Barriers to mental health services among British Bangladeshi men

South Asians (SA) comprise roughly 7.5% of the UK inhabitants (Nash, 2019). Studies point out that South Asians within the UK not often search mental health services. (Prajapati & Liebling, 2021). Most of the research have been performed among SA girls or the final SA inhabitants fairly than focussed on particular ethnic teams (Hussain & Cochrane, 2004; Neale et al., 2009; Prajapati & Liebling, 2021).

Although it was discovered that men are much less inclined to search assist for any mental health issues (Oliver et al., 2005); findings from a scoping overview counsel that though most community-based interventions goal the South Asian inhabitants, interventions are absent particularly for men (Baskin et al., 2021).

Evidence reveals that British Bangladeshis face important disadvantages; dwelling in council housing and expertise increased charges of workless households with dependent kids and poor health (Ali, 2006; Darko, 2021; Large & Ghosh, 2006). Along with socio-economic challenges, the standard notions of masculinity throughout the Bangladeshi group discourage men from counting on feminine relations and emphasise their position as suppliers; placing them beneath quite a lot of mental toll (Willott & Griffin, 1996). They are thought of a “hard-to-reach” inhabitants who underuse mental health services in contrast to white men (Darko, 2021), but analysis concerning their notion of mental health and help services is sparse.

This weblog summarises a latest qualitative examine by Dr Shah Alam, a British Bangladeshi Male Clinical Psychologist (2023) exploring the perceptions of British Bangladeshi men concerning limitations to mental health help.

Methods

The writer gathered private accounts via qualitative interviews. All contributors had been British-Bangladeshi men aged 22-59, scoring reasonable to extreme on the Patient Health Questionnaire-9 (PHQ-9) and the General Anxiety Disorder-7 (GAD-7). The examine excluded individuals who had been thought of ‘high at risk’, had been currenty utilizing or not too long ago obtained help from mental health services. 54 contributors had been recruited utilizing on-line social media and leaflet drops and screened for despair and anxiousness ranges utilizing PHQ-9 or GAD-7 questionnaires by way of Qualtrics. The qualitative knowledge was analysed following the framework of reflexive thematic evaluation. Data saturation was reached with 12 contributors.

Results

Reflexive thematic evaluation yielded the next most important themes:

Different understanding of mental misery

The contributors highlighted that there’s lack of know-how of mental health evidenced by prioritising bodily health reminiscent of diabetes, attributing any mental health signs to bodily health. Cultural norms throughout the Bangladeshi group discouraged open discussions about feelings, with people usually being reassured that they’re okay even when experiencing misery. Language limitations had been additionally recognized as hindering them from expressing freely. Participants generally attributed mental misery to spirits or black magic, and described the frequent beliefs a few of lack of mental health help services, which may lead to people not approaching services.

Culturally we don’t discuss our emotions and simply categorical dominance and this concept that “I’m ok”.

Traditional cultural expectations

The contributors believed that robust gender norms exist of their group. Men are anticipated to be the only real breadwinner of the household taking over all of the monetary accountability; compelled to supress one’s feelings in order to meet the societal expectations to be masculine beliefs.

Even with my dad, as a child, I’d cry and he would say “don’t do that”, “don’t be a girl” and for guys it’s extra like “buckle up”’.

Fear and loss

Participants expressed that affected by mental health issues meant to undergo from self-stigma, disgrace and dropping respect. This led to elevated worry for sharing and reaching out for skilled assist.

We have a tendency to hold it saved inside ourselves till it bursts or one thing huge occurs, after which it’s too late.

Coping sources

This theme delves into how the contributors consider that following one’s faith and its practices helped to preserve one’s mental health. Despite dealing with self-stigma and reluctance to search help, contributors indicated feeling comfy sharing their feelings with their companions, creating a way of security and help.

individuals discover solace and luxury in faith, in order that they pray, and I can’t disagree with that however on the identical time you’ve got to have a look at the sensible means as properly.

Barriers to entry

This theme factors out the important thing limitations to utilising mental health help services. Participants described inadequate consciousness and understanding concerning out there mental health help services, difficulties in communication with healthcare professionals owing to language limitations, adverse expertise with GP when looking for assist, and lack of belief in skilled healthcare staff.

There are not any interpreters both and I’d try to clarify myself the most effective I can…So, typically we don’t perceive, and we are able to wrestle. The language barrier has a huge impact on me.

Community outreach and collaboration

Participants harassed the significance of collaborative efforts between mental health services and the group to improve entry to help and stop mental health disaster. Participants highlighted the importance of involving individuals with lived expertise, integrating health schooling with non secular teachings.

How to flip to faith to assist with the stress you’re going via… You see quite a lot of men at mosque, that’s the greatest time to inform them.

Conclusions

This examine sheds mild on the complexities surrounding mental health, stigma, and help-seeking behaviours throughout the British Bangladeshi male group.

It reveals a number of elements influencing formal help-seeking, together with:

• consciousness about out there help services,
• the necessity to handle language limitations,
• the necessity to normalise expressing feelings, and
• the significance of constructing belief among the skilled health care services.

