How do we understand the underrepresentation of Black children and families accessing Child and Adolescent Mental Health Services (CAMHS)? A mixed methods qualitative research with professionals and service users

This research explores how professionals and service users make sense of the underrepresentation of Black children and families engaging with mental health services. A recent audit of referrals received in an inner London Children and Adolescent Mental Health Services (CAMHS) confirmed the underrepresentation. Using a Qualitative, Reflexive Thematic Analysis, audio recorded and transcribed, semi-structured interviews in focus groups explored the lived experiences of four Black mothers of African-Caribbean descent who accessed CAMHS; and four professionals who shared their experiences of working with Black families in need of mental health support. The findings revealed that difference, mistrust, fear, and disjointed thinking within the professional network affected access and engagement. Families described feeling isolated in their attempts to navigate the service and access support, and service satisfaction was variable depending on the stage of access. However, the children progressed when a good therapeutic alliance developed between service users and professionals. The findings were analysed, and the implications for the Black community, the practice of Child and Adolescent Psychotherapy and the NHS were considered using psychoanalytic concepts. Keywords: Black African-Caribbean; CAMHS; Health Inequalities; Child and Adolescent Psychotherapy; Reflexive Thematic Analysis; Focus Groups