Behind the Barrier: Health in Mind and Intercultural Youth Scotland’s Inclusive Mental Health Support
In the spirit of this, Dr Rahila Khalid from Health in Mind and Nina Abeysuriya from Intercultural Youth Scotland (IYS) share their journeys towards providing more inclusive and equitable mental health support for Black and racially minoritised communities in Scotland.
Health in Mind has a history of supporting Black and minority ethnic (BME) communities. Their project Men in Mind (now called ‘Equal Access’), which started in 1997, was the first mental health project in Scotland for Black and minority ethnic men. Today, their services encompass a breadth of support for both men and women in different communities across Edinburgh and the Lothians, including group and one-to-one peer support to provide individuals with the tools needed to regulate their wellbeing on their own terms.
Despite their history of providing much needed support to BME communities, they acknowledge that there is still much to do to ensure services are inclusive and accessible. Mental health disparities persist among the growing BME population, and there are several barriers for people from BME groups seeking access to mental health services: stigma and fear of being judged; the impact of cultural norms of masculinity and gender; language barriers; tradition and culture; involvement or influence of family and community pressure; and a lack of cultural awareness in health workers (Simkhada et al, 2021; Memon et al, 2016).
Research from Health in Mind and Outside the Box in 2008 highlighted that participants from racially minoritised backgrounds felt racism also presented a barrier to improving their mental health. One participant revealed, “I have realised that I am recovering from the discrimination as much as I am recovering from the mental health problems.”
In response, Health in Mind’s Equal Access project strives to provide culturally tailored services that integrate the values and inclusions of BME communities that are required to limit these barriers.
On a similar path, Intercultural Youth Scotland's (IYS) Mental Health Service focusses on the delivery of counselling and mentoring support for young Black people and People of Colour aged between 12-25 in Scotland. Their service is provided by specialised counsellors who are made up of mostly People of Colour with lived experience of racism, who all have an understanding of racial trauma, and centre race and racism in their practice. Nina Abeysuriya, Mental Health Service Manager at IYS, shares her reflections with us:
“Often, we hear about how structural barriers are ingrained in the social, economic, political, and cultural systems we interact with. This information is presented to us through statistics, pie charts, and predictions. However, despite the abundance of evidence, the less-travelled road from theory to practice in creating new, more equitable systems remains badly signposted and less trodden.
But what is it like to attempt to create a different experience inside a system fundamentally rigged for you to fail? Like other third-sector organisations creating and asking for change (in their loudest voice), Intercultural Youth Scotland’s Mental Health Service have been on this journey towards humanising mental healthcare and anti-racist practice since its launch two years ago.
To dismantle the barriers to access support and create equitable and compassionate treatment that is not found in mainstream health systems, the service is also prioritising the development of an anti-racist, culturally informed approach to practice, with their own anti-racist pillars to follow. This call to action has been amplified through events such as the ‘Conversation to Action’ Culturally Informed Anti-Racist mental health event alongside Glasgow Health and Social Care Partnership. This is a difficult path and has led to advocating in spaces of government and local authority. In some cases, the burden of proof seems to lie on us, the third-sector organisation, the parent, the victim, the survivor to prove the barrier, or the existence of structural racism in our systems, which becomes an equally big barrier to jump”.
Nina goes on to state that:
“What is often not said or factored into solutions, when 'barriers' are reported, is the reality of the historic mistreatment of Black people and People of Colour in our health systems, and how that creates some of the hurdles highlighted above, including a retraumatising in the interaction of care, and how 'care' is seldom found.
People of Colour in our mental and physical health systems are continuously let down, with layers of medical bias, fear of bringing race into the room, and inadequate culturally-informed training. Black people and People of Colour are consciously excluded and historically dehumanised, and that legacy lives on in the delivery of our care.
Despite this inhospitable terrain and the challenges ahead, Intercultural Youth Scotland's Mental Health service hopes to continue on the path of equitable, compassionate, humanised delivery of mental health support for young Black People and People of Colour in Scotland.”
Both Equal Access’s support and IYS’s counselling are offered at no cost, which is another important feature of their services when we consider that Black communities in Scotland are nearly twice as likely to experience poverty as someone from a White Scottish background.
By addressing the historical legacy of discrimination, dismantling barriers, and prioritising culturally informed approaches, these organisations are making significant strides toward creating a more inclusive and equitable mental health landscape.
If you would like to find out more about accessing support from these organisations or supporting their work, please visit:
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