Has psychological distress among UK South Asians been under‐estimated? A comparison of three measures in the west of Scotland population

Williams, Rory; Eley, Susan; Hunt, Kate; Bhatt, Sheila

doi:10.1080/13557858.1997.9961812

Cited by 30 publications

(26 citation statements)

References 21 publications

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“…If these high and low scores are indeed a true reflection of mental health, our data might concur with other research indicating worse mental health for migrant populations who have lived longest in the host country [17], [23]. However, data on the mental health of various ethnic minority groups living in the UK is far from congruent, with some surveys indicating a higher burden of distress among Indian [23], [44], Pakistani [9], [23], [44]–[46] and Asian women [12], others that South Asian women have less burden of illness [17], still others finding few differences in prevalence between Punjabi or White primary care attendees [47]. Explanations for differences include poor standardisation of screening and diagnostic instruments for cross-cultural use [17], [48], variation in classification of ethnic groups [49], and the consideration that the interaction between cultural, racial and ethnic identity might differ during the process of acculturation for individuals and populations [50].…”

Section: Discussionsupporting

confidence: 88%

Psychological Distress during Pregnancy in a Multi-Ethnic Community: Findings from the Born in Bradford Cohort Study

et al. 2013

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PurposeAntenatal anxiety and depression are predictive of future mental distress, which has negative effects on children. Ethnic minority women are more likely to have a lower socio-economic status (SES) but it is unclear whether SES is an independent risk factor for mental health in pregnancy. We described the association between maternal mental distress and socio-demographic factors in a multi-ethnic cohort located in an economically deprived city in the UK.MethodsWe defined eight distinct ethno-language groups (total N = 8,454) and classified a threshold of distress as the 75th centile of within-group GHQ-28 scores, which we used as the outcome for univariate and multivariate logistic regression for each ethnic group and for the sample overall.ResultsFinancial concerns were strongly and independently associated with worse mental health for six out of the eight ethnic groups, and for the cohort overall. In some groups, factors such as working status, education and family structure were associated with worse mental health, but for others these factors were of little importance.ConclusionsThe diversity between and within ethnic groups in this sample underlines the need to take into consideration individual social, migration and economic circumstances and their potential effect on mental health in ethnically diverse areas.

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Section: Discussionsupporting

confidence: 88%

Psychological Distress during Pregnancy in a Multi-Ethnic Community: Findings from the Born in Bradford Cohort Study

et al. 2013

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“… 24 The distress reported by our respondents reinforces concern that significant psychological ill health amongst South Asian communities may exist but go unnoticed 8 . 25 , 26 Whilst respondents were receptive to neutral listening, most sought more active socially orientated support. This may add to current debate about the lack of sustained benefit from counselling alone in those at risk of mental ill health 27 .…”

Section: Discussionmentioning

confidence: 99%

“…Respondents' perceptions of primary health care professionals may explain why some South Asians might appear less willing to declare psychological problems to GPs 34 . They may add to the debate about somatization of distress amongst South Asians 26 and its possible implications for under‐detection of psychological ill health 34 . 35 Concepts of health and illness may differ between cultures and communication difficulties may occur when assessing someone of another culture, particularly if compounded by language barriers.…”

Section: Discussionmentioning

confidence: 99%

Minority ethnic community participation in needs assessment and service development in primary care: perceptions of Pakistani and Bangladeshi people about psychological distress

Kai

Hedges

1999

Health Expectations

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OBJECTIVES: To promote community participation in exploring perceptions of psychological distress amongst Pakistani and Bangladeshi people, in order to develop appropriate services. DESIGN: Training and facilitation of resident community members (as community project workers), to define and conduct qualitative research involving semistructured interviews in their own communities, informing primary care led commissioning and service decision making. Setting A socio-economically disadvantaged inner-city locality in the UK. Participants One-hundred and four South Asian people (49 of Pakistani and 55 of Bangladeshi origin), interviewed by 13 resident community members. RESULTS: All community project workers completed training leading to a National Vocational Qualification, and successfully executed the research. Most study respondents located their main sources of stress within pervasive experience of racism and socio-economic disadvantage. They were positive about 'talking' and neutral listening as helpful, but sought strategies beyond non-directive counselling services that embraced practical welfare advice and social support. The roles of primary health care professionals were believed to be restricted to physical ill health rather than personal distress. The importance of professionals' sex, age, ethnicity and social status were emphasized as affecting open communication. Practical recommendations for the re-orientation and provision of services were generated and implemented in response to the findings, through dialogue with a primary care commissioning group, Health and Local Authority, and voluntary agencies. CONCLUSIONS: The work illustrates the feasibility and value of a community participation approach to research and service development in addressing a challenging and neglected area of minority ethnic health need. It offers one model for generating responsive service change in the context of current health policy in the UK, whilst also imparting skills and empowering community members. The study findings emphasize the need to recognize the social contexts in which distress is experienced and have implications for effective responses.

