management and polypharmacy. Minority ethnic groups in the United Kingdom are at risk of poor medication management because factors such as cultural beliefs, language barriers, lack of knowledge of how the healthcare system works may affect their ability to safely manage their medications. The aim of this systematic review was to review the literature focussing on medication management in the older population amongst ethnic minority communities in United Kingdom. Methods: The review was conducted and reported according to methods in the Cochrane Handbook and in the PRISMA 2020 statement using databases such as EMBASE, ASSIA, MEDLINE, PsychINFO and others. Studies conducted in the United Kingdom on individuals over 60 years of age and from a minority ethnic background were included. A thematic analysis was used to synthesize the results. Results and Discussion: Nine studies (eight from initial searches, one from a search update in 2021) met the inclusion criteria. Three main themes were identified: misbeliefs around medications, poor health literacy, communication and education as possible intervention to improve medication management. Misbeliefs around long‐term illnesses exert a negative impact on medication management. Poor health literacy around medications influences patients' adherence to treatments. Poor communication is perceived as barrier to successful medication management. Despite extensive searching, the team identified a limited number of studies and a lack of intersectional studies focussing on minority ethnic groups and the older population. What is New and Conclusion: Our findings suggest tailored education as a possible intervention to improve medication management amongst these minority groups. Future research should look at recruiting participants from specific ethnic groups and from rural as well as urban areas to explore how medication management operates in different areas of the United Kingdom. [ABSTRACT FROM AUTHOR]

Ongoing concern for the unique mental health challenges faced by university students has been magnified by the disruption of the global COVID-19 pandemic since March 2020. This study aimed to investigate changes in mental health and wellbeing outcomes for UK university students since the pandemic began, and to examine whether more vulnerable groups were disproportionately impacted. Students at a UK university responded to anonymous online cross-sectional surveys in 2019 (N = 2637), 2020 (N = 3693), and 2021 (N = 2772). Students completed measures of depression, anxiety and subjective wellbeing (SWB). Multivariable logistic regression models investigated associations of survey year and sociodemographic characteristics with mental health and SWB. Compared to 2019, fewer students showed high levels of depression and anxiety symptoms in 2020. However, there was evidence of worsened levels of anxiety and SWB in 2021 compared to 2019. Interaction effects indicated that students from a Black, Asian or minority ethnicity background and students previously diagnosed with a mental health difficulty showed improved outcomes in 2021 compared to previous years. There is a need for sector-wide strategies including preventative approaches, appropriate treatment options for students already experiencing difficulties and ongoing monitoring post-pandemic. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine cultural beliefs, attitudes, and practices of Black sub-Saharan Africans (BsSAs) in the UK regarding their type 2 diabetes (T2D) self-management using the concepts of the PEN-3 cultural model. A qualitative study involved 36 semi-structured interviews with BsSAs living with T2D in the UK to examine relevant cultural practices and beliefs that have contributed to the uneven burden of self-management behaviours. A narrative thematic analysis of the data was then conducted for the study using NVivo software and guided by the PEN-3 cultural model, which moves beyond individualistic health behaviour models of diabetes but centralises culture in understanding health behaviours. Cultural perceptions and self-management behaviours of T2D varied among the BsSAs. Systems of self-management and treatment practices that were congruent with their cultural beliefs and personal priorities were seen as essential in the positive response to self-managing T2D. Knowledge and perceptions of non-conventional and alternative remedies linked to cultural beliefs reflected the existential health-seeking behaviours, and the significance attached to BsSAs negotiated cultural identities and collective practices within the communities. Social network supports were seen as enablers while advice and regimens from healthcare professionals (HCPs) were presented as medicalised and devoid of cultural sensitivities to respondents. The study findings highlight the need to be not only aware of the negative impact of diabetes perceptions and health behaviours among the BsSA communities, but also be aware of the enabling factors and collective practices within the communities that are equally critical in influencing the self-management and health-seeking decisions of BsSAs living with T2D. PEN-3 model was significant with exploring not only how cultural context shapes health beliefs and practices, but also how social networks and systems play a critical role in enabling or nurturing positive health behaviours and health outcomes. [ABSTRACT FROM AUTHOR]

