Exploring barriers to South Asian help-seeking for eating disorders

Abstract

Purpose Referrals to specialist eating disorder services from the South Asian (SA) community are under-represented, despite research suggesting that disordered eating attitudes and behaviours of SA people are similar to the population in general. The study aimed to identify the reasons for this and sought to inform ways to encourage help-seeking. Design/Methodology/Approach A qualitative methodology was used to investigate barriers to help-seeking for eating disorders among the SA community. A key informant focus group was conducted with clinicians working within the local specialist eating disorder service (participants n=16, 12 female, 4 male). Six focus groups were conducted with members of the SA community in Leicester, UK, (participants n=28, 23 female, 5 male) recruited from a local university, two charities and Children, Young People & Family Centres. Findings A number of themes emerged as possible factors for delaying early access to help: lack of knowledge about eating disorders and their potential seriousness; ideals regarding body shape; family living circumstances, and the role of food in the community. Participants acknowledged stigma among their community associated with mental health issues, including eating disorders, and concerns about confidentiality when approaching services, particularly primary care. Originality/value General practitioners and specialist services need to be aware of the potential barriers to help-seeking for eating disorders as early specialist help is recommended for effective treatment. An educational campaign around eating disorders specifically designed with the SA community in mind may improve awareness, reduce stigma and promote early help-seeking.

Therapists’ Experiences of Working with Ethnic Minority Females with Eating Disorders: A Qualitative Study

“…Participants reported a belief that shame impacted how females used therapy or accessed treatment. The present finding from the participants complements findings by three other UK studies which also suggest that shame is a barrier for ethnic minority people accessing treatment (Channa et al 2019 ; Chowbey et al 2012 ; Wales et al 2017 ).…”

“…Participants felt that female patients’ families also expressed explanations of EDs, which put physical conceptualisations ahead of discourse around psychological distress. Aligned with this is research that has suggested that some people in the Asian community look for physical causes, such as a ‘thyroid disorder’, to explain the weight changes seen in EDs (Wales et al 2017 ). Therapists queried whether this expression might be due to minimising weight and shape concern due to shame.…”

“…Most empirical studies of ethnic minority patients with EDs in the UK have been conducted on patients’ perspectives, with only two studies exploring the views of therapists (Chowbey, Salway, and Ismail 2012 ; Wales, Brewin, Raghavan, and Arcelus 2017 ). The perspective of therapists is therefore an under-researched area.…”

“What will people say?”: Mental health stigmatization as a barrier to eating disorder treatment-seeking for South Asian American women.

“…Similar to other mental illnesses, EDs are also highly stigmatized and poorly understood among SAs. For example, barriers to treatment-seeking identified in a qualitative study conducted with a nonclinical sample of SAs in the United Kingdom (U.K.) included a lack of knowledge about EDs, stigmatization of EDs in the SA community, and concerns about confidentiality when seeking care (Wales et al, 2017). These findings are similar to those of another qualitative study in the U.K., in which treatment-seeking SA women with EDs noted that their parents initially did not acknowledge their condition and only felt comfortable seeking services when it became clear their physical health was compromised (Hoque, 2011).…”

Stigmatising views towards individuals with eating disorders: trends and associations from 1998 to 2008 using a repeated cross-sectional design

“…21 This could be explained by lower rates of help-seeking, failure to identify eating disorders in these populations in primary care, or both. Qualitative studies have highlighted that lower mental health literacy and greater stigma towards mental health conditions are barriers towards help-seeking for eating disorders 22 and mental health problems in general in minority ethnic communities. 23 Interventions aimed at increasing mental health literacy therefore have multiple benefitsfrom encouraging greater helpseeking to reducing internalised stigma and improving people's quality of life.…”