Isiwele Anthony, Rivas Carol, Stokes Gillian
IOE-Social Research Institute, UCL Institute of Education, University College London, London, UK.
Ethn Health. 2025 Jul;30(5):638-658. doi: 10.1080/13557858.2025.2511631. Epub 2025 May 29.
This study explores the lived experiences of Ghanaian and Nigerian youth in London's mental health system, highlighting systemic barriers, cultural misalignment, and practitioner perspectives on care models. Standardised approaches, such as Cognitive Behavioral Therapy (CBT), often fail to accommodate the cultural and systemic needs of these communities, contributing to disparities in access and engagement.
A qualitative study employing Interpretative Phenomenological Analysis (IPA) was conducted with 12 participants, including Ghanaian and Nigerian youth (n = 5), parents (n = 2), and mental health practitioners (n = 5). Semi-structured interviews facilitated an in-depth exploration of personal and shared experiences, analysed using idiographic and group-level thematic approaches.
Three overarching themes emerged: (1) ' - highlighting system-level barriers such as long wait times, unfulfilled referrals, and marginalisation; (2) - revealing tensions between cultural differences in therapy, mixed practitioner experiences, and challenges in building rapport; (3) - illustrating the rigidity and cultural insensitivity of standardised therapeutic approaches, particularly within NHS Talking Therapy (formerly IAPT).
The study highlights the need for a shift from cultural competence to cultural humility in mental healthcare. Addressing systemic barriers requires integrating cultural humility in practitioner training, adapting care models to accommodate diverse experiences, and fostering inclusive mental health policies. These findings advocate for rethinking mental health service delivery to ensure equitable and effective care for Ghanaian, Nigerian and diverse youth in London.
本研究探讨了加纳和尼日利亚青年在伦敦心理健康系统中的生活经历，突出了系统性障碍、文化错位以及从业者对护理模式的看法。标准化方法，如认知行为疗法（CBT），往往无法满足这些社区的文化和系统需求，导致在获得服务和参与度方面存在差异。
采用解释现象学分析（IPA）的定性研究对12名参与者进行了调查，其中包括加纳和尼日利亚青年（n = 5）、父母（n = 2）和心理健康从业者（n = 5）。半结构化访谈有助于深入探索个人和共同经历，采用独特的和群体层面的主题方法进行分析。
出现了三个总体主题：（1）“——突出系统层面的障碍，如长时间等待、未完成的转诊和边缘化；（2）——揭示治疗中文化差异、从业者不同经历以及建立融洽关系方面的挑战之间的紧张关系；（3）——说明标准化治疗方法的僵化和文化不敏感性，特别是在国民保健服务谈话疗法（原改善心理治疗服务）中。
该研究强调了在心理保健中从文化能力转向文化谦逊的必要性。解决系统性障碍需要在从业者培训中融入文化谦逊，调整护理模式以适应不同经历，并制定包容性的心理健康政策。这些发现主张重新思考心理健康服务的提供方式，以确保为伦敦的加纳、尼日利亚和其他青年提供公平有效的护理。