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“…Among female subjects, there are significant British Asian advantages at age 14-15 in limiting illness and chronic phlegm, which were not present in the mainly migrant group at age 30-40, and the migrant group's substantial disadvantage in self rated health (probably influenced by high levels of psychological distress) 17 has disappeared. On the other hand a significant advantage in the migrant group's experience of accidents is also no longer present.…”

Section: Resultsmentioning

confidence: 96%

Generational continuity and change in British Asian health and health behaviour

Williams

Shams²

1998

Journal of Epidemiology & Community Health

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Objectives-To trace patterns of health and health behaviour in those with ancestry in the Indian subcontinent (British Asians) compared with the general population of their age (1) in the younger generation age 14-15 mainly born in the UK and (2) in the older mainly migrant generation. Design-Cross sectional random sample surveys of two age groups in Glasgow. (J Epidemiol Community Health 1998;52:558-563) The health behaviour of British Asians (those with ancestry in the Indian subcontinent) is generally thought to be advantageous for health. Even allowing for variations within heterogeneous British Asian communities, the general picture is favourable whether in regard to smoking, drinking or diet, 1 2 and only exercise levels seem to be unfavourable. Samples-334 3However, the health of these communities does not seem to have benefited as much as it should from their generally exemplary behaviour. Low levels of lung cancer are not matched by low levels of heart disease, and respiratory health too does not seem to show the advantages that might be expected from such low smoking levels, particularly among women. It is true that while migrant women of South Asian descent show a number of health disadvantages, migrant men show a number of advantages in relation to the majority of population, and this is evident both in studies of mortality, 4 5 and morbidity. 6 The male advantage, however, tends to be put down to positive selection for health at the time of migration, though this has been assumed rather than tested.It would be tempting, in this situation, for the younger generation of British Asians to conclude that good behaviour does not pay; and certainly the health record does not provide much counterweight to the powerful pressures drawing them towards conformity with the norms of their peers in the majority population. Although earlier studies have shown health behaviour in young British Asians that continues to diVer from the patterns of the majority population in broadly similar ways to that of their parents, 7 it has not been possible without more accurate comparisons to assess how far these diVerences are eroding. Meanwhile little is known of the general health of young British Asians, or, consequently, of whether their health is as unrelated to their health behaviour as it is in the migrant generation.An opportunity to explore these issues is provided by a school-based study of 14-15 year olds from the British Asian and general populations, nearly all born in the UK, which asked similar questions on health and health behaviour to a community survey of migrant South Asians and the general population aged 30-40, both studies taking place in the same city. This report considers the following questions:(1) What pattern of health advantages and disadvantages do young British Asians show compared with the majority population?(2) What patterns of health behaviour do they show compared with the majority population, at the age when addictive behaviours tend to be tried out?

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Has psychological distress among UK South Asians been under‐estimated? A comparison of three measures in the west of Scotland population

Abstract: Clinical measures may have under-estimated distress in several South Asian groups. The results may be due to a preference for a particular language of emotion in the affected groups or to a higher frequency of stressful situations which provoke distinctive reactions.

Cited by 30 publications

References 21 publications

Psychological Distress during Pregnancy in a Multi-Ethnic Community: Findings from the Born in Bradford Cohort Study

Psychological Distress during Pregnancy in a Multi-Ethnic Community: Findings from the Born in Bradford Cohort Study

Minority ethnic community participation in needs assessment and service development in primary care: perceptions of Pakistani and Bangladeshi people about psychological distress

Generational continuity and change in British Asian health and health behaviour

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