Peer-reviewed article
BLACK-ARTS: a qualitative study exploring the insights of black young people with psychiatric disorders and the uses of creative arts therapies to improve mental well-being.
Applewhite B, Birnkammer S, Hartland V, Campbell O, Horsley C et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how black young people aged 16-24 with mental health conditions and NHS clinicians view creative arts therapies (music, art, dance, drama) as a mental health support. Researchers conducted focus groups with 20 young people and 15 clinicians across five NHS hospitals in England. Participants saw creative arts therapies as emotionally helpful and culturally relevant, but identified barriers including lack of funding, stigma, and insufficient cultural training among NHS staff. The study suggests that integrating these therapies into NHS mental health pathways could improve engagement and trust with black youth.
Key points
- Creative arts therapies were perceived as emotionally regulating and accessible to black young people with mental health challenges
- Participants identified strong alignment between creative arts approaches and black cultural identity
- Major barriers to implementation include underfunding, stigma around arts therapies, and insufficient cultural competence within the NHS
- Black young people reported disconnection and mistrust within clinical encounters with existing services
- Early integration of culturally competent creative modalities into NHS pathways (CAMHS, Talking Therapies) could enhance engagement
Limitations
This qualitative study captures perceptions and experiences but cannot measure clinical outcomes or the actual effectiveness of creative arts therapies on mental health. The findings are based on 20 young people and 15 clinicians from five NHS trusts in England and may not represent all black young people or all healthcare settings.
Abstract
Background Black people experience persistent inequalities in mental health outcomes, access and care quality compared with their white counterparts. These disparities are compounded by structural racism and a lack of culturally competent care within National Health Service (NHS) services. Creative arts therapies (CATs), including music, art, dance and drama therapy, may offer culturally relevant, non-verbal approaches to mental health support for this population. Objective To explore how black young people with mental health challenges and NHS clinicians perceive the usefulness and cultural relevance of CATs and to examine their potential as culturally competent interventions for improving mental well-being. Methods A qualitative, multicentre study was conducted across five NHS Trusts in England. 20 black service users (aged 16-24) and 15 clinicians participated in 10 online focus groups (45-60 min each). Transcripts were analysed thematically using Braun and Clarke's six-step thematic analysis method constructed with NVivo V.12 software. Coding was led by the first author, with regular discussions with a second researcher to refine interpretations and develop themes. Findings Five overarching themes were identified: (1) creative arts as vehicles for emotional healing, identity and agency, (2) challenges and barriers to CAT implementation, (3) disconnection and mistrust within clinical encounters, (4) discovering therapeutic potential through creative experience and (5) creative expression as a bridge between culture and care. Participants viewed CATs as emotionally regulating, accessible and aligned with black cultural identity though limited by underfunding, stigma and insufficient cultural competence within the NHS. Conclusions CATs may provide a culturally congruent and emotionally accessible approach to mental healthcare for black youth. Embedding culturally competent, creative modalities within NHS pathways could enhance engagement, trust and equity in service outcomes. Clinical implications CATs should be integrated early in NHS pathways (eg, Child and Adolescent Mental Health Services, Talking Therapies) to improve engagement among black youth who may be hesitant to engage in verbally dominant therapies. However, scaled implementation requires meaningful coproduction with black communities, cultural competence training for multidisciplinary teams and recognition within NHS and National Institute for Health and Care Excellence frameworks.