Journeys and experiences accessing trauma support for Black adults with complex trauma: a qualitative study

Despite growing evidence depicting the importance of trauma-informed practices within mental health services, little is known about Black groups who have experienced complex trauma and their unique experiences of accessing and receiving mental health support. Black communities are disproportionately exposed to various forms of trauma, including systemic and interpersonal violence, with elevated rates of trauma related conditions such as PTSD. In addition to these heightened exposures, Black groups are also more likely to encounter mental health services through adversarial and coercive care pathways, placing them at risk of further trauma and harm. This qualitative study focuses on Black adults with complex trauma by understanding their journeys, experiences, and perceptions of mental health care. Ten in-depth interviews were conducted. Using a thematic narrative analysis approach and underpinned through a critical realist framework, six themes emerged within the data: a fragmented mental health system, alternative support systems, inadequate or inappropriate assessments, overly clinical and medical focuses, cultural matching, and improving person-centred care. The study provides grounded examples of what trauma-informed, culturally responsive care may look like in practice, contributing to a more nuanced understanding of how support systems can better meet the needs of those most often underserved. • Black adults face significant barriers when accessing complex trauma services. • Their needs are often overlooked, dismissed, or inadequately addressed within existing systems. • The absence of culturally responsive practices can cause further harm and worsen outcomes. • This study offers insight into how trauma-informed care can be adapted to better serve Black adults with complex trauma.