The Michelle Cox tribunal is one of the highest-profile racial discrimination cases in the history of the NHS. [ABSTRACT FROM AUTHOR]

Background: Evidence acknowledges inequalities to progression and achievement for black, Asian and minority ethnic students within higher education, as well as barriers for promotion of black, Asian and minority ethnic staff within the NHS. In the UK, legislation and regulatory guidance requires students studying undergraduate midwifery to undertake their programme across both these institutions. Aims: To understand the experiences of black, Asian and minority ethnic students studying undergraduate midwifery at a UK university. Methods: This qualitative study used semi-structured interviews with five student midwives who identified as black, Asian or minority ethnic from a university, conducted by a peer researcher. Thematic analysis was used to analyse anonymised transcript data. Results: Three key themes were identified: 'invisibility', 'emerging visibility' and 'managing visibility'. Participants experienced a monocultural focus in the curriculum and in practice and were exposed to racist behaviours, causing them to modify behaviours. Conclusions: A need for diverse teaching materials and cultural inclusivity across institutions was identified to help combat outdated systemic Eurocentric practices and support the implementation of recently published midwifery standards. [ABSTRACT FROM AUTHOR]

Objective: Black men are three times more likely to develop prostate cancer (PCa), to do so at a younger age and to experience a more aggressive form than White men. This study aims to understand the experiences of African-Caribbean men with respect to their discharge to primary care following successful PCa treatment and the challenges associated with survivorship. Design: Eight African-Caribbean men, who had been successfully treated for PCa, were recruited through the charity BME Cancer Communities. They participated in a focus group, which took place on the premises of the charity and was audio-recorded. The recording was transcribed and the data were analysed employing thematic analysis. Results: Three overarching themes were developed: Discharge – misconceptions and uncertainties; Survivorship – challenges and ways of coping; Black men and PCa: real and potential discrimination. Participants expressed concerns regarding the lack of information and clarity about what discharge meant, the quality of follow-up care, especially the levels of specialist knowledge among GPs, and the impact of side-effects, particularly erectile dysfunction (ED). Participants linked ED with stereotypes of Black male sexuality, particularly in relation to difficulties of expressing their emotions and psychological distress. African-Caribbean men face particular challenges in dealing with the side-effects of treatment for PCa, which are linked to socially-constructed ideas of masculinity. Conclusion: There needs to be a greater focus in primary care on understanding these issues and providing individualised culturally-sensitive care. In particular, GPs should be aware of sensitivities concerning help-seeking related to culturally-mediated understandings of masculinity. [ABSTRACT FROM AUTHOR]

This paper is a narrative review of the use of collective terminology in relation to race and health in Britain, with particular reference to the 'Black African' community. 'Black Africans' have been categorised in the 1991–2011 censuses with added free‐text in 2021 in response to user demand. However, the UK government is increasingly reporting data for the 'Black' pan‐ethnicity, especially in the even more generalised 'BAME' ('Black, Asian and Minority Ethnic') acronym in COVID‐19 pandemic reports. The consequences of this practice are addressed. Firstly, with respect to ethical challenges, Black Africans find their conscription by government into the term BAME offensive and do not accept it as a self‐descriptor. This labelling, which subsumes Black Africans' self‐assigned ethnicity in the census, and consequent misrecognition may be interpreted as a micro‐aggression (a term coined in the 1970s but used here to denote microinvalidation), as suggested in the current black activism of the 'Black Lives Matter movement'. Secondly, ONS has warned that concealed heterogeneity renders the pan‐ethnicities unreliably crude, making them scientifically inaccurate. Analysts are recommended to present ethnic group data for the full census classification where possible for reasons of validity and respect for the patient as arbiter of their ethnic group. [ABSTRACT FROM AUTHOR]

