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Mental health is an underdeveloped service to the population generally and to African-Caribbean in particular. There is a need for more sensitive diagnosing, treatment and care. African-Caribbean people are asking for a more culturally competent mental healthcare system.

This chapter aims to address the following issues: how African-Caribbean people reflect on mental health and mental ill health. Their reflections are drawn from interviews done with African-Caribbean people who are involved with Hagar, a mental health charity in Lewisham, London. Mental health and mental illnesses will be examined, followed by the Psychiatrists’ use of the diagnostic tools that do a disservice to Black people. The Trans-Atlantic slave trade and its contribution to the mental ill health of Black people will be addressed, thus providing a historical underpinning for much of Black people’s struggle with mental ill health. Racism and its contribution to mental health issues will be presented. The views of the Black Psychiatrist Franz Fanon will be argued as a way of understanding oppression, alienation and mental ill health in Black people, and going on to open up ways of providing treatment and care. Finally suggestions will be made about how to provide a culturally competent mental health service to African Heritage peoples.

The purpose of this paper is to examine to what extent service delivery in the Canadian federal government actually improved after a decade of reform efforts, and how employee empowerment accounted for any improvements that arose.

Five focus group interviews were conducted in 2002 with federal government employees involved in service delivery. Interview transcripts were content analyzed. The employee empowerment and service quality literatures, including critical perspectives, provide the theoretical underpinnings of the study.

Productivity and service enhancement did materialize, but little empowerment occurred. Work intensification was revealed. The shortcomings of applying private sector‐style definitions of productivity to the public sector were identified.

Study findings have limited generalizability due to small sample size. Findings must be verified through additional research. Comparative findings from countries that introduced service reforms more comprehensively than did Canada would be of interest.

Public sector efforts to improve service delivery should address possible material barriers affecting service delivery and pay more attention to employee needs. The efficacy of quantitative performance targets should be re‐examined.

The outcomes of a public service reform initiative intended to improve service quality by allegedly empowering front‐line workers are presented from an employee perspective. As there is limited empirical research done on this topic from that perspective it should be of general interest to researchers in the fields of public policy and human resources management.