Implementing culturally appropriate recovery approaches in mental health services: perspectives from the Irish Traveller community

Objectives: This study explores the perspectives of Irish Travellers, an ethnic minority group in Ireland, on the service improvements needed to implement culturally appropriate recovery approaches in mental health services.

Methods: A community-based participatory research approach was employed. Seventeen Traveller peer researchers conducted thirteen qualitative participatory workshops and five individual interviews across Ireland. Eighty-seven adult members of the Traveller community (83% female, mean age = 33, 56.3% not in education or employment) were recruited through convenience sampling. Participatory thematic analysis was employed.

Results: Travellers' ideas about improvements in mental healthcare involve practitioners in creating a trusting environment, increasing representation of Travellers within mental healthcare staff and working in partnership with Traveller service users to co-produce strategies that are owned by the community. Study participants emphasised the importance of Traveller cultural awareness, strengthening trauma-informed care, and embedding an ethos of cultural humility within mainstream services. The findings indicate the need for increased collaboration between mental health service providers and non-mental health agencies, and a reorientation of care towards empowering Traveller service users to achieve their social aspirations and building a positive self-identity.

Conclusions: This study demonstrates that implementing a recovery approach for Travellers requires a reorientation of services, in line with Travellers' definition of culturally appropriate mental healthcare. This study calls for an expanded mandate for mental health services beyond individual care and towards intersectoral action in addressing the social determinants of Travellers' mental health. This will help to shape an equitable and inclusive healthcare setting that promotes Travellers' mental health and recovery.