The present research explores Caribbean-born women's constructions of retirement. Eight participants (self-identified as retired) were recruited using purposive and snowball sampling. Data were obtained using individual semi-structured interviews and analyzed using discursive psychology. Findings center around a discussion of the negotiating difference discourses. This construction consists of two sub-creations: work and retirement, and home. Both creations present participants engaging in a process of negotiation to merge the life they once knew with their retirement experience. Implications for participants and the construction of retirement are considered, and suggestions put forward for future research and for clinicians working with the studied population. [ABSTRACT FROM AUTHOR]

Background and Objectives Understanding the influences of marginalized cultural and social identities as experienced by the African Caribbean diaspora within the context of dementia care is essential to minimize the gaps in current practice and policy in the health care setting. This study explores the impact of marginalized identities upon the meaning-making process, access to services and experience of care provisions through a scoping review and consultancy exercises with key stakeholders. Research Design Fourteen databases were searched using key terms. Primary studies in English, any year, study design, and country of origin were eligible. Titles, abstracts, and full texts were screened for inclusion and data were extracted in stages. Thematic analysis was performed and the findings were discussed in a series of consultation meetings with people with dementia, carers, and health care professionals in Manchester (United Kingdom) and Jamaica. Results The scoping review retrieved n = 1,989 research articles. Nineteen were included, most were qualitative (n = 14), 3 quantitative, and 2 mixed-method. The findings revealed limited insight into cultural and multiple individual identities in explaining conceptualization and service access. Consultation meetings confirmed these findings and highlighted differences in health care services and systems in the United Kingdom and Jamaica. Discussion and Implications This study suggests there is a complex interaction of sociocultural processes that marginalize African Caribbean persons in and across various national settings within the context of dementia care. The study highlights the importance of acknowledging and addressing how prevalent racialized- and class-based divides and related marginalized social locations are reflected in inequities in access to and use of dementia services. [ABSTRACT FROM AUTHOR]

"Old" universities in the UK are typically populated with White middle‐class students who hail from White majority hometowns, whilst "new" universities have more diverse cohorts from diverse hometowns. Our research conducted with 17 Black students at a predominantly White university, examined the initial encounters in which Black students first realise their minority status on campus. We found that White numerical dominance combined with White students' racialised place‐based assumptions about who belongs where, had an immediate and powerful impact on our participants. Importantly, our findings suggest that for Black students coming from diverse hometowns, experiences such as being the only Black person in lecture halls, being told that you are the first Black person your peers have met, and being expected to use urban street slang and sell drugs constituted both a denial of their student identity and a misrecognition of their Black identity. Our analysis highlights the importance of considering the diversity within institutions alongside Black and White students' place‐based histories with diversity; and how these are consequential for Black students' experiences of (mis)recognition and (non)belonging on campuses. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement. [ABSTRACT FROM AUTHOR]

Purpose: It is believed that more than 120 million women have undergone female genital mutilation (FGM) and more than 2 million young girls are at risk of undergoing FGM. FGM is practiced in different parts of the world. With globalisation and the increased movement of people across the globe, FGM is now a global problem. While ending FGM remains a priority, the approaches and strategies being used have generated contested views across the social divide. The purpose of this study is to explore the challenges in combatting FGM as experienced by Black Sub-Saharan African (BSSA) women in Diaspora. Design/methodology/approach: This qualitative study used a phenomenological approach. Narratives were collected from 40 BSSA women from 20 Sub-Saharan African countries living in the English West Midlands region. A thematic approach underpinned by the four phases of data analysis in the Silences Framework were used to analyse the data. Findings: The research study found that stigmatisation of survivors, utilisation of graphic images in FGM awareness, exclusion of practising communities' gatekeepers in FGM interventions, conflation of religion and FGM practice and obsession with securing a conviction were obstacles in combating FGM. Diaspora community-driven studies exploring FGM and contested notions in addressing it from women perspectives are scarce. Originality/value: This study pulls together the experiences of BSSA women and their perspectives on contested notions in combating FGM in the UK. The debate asserts the growing need to consider gender sensitive radical interventions, which involves educating perpetrators and gatekeepers among FGM practising communities. [ABSTRACT FROM AUTHOR]

