This research looks at areas of good practice in relation to access, experience and outcomes for Black men in mental health services.
The research consisted of:
- a rapid review of the evidence
- key stakeholder interviews
We commissioned Queen Mary University of London and University College of London to carry out this research and write the summary below.
What this report is about
Black men in England often don’t get the mental health care they need. Sometimes, the system even makes things worse for them. This report is about improving that issue and making mental health services better for Black men. It asks the important question: What does good mental health care look like for Black men?
The research was conducted because the Care Quality Commission (CQC), the organisation that checks if health and care services in England are safe and good quality, wants to understand the experiences of Black men and find ways to improve care for them.
Why this project matters
Mental health services should help people heal. But for too many Black men, these services are another source of racism, which causes more harm. This project is important because it shows that change can happen. Some people and services are already doing things the right way. But to make real improvements, we need to listen to Black men, learn from them, and act on what they say needs to change.
What we did
To understand how mental health care can be better for Black men, we did two main things:
1. We looked at the research
We read over 100 studies from the last 10 years or more. These studies came from the UK, the USA, Canada, and other places. We chose the best ones, especially those about Black men and mental health. This helped us learn what helps Black men get the care they need, what gets in the way, what kind of services make them feel better.
2. We talked to people
We spoke with 23 people about what good mental health care looks like for Black men. Some of these people were Black men who used mental health services, and some were Black men’s family members and carers. Others worked in mental health services or organisations related to mental health. We asked them questions like:
- What does good care look like?
- What is not working?
- What needs to change?
We worked with a group of Black men who helped us understand the problem and how our findings can be used to improve mental health services. This group included eight Black men who called themselves the Black Men’s Health Taskforce. Some of the men had used mental health services, some had cared for others, and some were community leaders or activists. They helped us decide what questions we should ask, shared their views on what we found, came up with ideas for improving care, and gave their recommendations directly to CQC.
What we found
Part 1: what the previous research says
To support Black men’s mental health, services need to improve in three main areas:
1. Organisational culture
Mental health services need to be anti-racist, culturally humble, and stigma-aware:
- Anti-racist: This means not just avoiding racism but actively fighting against it in services and the medical field. Services need to challenge racist ideas, like wrongly assuming Black men are dangerous. They should also use care models produced by and for African-Caribbean people.
- Cultural humility: Black men come from lots of different backgrounds. Staff should listen and learn from them instead of assuming they know what is best.
- Tackling stigma: In many Black communities, mental health is seen as shameful or something people don’t talk about. Services should help break this silence and avoid making things worse by judging people or labelling them unfairly.
2. Service design
Good services should be created together with Black men (co-production), focus on their lives, and help both Black men and health care workers learn:
- Co-production: Black men should lead in the design, delivery and evaluation of services, not just give feedback after decisions are made.
- Relevance: Services need to understand Black men’s lives, including their cultures, histories, and challenges like, racism, problems with jobs, or housing problems.
- Shared learning: Mental health professionals should learn from Black communities. At the same time, Black communities need clear, honest information about the services available.
3. Service delivery
Mental health care should be based in the community, person-centred, trauma-informed, and communicated respectfully:
- Community-based: Services should reach Black men in places where they already feel comfortable – like barber shops, churches, or community centres.
- Person-centred and trauma-informed: Black men may carry deep scars from racism and tough experiences. Services must treat them as whole people, not just “patients with problems”.
- Communication that builds trust: Black men often do not get enough information about their care. Providers need to explain things clearly, treat them with respect, and be honest.
Part 2: What people told us in interviews
We spoke to 23 people. Here’s what they said:
Care needs of Black men
- Mental health care should focus on the whole person – not just symptoms or medication.
- Black men are all different. Care should be personal and based on what each person needs, not just one standard approach. “Sometimes it’s not just about medicine. It could be about helping with housing, a job, or dealing with past trauma.” – Service provider
What good care looks like
- Services that listen to people, include families, and can adapt to different needs.
- Staff who understand Black cultures – or even better, staff who are Black themselves.
