Perceived barriers to accessing mental health services among ethnic minorities: a qualitative study in southeast england

Background: In most European countries, there are significant disparities in the understanding of mental health conditions and access to mental health services among ethnic minority groups. Studies in the UK suggest that individuals from ethnic minorities: have complex pathways to, accessing mental health services, have longer length of inpatient stays, are less likely to take antidepressants, are less likely to contact general practitioners about mental health. It is unclear whether these disparities represent variation in mental health needs, or result from personal/environmental factors and/or relationships between service users and healthcare providers. This qualitative study sought to identify perceived barriers to accessing mental health services among individuals from ethnic minorities in Southeast England to inform the development of effective and culturally acceptable services. Methods: Twenty six adults from ethnic minorities were recruited by community development workers to participate in two focus groups. Discussions were facilitated by researchers trained in cross-cultural communication and the qualitative methodology. Thematic analysis was conducted to identify key emerging themes. Results: Two broad themes were identified: Personal and environmental factors including: inability to recognise symptoms; males being reluctant to seek help; absence of social networks; social networks as an alternative to professional services; cultural identity and stigma; and financial factors. Relationship between service user and healthcare provider including: waiting times; language and communication difficulties; health professionals not listening to concerns or responding to individual needs; power and authority imbalance between healthcare providers and patient; culturally insensitive services; and lack of awareness about services. Conclusion: Members of ethnic minorities require greater mental health literacy and practical support to raise awareness of mental health issues, and provided with appropriate information about the different services and pathways to access these services. Healthcare providers need to be supported in developing effective communication strategies to deliver individually tailored and culturally sensitive care. The engagement of ethnic minorities in the development and delivery of culturally appropriate mental health services could also facilitate better understanding of mental health conditions and improved utilisation of mental health services.