Black and minority ethnic communities are at higher risk of mental health problems. We explore differences in mental health and the influence of social capital among ethnic minority groups in Great Britain. Cross-sectional linear and logistic regression analysis of data from Wave 6 (2014–2016) of the Understanding Society databases. In unadjusted models testing the likelihood of reporting psychological distress (i) comparing against a white (British) reference population Indian, Pakistani, Bangladeshi and mixed ethnic minority groups recorded excess levels of distress; and (ii) increasing levels of social capital recorded a strong protective effect (OR = 0.94: 95% CI 0.935, 0.946). In a subsequent series of gender-specific incremental logistic models-after adjustment for sociodemographic and socioeconomic factors Pakistani (males and females) and Indian females recorded higher likelihoods of psychological distress, and the further inclusion of social capital in these models did not materially alter these results. More research on the definition, measurement and distribution of social capital as applies to ethnic minority groups in Great Britain, and how it influences mental wellbeing is needed. [ABSTRACT FROM AUTHOR]

Background People from South Asian and black minority ethnic groups are disproportionately affected by the COVID-19 pandemic. It is unknown whether deprivation mediates this excess ethnic risk. Methods We used UK Biobank with linked COVID-19 outcomes occurring between 16th March 2020 and 24th August 2020. A four-way decomposition mediation analysis was used to model the extent to which the excess risk of testing positive, severe disease and mortality for COVID-19 in South Asian and black individuals, relative to white individuals, would be eliminated if levels of high material deprivation were reduced within the population. Results We included 15 044 (53.0% women) South Asian and black and 392 786 (55.2% women) white individuals. There were 151 (1.0%) positive tests, 91 (0.6%) severe cases and 31 (0.2%) deaths due to COVID-19 in South Asian and black individuals compared with 1471 (0.4%), 895 (0.2%) and 313 (0.1%), respectively, in white individuals. Compared with white individuals, the relative risk of testing positive for COVID-19, developing severe disease and COVID-19 mortality in South Asian and black individuals were 2.73 (95% CI: 2.26, 3.19), 2.96 (2.31, 3.61) and 4.04 (2.54, 5.55), respectively. A hypothetical intervention moving the 25% most deprived in the population out of deprivation was modelled to eliminate between 40 and 50% of the excess risk of all COVID-19 outcomes in South Asian and black populations, whereas moving the 50% most deprived out of deprivation would eliminate over 80% of the excess risk of COVID-19 outcomes. Conclusions The excess risk of COVID-19 outcomes in South Asian and black communities could be substantially reduced with population level policies targeting material deprivation. [ABSTRACT FROM AUTHOR]

Background Obesity prevalence in the UK varies according to ethnicity, with children from minority ethnic groups experiencing higher levels, and yet, there is a scarcity of projects that involve minority ethnic groups in the design of interventions to promote healthy weight maintenance. This article presents an account of the involvement of the participants in a co-creation activity to design public health resources for the maintenance of healthy weight. Methods The material is drawn from a study that involved Black African parents (n  = 30) and Health Visitors (n  = 32), residing and working in the East Midlands, UK, respectively. The participants were purposely selected according to an inclusion/exclusion criterion and invited to participate in seven focus groups (FG) conducted for parents (FG-4) and health visitors (FG-3) at a time and place convenient to the participants. Following the focus groups, the Black African parents participated in three co-creation workshops. Results The co-creation activities involved the participants, the researcher and a nutritionist. The outcome was an African heritage eatwell guide and a framework to promote healthy weight, which was well-received when presented to members of the community and local health and social care practitioners. Conclusion The co-creation process went beyond giving the participant a voice in shaping the promotion of healthy weight within their community, as they also became active participants in the design and creation of the specific public health service. The approach offered the potential for improved levels of community satisfaction for a public health intervention. [ABSTRACT FROM AUTHOR]

