Pakistani women's use of mental health services and the role of social networks: a systematic review of quantitative and qualitative research

Kapadia, Dharmi; Brooks, Helen; Nazroo, James; Tranmer, Mark

doi:10.1111/hsc.12305

Cited by 26 publications

(25 citation statements)

References 38 publications

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“…Thus, results cannot be generalized across minority groups based on ethnicity or sexuality. There is some evidence from other countries that some groups within LGBT communities and ethnic minorities are more at risk from MH crises and in need of supportive networks due to increased health needs coupled with limited access to social resources . Despite this, the study also has strengths.…”

Section: Discussionmentioning

confidence: 99%

How do people with long‐term mental health problems negotiate relationships with network members at times of crisis?

Walker

Kennedy

Vassilev

et al. 2017

Health Expectations

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BackgroundSocial network processes impact on the genesis and management of mental health problems. There is currently less understanding of the way people negotiate networked relationships in times of crisis compared to how they manage at other times.ObjectiveThis paper explores the patterns and nature of personal network involvement at times of crises and how these may differ from day‐to‐day networks of recovery and maintenance.MethodSemi‐structured interviews with 25 participants with a diagnosis of long‐term mental health (MH) problems drawn from recovery settings in the south of England. Interviews centred on personal network mapping of members and resources providing support. The mapping interviews explored the work of network members and changes in times of crisis. Interviews were recorded, transcribed and analysed using a framework analysis.ResultsThree key themes were identified: the fluidity of network relationality between crisis and recovery; isolation as a means of crises management; leaning towards peer support. Personal network input retreated at times of crisis often as result of “ejection” from the network by participants who used self‐isolation as a personal management strategy in an attempt to deal with crises. Peer support is considered useful during a crisis, whilst the role of services was viewed with some ambiguity.ConclusionsSocial networks membership, and type and depth of involvement, is subject to change between times of crisis and everyday support. This has implications for managing mental health in terms of engaging with network support differently in times of crises versus recovery and everyday living.

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Section: Discussionmentioning

confidence: 99%

How do people with long‐term mental health problems negotiate relationships with network members at times of crisis?

Walker

Kennedy

Vassilev

et al. 2017

Health Expectations

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“…Previous reviews have identified cultural factors that may influence help-seeking for South Asian groups. These include stigma [ 21 ], collectivist values and pluralistic treatment options [ 22 ], as well as religious beliefs and somatisation [ 15 ]. Although these findings highlight the role of individual differences and cultural “explanatory models” in help-seeking, they neglect the roles of systemic sociopolitical factors in causing and contributing to distress and healthcare systems in perpetuating underutilisation through their ongoing failures to address institutional racism and ethnic inequalities.…”

Section: Introductionmentioning

confidence: 99%

Accessing Mental Health Services: a Systematic Review and Meta-ethnography of the Experiences of South Asian Service Users in the UK

Prajapati

Liebling

2021

J. Racial and Ethnic Health Disparities

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Background Despite calls to address ethnic inequalities to accessing mental health services in the UK, governmental initiatives have had limited impact. Studies indicate that South Asian communities underutilise mental health services. Previous reviews have identified cultural and institutional factors that may influence service use, but these are mostly narrative and limited in their scope. Method A systematic literature search resulted in fifteen studies exploring the experiences of seeking help and barriers to accessing and using services from the perspective of British South Asian service users. Findings Qualitative data was synthesised through meta-ethnography, and three themes emerged: Distanced from Services, Dilemma of Trust and Threat to Cultural Identity. South Asian service users were positioned at a distance from being able to access services and stuck in a dilemma of mistrusting White and Asian professionals. They constructed their cultural identity through a set of important values which were neglected by mental health services. Service users, therefore, appeared to engage in an ongoing evaluation of the potential benefits of accessing services against the risks of threat to their personal and cultural identities. The findings are discussed in relation to Eurocentric models of care and community engagement approaches. Conclusion The review argues that institutional racism and cultural dissonance marginalise South Asian service users from access to quality and effective mental healthcare. It is recommended that services acknowledge the impact of alienation and powerlessness and advance their practices to establish trust and cultural safety for South Asian service users in the UK.

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“…For example, research has suggested that those from middle class backgrounds are more likely to participate in healthcare decisions than their counterparts [ 39 ]. Additionally, those from different ethnicities may have raised different issues [ 40 ]. Focus groups involved both service user and carer participants and, whilst this did not appear to be the case, it should be acknowledged that this might have impacted on the level of disclosure from service users and/or carers.…”

Section: Discussionmentioning

confidence: 99%

Exploring the potential implementation of a tool to enhance shared decision making (SDM) in mental health services in the United Kingdom: a qualitative exploration of the views of service users, carers and professionals

Brooks

Harris

Bee

et al. 2017

Int J Ment Health Syst

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BackgroundAs a response to evidence that mental health service users and carers expect greater involvement in decisions about antipsychotic medication choice and prescribing, shared decision-making (SDM) has increasingly come to be viewed as an essential element of person-centred care and practice. However, this aspiration has yet to be realised in practice, as service users and carers continue to feel alienated from healthcare services. Existing understanding of the factors affecting the use of tools to support SDM is limited to inter-individual influences and wider factors affecting potential implementation are underexplored.AimTo explore the potential use of a tool designed to enhance collaborative antipsychotic prescribing from the perspectives of secondary care mental health service users, carers and professionals.MethodsWe conducted a qualitative study (semi-structured interviews and focus groups) using a convenience sample of 33 participants (10 mental health service users, 10 carers and 13 professionals) involved in antipsychotic prescribing in one Trust in the North of England. Participants were asked about the potential implementation of a tool to support SDM within secondary mental health services. Framework analysis incorporating the use of constant comparative method was used to analyse the data.ResultsThe study identified a divergence in the views of service users and professionals, including a previously undocumented tendency for stakeholder groups to blame each other for potential implementation failure. This dissonance was shaped by meso and macro level influences relating to paternalism, legislative frameworks, accountability and lack of resources. Participants did not identify any macro level (policy or structural) facilitators to the use of the tool highlighting the negative impact of mental health contexts. Our study indicated that inter-individual factors are likely to be most important to implementation, given their potential to transcend meso and macro level barriers.ConclusionsConsideration of the meso and macro level influences identified areas for potential intervention, including challenging professionals’ and service users’ perceptions of each other, rebalancing the notion of accountability within services and introducing new means for service user feedback on the quality of SDM. Multi-level strategies for facilitating the implementation of tools to support SDM are also presented.

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Pakistani women's use of mental health services and the role of social networks: a systematic review of quantitative and qualitative research

Cited by 26 publications

References 38 publications

How do people with long‐term mental health problems negotiate relationships with network members at times of crisis?

How do people with long‐term mental health problems negotiate relationships with network members at times of crisis?

Accessing Mental Health Services: a Systematic Review and Meta-ethnography of the Experiences of South Asian Service Users in the UK

Exploring the potential implementation of a tool to enhance shared decision making (SDM) in mental health services in the United Kingdom: a qualitative exploration of the views of service users, carers and professionals

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