The model isn't made for us: Ghanaian and Nigerian youths' experiences in London's mental health system: a qualitative study.

Abstract

Objectives: 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.

Design: 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.

Results: Three overarching themes emerged: (1) 'They didn't really help me' - highlighting system-level barriers such as long wait times, unfulfilled referrals, and marginalisation; (2) Cross-racial therapeutic dynamics and practitioners' observations - revealing tensions between cultural differences in therapy, mixed practitioner experiences, and challenges in building rapport; (3) There hasn't been enough in the model of care - illustrating the rigidity and cultural insensitivity of standardised therapeutic approaches, particularly within NHS Talking Therapy (formerly IAPT).

Conclusion: 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.