Objectives: In the UK, people of African‐Caribbean background have the highest rates of psychosis and greatest inequity in mental health services of all ethnicities. National policies have highlighted the lack of evidence‐based psychological interventions for this group. The aim of this study was to examine the acceptability of a novel Culturally adapted Family Intervention (CaFI) for African‐Caribbean individuals diagnosed with non‐affective psychosis and their relatives. Design: A qualitative design. Methods: Semi‐structured interviews conducted with 22 service users and 12 family members following participation in CaFI. The interview topic guide included perceptions of the needs and benefits of CaFI; usefulness, cultural specificity and accessibility of CaFI therapy and supporting materials; content and delivering of CaFI sessions; views and experiences of working with CaFI therapists; and perceived barriers and facilitators to implementation. Results: Deductive framework analysis identified three main themes for service users: perceived benefits, barriers and limitations, and delivery of the therapy. Four themes were identified for family members: perceived benefits, perceptions of therapists, delivery of therapy, and accessibility of therapy content, supporting materials, and cultural appropriateness. Conclusions: CaFI was found to be an acceptable intervention for African‐Caribbean service users with psychosis and their relatives. Family interventions considering the needs of ethnic and cultural groups have the potential to improve the mental health care and experiences of service users and their families. Practitioner points: The Culturally adapted Family Intervention (CaFI) was viewed as acceptable to African‐Caribbean service users with psychosis and their families.Through adapting interventions to be more culturally sensitive, it is possible to enhance the care of those who typically have poor engagement with mental health services.In‐keeping with their ethos of individualized care delivery, mental health services should place more emphasis on being able to offer appropriate, culturally adapted interventions to their service users. [ABSTRACT FROM AUTHOR]

Background: Arts-based research practices draw upon music, visual art, poetry and other media as methodological tools throughout the research process. There is also growing recognition of the contribution of arts-based practices, including music as method, to interdisciplinary fields of health, social sciences, humanities and education. Research into: i) the role of music as a therapeutic intervention; and ii) the use of creative approaches to practice development are clearly evident in the literature. What is less evident is the role of music as method. This article is a critical reflection on the novel use of music recordings during qualitative interviews in a small-scale study exploring the role of music in the work and lives of black, Asian and minority ethnic women working in a UK domestic violence and abuse charity. Aim: To describe a critical reflection on music as method in a small-scale qualitative research study. Implications for practice: • Music has potential as a model and method in qualitative health and social care research practice, particularly with sensitive topics such as drug misuse or homelessness • Music is a means of developing compassion and critically reflective practice development in the field of domestic violence and abuse and other areas of practice. [ABSTRACT FROM AUTHOR]

Children from some black and minority ethnic (BME) backgrounds are routinely placed with substitute carers who do not match their cultural, linguistic, religious and ethnic backgrounds. The shortage of foster carers and adopters of specific backgrounds means that the demand in the care population often outweighs the availability of matched placement options. While the shortages of BME foster carers and adopters are widely recognised, there is virtually no research into the barriers faced by specific BME groups, so there are no informed recruitment strategies to increase the pool of potential matches. This research focuses on Somalis living in a large English city where there is a significant shortage of Somali foster carers and adopters despite people of Somali heritage comprising a sizeable proportion of the care and city population. Findings from the study suggest that there is no lack of motivation among the Somali population to foster or adopt, but participants felt that potential applicants are either rejected or deterred by institutional barriers, social exclusion and negative perceptions of social care, and that these factors are closely interlinked. The study makes practical suggestions for recruitment and assessment practice, but also stresses the importance of cultural competence and community engagement in a wider context of social care if welfare agencies wish to see more disenfranchised communities volunteering to work with them. [ABSTRACT FROM AUTHOR]

The "strong Black woman" (SBW) is a Western cultural stereotype that depicts African-heritage women as strong, self-reliant, independent, yet nurturing and self-sacrificing. US research indicates that this stereotype negatively impacts the emotional wellbeing of African-heritage women, while also allowing them to survive in a racist society. UK research has documented the significance of this stereotype in relation to African Caribbean women's experience of depression around the time of childbirth and "attachment separation and loss". However, research is yet to explore how UK African Caribbean women make sense of and negotiate the SBW stereotype in relation to their emotional wellbeing more broadly. Using five focus groups, with a total of 18 women, this research explored how these women experienced and managed emotional distress in relation to the SBW stereotype. The importance of "being strong" consistently underpinned the participants' narratives. However, this requirement for strength often negatively impacted their ability to cope effectively with their distress, leading them to manage it in ways that did little to alleviate it and sometimes increased it. This study offers important implications for understanding the experiences of emotional distress for UK African Caribbean women. [ABSTRACT FROM AUTHOR]

