Exploring perceptions of "wellness" in black ethnic minority individuals at risk of developing psychosis.
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.


OBJECTIVE
This study explored perceptions of wellness in Black African and Black Caribbean individuals with an At Risk Mental State (ARMS) for psychosis.


METHODS
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.
King's College London, and South London and Maudsley NHS Trust, UK. louisa.codjoe@slam.nhs.uk
Louisa
L
Codjoe
Majella
M
Byrne
Matthew
M
Lister
Philip
P
McGuire
Lucia
L
Valmaggia
D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D044383:Black People / Q000235:genetics / Q000523:psychology*; D003431:Cross-Cultural Comparison; D003469:Culture; D054242:Emigrants and Immigrants / Q000523:psychology*; D005260:Female; D006293:Health Promotion; D006801:Humans; D008131:London; D008297:Male; D008519:Medicine, Traditional / Q000523:psychology; D008603:Mental Health; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000523:psychology; D011618:Psychotic Disorders / Q000208:ethnology* / Q000235:genetics / Q000523:psychology*; D011779:Q-Sort; D012069:Religion and Psychology; D012307:Risk Factors; D029181:Spirituality; D055815:Young Adult