The African-Caribbean Community Initiative (ACCI) has been offering mental health support in Wolverhampton for almost 40 years. I was lucky enough to visit ACCI’s hub and meet its chief executive Alicia Spence recently.
A fundamental principle of ACCI is that it provides its members (not ‘service users’ or ‘clients’) with a hot, home-cooked lunch at the hub. It’s at the heart of a place where people show they care about each other and support is delivered relationally, flexibly, and holistically.
In Alicia’s thirty plus years of working at ACCI, she says she’s seen some things change, and some things not. One significant change is the level of awareness and understanding about mental health in the Black community. There’s a greater openness about mental health, and with it more willingness to seek help. ACCI reaches out to faith groups in the city to help to change the conversation about mental health, as well as connecting with the local football club and the Family Hub down the road.
ACCI is an open, friendly, and (perhaps most importantly) safe space for a diverse range of people from multiple communities in the city. There’s a wide range of activities happening, from counselling and physical health checks to creative workshops and walking groups. It’s got an allotment, and it provides supported accommodation for up to 25 people close to its hub. It recognises that for many people, clinical care can only take place when their basic needs are met: as Alicia put it, “We can’t talk about medication compliance when a person has nowhere to sleep tonight”.
ACCI’s relationship with statutory mental health services is crucial to its impact. For many of its members, it’s a ‘bridge’ to community mental health services. It’s both an alternative to clinical care and a complement to it. It supports people when they leave hospital, and its staff will accompany members to GP appointments where necessary to help with physical health needs. It employs a community psychiatric nurse who connects with staff from both inpatient and community mental health services to support members to get their needs met.
Alicia describes ACCI as being like a family. Because people are ‘members’, they don’t get discharged. “You can always walk back through the door.” Members can come to ACCI when they need to, and less so when they don’t need it as much. But if someone suddenly stops coming, ACCI staff check in that they’re ok, as this might be a sign they are having difficulties. Noticing changes like this can be a way to prevent a crisis and bridge across the statutory services when urgent help is needed.
One thing that never changes for ACCI and organisations like it is funding challenges. ACCI’s work is funded by its local NHS trust, the city council, and charitable foundations. It has to work hard to maintain its service, never being sure of its future under the pressure of short-term contracts and many funders’ thirst for ‘innovation’ over doing what already works.
The critical elements of how ACCI works are ones we’ve seen in our research elsewhere. It’s not just ‘in’ the community but ‘of’ and ‘by’ the community. It’s open access, creating a safe space where mental health support is delivered alongside other activities. It’s friendly, welcoming, and proactive. It’s flexible in its support offer, recognising the challenges people face in their lives and providing practical help where it’s needed. And it is complementary to statutory mental health services – not seeking to replace them but to work alongside and advocate for its members (individually and collectively).
Organisations like ACCI are at the heart of what equitable and effective mental health care can look like. For nearly 40 years, ACCI has been a steady and consistent presence in its community, and it will have an important role long into the future as part of a wider system of care and support.
Image courtesy of African-Caribbean Community Initiative