Black, Asian and Minority Ethnic nurses and midwives are under-represented in higher and managerial roles. This study explored the presence and nature of career progression delays for Black, Asian and Minority Ethnic nurses and midwives and investigated where the barriers to progression were. A secondary analysis of data from a wider cross-sectional survey investigating workplace experiences, burnout and patient safety in nurses and midwives. 538 nurses and midwives were recruited from four UK hospitals between February and March 2017. A career progression delay was viewed as being present if Black, Asian and Minority Ethnic nurses and midwives had spent longer on the entry level nursing grade and less time on higher grades in the previous 10 years. The analysis included items pertaining to: receipt of professional training, perceived managerial support for progression, likelihood of submitting applications and application success rates. Data were analysed using linear regression, odds ratios and t-tests. Results were reported using the STROBE Checklist. Black, Asian and Minority Ethnic nurses and midwives (n = 104; 19.4%) had spent more months working at the entry-level grade (M = 75.75, SD = 44.90) than White nurses and midwives (n = 428; 79.7%; M = 41.85, SD = 44.02, p < 0.001) and fewer months at higher grades (M = 15.29, SD = 30.94 v 29.33, SD = 39.78, p = 0.006 at Band 6; M = 6.54, SD = 22.59 v M = 19.68, SD = 37.83, p = 0.001 at Band 7) over the previous 10 years. Black, Asian and Minority Ethnic nurses and midwives were less likely to have received professional training in the previous year (N = 53; 53.0% v N = 274; 66.0%, p = 0.015) and had to apply for significantly more posts than White nurses and midwives before gaining their first post on their current band (M = 1.22, SD = 1.51 v M = 0.81, SD = 1.55, p = 0.026). Interventions are needed to improve racial equality regarding career progression in nurses and midwives. Increasing access to professional training and reducing discriminatory practice in job recruitment procedures may be beneficial. Black, Asian and Minority Ethnic nurses and midwives experience career progression inequalities. Interventions should improve transparency in recruitment procedures and enhance training opportunities. [ABSTRACT FROM AUTHOR]

This study focuses on the impact of the COVID-19 outbreak on mental health outcomes in Black and South Asian people in the United Kingdom. A sample of 226 participants completed a survey consisting of measures of ethnic identification, religiosity, British national identification, perceived discrimination, fear of COVID-19, generalised anxiety, depression and life satisfaction. Black participants reported more frequent ethnic discrimination than South Asians who, conversely, reported more religious discrimination. Structural equation modelling showed that discrimination had a direct impact on fear of COVID-19 and an indirect impact through decreased British national identification and life satisfaction. Religiosity and ethnic identification appeared to be protective against fear of COVID-19. Fear of COVID-19 was in turn associated with increased depression and generalised anxiety and decreased life satisfaction. The results suggest that some minority groups may be facing poorer mental health outcomes due to discrimination and minority stress. [ABSTRACT FROM AUTHOR]

Purpose: Sexual transmitted infections (STIs) are associated with high stigma leading to poor sexual health-seeking behaviour and mental health problems. Although human immunodeficiency virus (HIV) prevention has generally been successful in many communities across the world, statistics for young people have remained relatively low, especially among most affected communities such as the black sub-Sahara African (BSSA) communities. This paper aims to explore the barriers to STIs and HIV testing among young BSSA communities living in the UK. Design/methodology/approach: The research study used an explorative qualitative approach. The study included 6 focus groups comprising 10 people each (N = 60), and 12 one-to-one follow-up interviews were held with the research participants. Two one-to-one follow-up interviews were held from each focus group (N = 12). Findings: The study found that perceived risk taking, perceived HIV test embarrassment, sexual health professionals' attitudes, perceived HIV as death sentence, limited educational awareness and general HIV stigma prevented research participants from testing and impacted on their mental health well-being. Originality/value: There is a need to increase sexual health and mental health education awareness among young BSSA communities. More importantly culturally sensitive interventions to reduce the impact of HIV stigma need to be rolled out in different diverse communities. This study is the first of its kind to look at the barriers affecting young BSSA communities in accessing sexual health testing services in the UK. [ABSTRACT FROM AUTHOR]