- Therapies that are creative, open, and help build trust. “The best care I had was when I was listened to and treated as an equal.” – Person who uses services
Access to services
- There are many barriers that make it hard for Black men to use mental health services, like stigma (negative attitudes) in communities and confusing systems.
- Some people don’t know where to get help or don’t feel safe asking for it. “Our communities are scared of mental health services. Some of us worry we won’t come out alive.” – Person who uses services
- We can make mental health services easier to access if we make use of familiar places like barbershops and community groups like faith groups.
What gets in the way
- Services focus too much on medicine and not enough on solving deeper problems such as the complex trauma that many Black men may have experienced.
- Poor communication between staff and teams which limits the opportunities to deliver holistic care.
- Not enough Black professionals in the field and not enough cultural training for staff.
- Lots of small, short-term projects (called pilots) that don’t last long enough to make a real difference. “Everything’s just a pilot. Then it stops. Nothing lasts.” – Advocacy group
How services can improve
- Hire more Black therapists and peer support workers.
- Involve Black men and communities in designing services.
- Allow anonymous feedback – and show that it leads to real changes.
- Engage with Black men in ways that don’t cause more harm. “Why keep giving feedback if nothing changes?” – Advocacy group “Don’t make us repeat our trauma if you won’t use it to make things better.” – Advocacy group
Perspectives from the Black Men’s Health Taskforce
The Taskforce wanted to push for real change, not just talk about what’s wrong. Here is what they shared:
“We do not just have lived experience – this is our living experience.” The group said the term “lived experience” doesn’t show the full picture. Racism and bad treatment in mental health services aren’t just things of the past – they are still happening now. Some Black men face life-threatening issues every day. “This is about staying alive. It’s not just our past – it’s our every day.” – Taskforce member
Mental health care must be anti-racism and culturally safe. Members described how they have been misdiagnosed, called “aggressive”, or ignored. They said services need to work with Black communities from the beginning to stop these harmful patterns.
Black men must be leaders, not just participants. The group said Black men should be involved in decisions – helping design, deliver, and review services. “If you’re not giving us a seat at the table, you’re not serious about change.” – Taskforce member
“We’re tired of being studied without seeing change.” The group felt heard in this project, but they said this does not happen often. They want the CQC and others to act on what they have heard, not just write another report. “If nothing changes after this, it’s just more trauma.” – Taskforce member
What needs to change
The people we spoke to and the research we looked made one thing clear: Mental health care for Black men needs a major reset.
Here is what should change:
- Change the culture to fight racism and improve mental health care with Black men. This means fighting racism wherever it appears in mental health services and making sure that Black men are involved in decisions about their care and the way services are run.
- Train CQC and NHS staff to understand the needs of Black men. Many staff want to help but do not know how to give care that is anti-racist and culturally safe. Training must be long-term, created with Black men, and based on real situations – not just tick-box exercises.
- Ask the right questions. CQC inspectors should ask the questions that matter most to Black men. To do this, they need to work closely with Black men and their communities, so they can spot the problems within health care services and help find the best solutions.
- Use better data to drive change. Often, we do not have clear information about how Black men are treated in mental health services. CQC inspections need to use information about the race and the ethnicity of patients to identify problems and poor treatment of Black men.
- Stop starting from scratch - build on what already works. There are already good examples of care for Black men, but they are often small and underfunded. We should learn from these and use what works to improve services everywhere.
Conclusion
Mental health care for Black men in England needs major change. For a long time, services have been unfair, unsafe, and damaging. But change can happen. We already know what good mental health care should look like. It should be anti-racist, co-produced (designed for the people it’s for), and community-based. It should see Black men as whole people, and it should be built on trust. Black men must be part of making decisions about their own care. Staff must have proper training so they can challenge racism and treat Black men with respect and understanding. When services fail to do the right thing, they must be held accountable.
As a member of the Black Men’s Health Taskforce said: “This is life and death for some of us.”
The Black Men’s Health Taskforce and the CQC worked closely together on this project. Taskforce members have real experience with mental health services, fighting racism, and improving care. We recommend that the CQC keeps working with the Taskforce and includes them when deciding how to put these recommendations into action.
More information
Queen Mary University of London's Health Equity Evidence Centre has more information about this research.