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Exploring Perceptions of “Wellness” in Black Ethnic Minority Individuals at Risk of Developing Psychosis

Published online by Cambridge University Press:  16 October 2012

Louisa Codjoe ,
Majella Byrne ,
Matthew Lister ,
Philip McGuire  and
Lucia Valmaggia
Louisa Codjoe*
Affiliation:
King's College London, and South London and Maudsley NHS Trust, UK
Majella Byrne
Affiliation:
King's College London, and South London and Maudsley NHS Trust, UK
Matthew Lister
Affiliation:
Oxford Health NHS Foundation Trust, UK
Philip McGuire
Affiliation:
King's College London, and South London and Maudsley NHS Trust, UK
Lucia Valmaggia
Affiliation:
King's College London, South London and Maudsley NHS Trust, UK, and Maastricht University, Netherlands
*
Reprint requests to Louisa Codjoe, Institute of Psychiatry, Psychosis Studies, PO Box 63, de Crespigny Park, Denmark Hill, London SE5 8AF, UK. E-mail: louisa.codjoe@slam.nhs.uk
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Abstract

Background: The NICE Schizophrenia guidelines (NICE, 2009, Update) recommend that services should address cultural differences in treatment, expectations and adherence, and clients’ explanatory models of illness should be better understood. Service users from Black African and Black Caribbean communities are overrepresented in psychosis services in the UK, yet there is no literature on how wellness is understood by this group. Aims: This study explored perceptions of wellness in Black African and Black Caribbean individuals with an At Risk Mental State (ARMS) for psychosis. Method: A Q set of potential meanings of wellness was identified from a literature search and interviews with people at risk of developing psychosis. From this, 50 potential definitions were identified; twenty Black African and Black Caribbean ARMS clients ranked these definitions. Results: Following factor analysis of completed Q sorts, six factors emerged that offered insight into perceptions of wellness in this population. These factors included: sense of social purpose explanation, the surviving God's test explanation, the internalization of spirituality explanation, understanding and attribution of symptoms to witchcraft explanation, avoidance and adversity explanation, and seeking help to cope explanation. Conclusions: Although preliminary, differences between the factors suggests that there may be perceptions of wellness specific to these groups that are distinct from the medical view of wellness promoted within early detection services. These differences may potentially impact upon engagement, particularly factors that clients feel may facilitate or aide their recovery. It is suggested that these differences need to be considered as part of the assessment and formulation process.

Keywords

At Risk Mental State (ARMS)psychosisprodrome wellnessBlack African and Black CaribbeanQ methodology
Type
Empirically Grounded Clinical Interventions
Information
Behavioural and Cognitive Psychotherapy , Volume 41 , Issue 2 , March 2013 , pp. 144 - 161
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2012

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