In Europe and the US, childhood obesity is found to be higher in migrant children from black African communities and other visible minority ethnic groups. However, very little is known about the factors that contribute to the significant rates of obesity in these groups. The material for this study is drawn from a community‐based qualitative study that examined the sociocultural, familial and environmental factors that either facilitate or hinder healthy weight in black African children during early childhood. The participants for the study were black African parents (n = 30) and health visitors (n = 32), residing and working in the East Midlands, UK. The participants were purposively selected according to an inclusion/exclusion criterion and invited to participate in seven focus groups (FG‐7) conducted for parents (FG‐4) and health visitors (FG‐3) at a time and place convenient to the participants, between March and June 2018. The focus groups examined a number of issues, including the participants' views on the barriers and facilitators to achieving and maintaining a healthy weight. Thematic analysis was used to identify themes within the data. Although participants were knowledgeable about the need for a healthy weight in early childhood, the parents discussed how immigration status and experiences of discrimination had an impact on their children's diet and well‐being, also discussing how structural factors influenced the decisions they made regarding healthy weight in early childhood. While the health visitors in general felt they did not have the skills to advise black African parents about the cultural influences on diet during early childhood, findings highlighted a need for a system‐based approach in meeting the nutritional needs of black African children. This study concludes by suggesting the need for broad social‐environment and economic changes that address factors such as migration status, deprivation and discrimination, coupled with culturally specific healthy diet messages. [ABSTRACT FROM AUTHOR]

Purpose: Since the early 19th century, the UK has seen a decrease in mortality rates and increase in life expectancy. This has increased the number of elderly people being put into residential care. Change in British population demography with the arrival of many Africans from the black Sub-Sahara African (BSSA) countries has increased the need of these services. The purpose of this paper is to explore perceptions and attitude of BSSA towards residential care from potential user perspective. Design/methodology/approach: This study was explorative qualitative in nature, using focus group discussions and one-on-one follow up semi-structured interviews. The focus group discussions and interviews were audio recorded and transcribed verbatim. The Silences Framework was used to guide this study, and the collection of data was done using the thematic analysis approach. Findings: This study found out that the sense of confinement, lack of ownership, non-provision of culturally friendly food, non-provision of culturally friendly personal care, non-provisional of culturally orientated death and dying care, stigma for being neglected and perceived poor inclusivity leading to loneliness were found to discourage BSSA research participants from taking up residential care in the UK. Research limitations/implications: In future, there is need for cross-cultural comparisons of BSSA communities living in the UK and BSSA communities living in Africa or other parts of the world. This may enhance understanding the differences and similarities based on contextual social, political and economic factors. Practical implications: There is a need to understand the needs and concerns of new communities in relation to residential care and make necessary changes to enhance diversity and inclusivity. More importantly, the curriculum and professional development courses for staff in health and social care need to factor in the concepts of cultural competency and inclusivity to prepare them for the increasingly changing terrain of social care. Originality/value: Owing to the changing demography and diversity in the UK population, there is a need to re-orient and re-design residential care services provision to make it diverse and inclusive of new communities from other cultures. [ABSTRACT FROM AUTHOR]