Strengths and limitations

One of the primary strengths of this examine is that it employed varied strategies to preserve qualitative rigour, reminiscent of reflexive thematic evaluation, member-checking, moral concerns, and a misery protocol. Another energy is the researcher’s fluency in Bengali and Sylheti, which helped to guarantee correct translation and interpretation, enhancing the reliability of the findings. Unlike previous research, which focussed on the general South Asian inhabitants and South Asian girls, it’s fairly a novel examine unravelling the wants of British Bangladeshi men’s perceived mental health.

One limitation is that the examine relied closely on social media for recruitment, doubtlessly excluding people with out web entry or these from decrease socio-economic backgrounds, which limits the illustration of Bangladeshi men residing in London. The writer acknowledged the adoption of information saturation, however solely 12 contributors had been deemed eligible whereas recruiting, elevating questions on whether or not they regarded for knowledge saturation or pre-determined the pattern measurement primarily based on literature suggesting 12 contributors are adequate. Moreover, though the writer acknowledged that the examine used a co-production strategy, there was no proof of this or additional clarification on how this was executed.

Another limitation is the exclusion of the individuals who have not too long ago used the NHS services for his or her mental health points as there may need been men who had discontinued their remedy after experiencing particular limitations, which could possibly be instrumental for this examine. The lived expertise of such Bangladeshi men might present invaluable insights. Additionally, this examine didn’t discover one of many key studying goals associated to low and high-intensity CBT practitioners. Outcome measures had been gathered to improve strong knowledge evaluation, subsequently, the dialogue could possibly be enhanced with cross-examination of the literature alongside the findings of the mental health of British Bangladeshi men.

Implications for apply

The findings indicate that there’s an pressing want to increase mental health consciousness within the British Bangladeshi Muslim communities. This could be achieved by organising such programmes in components of UK the place Bangladeshi group residents are populous. For occasion, mental health professionals and organisations can promote consciousness throughout particular festivities like Eid, help management and facilitation by non secular leaders and construct native networks for men.

The examine findings counsel that men might confide their feelings to their wives, therefore, females is also included in varied group outreach programmes to increase consciousness round mental health services. Community outreach applications in faculties, mosques, and the broader locality could possibly be accomplished to assist individuals perceive entry mental health services and normalise speaking about feelings and misery. As GPs are the primary level of contact for any health care, it is vital to construct belief and supply non-judgemental care.

Future analysis reminiscent of ethnographic commentary and qualitative explorations could possibly be performed to higher perceive the opposite facet of the coin; healthcare professionals’ views on care provision to British Bangladeshi men. An in-depth examine could possibly be executed with British Bangladeshi men who’ve not too long ago obtained psychological remedy from the NHS on how they conceptualise mental health help and what’s lacking from services.

Statement of pursuits

As a part of my PhD, I’m exploring suicide and self-harm in South Asia. No conflicts of curiosity.

Links

Primary paper

Alam, S. (2023). British-Bangladeshi Muslim men: eradicating limitations to mental health help and successfully supporting our group. The Cognitive Behaviour Therapist, 16, e38.

Other references

Ali, N. (2006). A postcolonial individuals: South Asians in Britain. Wm. B. Eerdmans Publishing.

Baskin, C., Zijlstra, G., McGrath, M., Lee, C., Duncan, F. H., Oliver, E. J., Osborn, D., Dykxhoorn, J., Kaner, E. F., & LaFortune, L. (2021). Community-centred interventions for enhancing public mental health among adults from ethnic minority populations within the UK: a scoping overview. BMJ open, 11(4), e041102.

Darko, N. (2021). Engaging black and minority ethnic teams in health analysis:‘hard to reach’? Demystifying the misconceptions. Policy Press.

Hussain, F., & Cochrane, R. (2004). Depression in South Asian girls dwelling within the UK: a overview of the literature with implications for service provision. Transcultural psychiatry, 41(2), 253-270.

Large, P., & Ghosh, Okay. (2006). Estimates of the inhabitants by ethnic group for areas inside England. Population Trends(124), 8-17.

Nash, A. (2019). National inhabitants projections: 2018-based. Office for National Statistics.

Neale, J., Worrell, M., & Randhawa, G. (2009). Breaking down limitations to accessing mental health help services‐a qualitative examine among younger South Asian and African‐Caribbean communities in Luton. Journal of Public Mental Health, 8(2), 15-25.

Oliver, M. I., Pearson, N., Coe, N., & Gunnell, D. (2005). Help-seeking behaviour in men and girls with frequent mental health issues: cross-sectional examine. The British Journal of Psychiatry, 186(4), 297-301.

Prajapati, R., & Liebling, H. (2021). Accessing mental health services: a scientific overview and meta-ethnography of the experiences of South Asian Service customers within the UK. Journal of racial and ethnic health disparities, 1-22.

Willott, S., & Griffin, C. (1996). Men, masculinity and the problem of long-term unemployment. Understanding masculinities, 77-92.