Purpose: Undergraduates are highly susceptible to the development of mental health difficulties. Afro-Caribbean students are particularly vulnerable to the pressures of university yet are less likely than other ethnic groups to receive early intervention. This paper aims to understand the barriers and facilitators that Afro-Caribbean undergraduates perceive towards accessing mental health services in the UK. Design/methodology/approach: Critical Incident Technique was used as the qualitative method because it explores the critical factors that contribute to or detract from a specific experience. Seventeen Afro-Caribbean undergraduates participated in five focus groups. This involved engaging in a novel psychosocial activity that incorporated vignettes to encourage the identification of barriers and facilitators to service access. The data were analysed thematically to generate categories of critical incidents and wish-list items. Findings: Analysis revealed rich data from a sub-group rarely researched within UK literature. Fifteen barriers, eleven facilitators and five wish-list items were identified. The importance of mental health literacy, social networks, cultural sensitivity and concerns surrounding services underpinned many categories. Originality/value: Findings provide a new perspective on barriers reported in previous literature. Novel facilitators were highlighted where, although psychological and sociocultural factors were deemed valuable, structural changes were most desired. Recommended changes illustrate innovative interventions that could make services accessible for young adult Afro-Caribbean populations. Future research should explore the barriers and facilitators identified by Afro-Caribbean undergraduates across various universities who have successfully accessed and engaged with services. This could provide a holistic perspective on viable facilitators enabling access despite the presence of barriers. [ABSTRACT FROM AUTHOR]

To inform the development of interventions to increase uptake and adherence to antiretroviral therapy (ART), we explored perceptions of ART in semi-structured interviews with 52 men and women from UK black African and black Caribbean communities. Verbatim transcripts were analyzed using framework analysis. Perceptions of ART could be grouped into two categories: doubts about the personal necessity for ART and concerns about potential adverse effects. Doubts about necessity stemmed from feeling well, doubts about the efficacy of ART, religious beliefs and the belief that treatment was futile because it could not cure HIV. Concerns about adverse effects included the fear that attending HIV services and taking treatment would lead to disclosure of HIV, feeling overwhelmed at the prospect of starting treatment soon after diagnosis, fears about side effects and potential long-term effects, and physical repulsion. The findings will facilitate the development of interventions to increase uptake and adherence to ART. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the factors influencing preexposure prophylaxis (PrEP) uptake among Black African heterosexuals in the United Kingdom, while using a 2-phase sequential mixed-methods design. Methods: Surveys from 247 mixed-gender participants were followed by focus groups involving 18 women. Results: Despite the general lack of HIV and PrEP awareness, the study found significant associations between HIV testing, HIV awareness, PrEP awareness, and uptake interest. Stigma was also seen as key barrier: PrEP being connected with HIV positivity, promiscuity, and risky behaviors. Conclusion: This study underlines the need for service providers to develop HIV-prevention interventions that take into account the Black African sociocultural contexts in the United Kingdom. [ABSTRACT FROM AUTHOR]

An editorial is presented in which discusses the role of Black faith organisations as partners for a community led stigma intervention. Topics discussed the announcement by Prime Minister review on the Mental Health Act; mentions the higher rates of serious mental illness in Gajwani, Parsons, Birchwood, and Singh; and information on the role of Black community to open up channels of communication, improve mental health awareness and reduce barriers to help-seeking.

Refugees and asylum seekers face a number of barriers in accessing healthcare. However, there is a lack of quantitative research examining healthcare usage by refugees and asylum seekers in the UK. Using EMIS data from two GP practices in South London, all patients who had registered as refugees or asylum seekers were identified (n=35). The following data were extracted: date of registration; number of appointments in the 12 months from registration; reason for appointment; secondary care referrals and whether these were attended; and demographic data (age, sex, ethnicity). The mean number of appointments in 12 months was 5.8, and the median was 4. 60% of patients had 5 or fewer appointments. The most common reasons for appointments were psychiatric, musculoskeletal, and dermatological. 51% had a secondary care referral, of which 72% were attended; the most common referrals were to radiology. Of 35 patients, 20 were male and 15 female; the mean age was 32 and the most common ethnic category was Black African. Comparing this data to UK averages suggests that the survey cohort consulted their GP with roughly the same frequency as the average member of the public. There was a higher frequency of psychiatric symptoms, although referrals to secondary psychiatric care were infrequent. The survey cohort attended fewer secondary care referrals than comparable UK-wide data. This suggests that more work is necessary on identifying barriers to healthcare access for this population, and that they present with complex needs. This has implications for policy and for training GPs. [ABSTRACT FROM AUTHOR]