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BMC Psychiatry
Published in: BMC Psychiatry 1/2016

Open Access 01-12-2016 | Research article

Sub-Saharan African migrant youths’ help-seeking barriers and facilitators for mental health and substance use problems: a qualitative study

Published in: BMC Psychiatry | Issue 1/2016

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Abstract

Background

Many young migrants and their parents are reluctant to seek help for mental health and substance use problems. Help-seeking delays can result in longer duration of untreated problems and poorer outcomes. In this study, we aimed to identify the help-seeking barriers and facilitators for anxiety, depression and alcohol and drug use problems in young people from recently established sub-Saharan African migrant communities.

Methods

A qualitative study, incorporating individual, in-depth interviews and focus group discussions, was undertaken in Melbourne, Australia. Twenty-eight young sub-Saharan African migrants participated in the individual interviews, and 41 sub-Saharan African-born parents and key community leaders participated in 4 focus groups. All participants were aged 16 years or over. A thematic analysis of the data was undertaken.

Results

Themes and related sub-themes were abstracted from the data, reflecting the young people’s, parents’ and key community leaders’ beliefs about barriers and facilitators to help-seeking for mental health and substance use problems. Four help-seeking barriers were identified: stigma of mental illness, lack of mental health literacy in parents and young people, lack of cultural competency of formal help sources, and financial costs deterring access. Five help-seeking facilitators were abstracted: being open with friends and family, strong community support systems, trustworthiness and confidentiality of help-sources, perceived expertise of formal help-sources, increasing young people’s and parents’ mental health literacy.

Conclusion

Programs that identify and build on help-seeking facilitators while addressing help-seeking barriers are needed to address mental health issues among young sub-Saharan African migrants. Strategies to address help-seeking barriers should consider counteracting stigma and increasing mental health literacy in sub-Saharan African communities, increasing health providers’ cultural competency and perceived trustworthiness, and addressing financial barriers to accessing services.
Literature
1.
Australian Bureau of Statistics. Migration, Australia, 2011-12 and 2012-13, cat.no. 3412.0. Canberrra: ABS; 2013.
2.
Berry JW. Immigration, acculturation, and adaptation. Appl Psychol Int Rev. 1997;46(1):5–34.
3.
Renzaho AMN. Immigration and social exclusion: examining health inequalities of immigrants through acculturation lenses. In: Taket A, Crisp B, Nevill A, Lamaro G, Graham M, Barter-Godfrey S, editors. Theorising Social Exclusion. Oxford: Routledge; 2009. p. 117–26.
4.
Renzaho AMN, Green J, Mellor D, Swinburn B. Parenting, family functioning and lifestyle in a new culture: the case of African migrants in Melbourne, Victoria, Australia. Child Fam Soc Work. 2011;16(2):228–40.CrossRef
5.
Renzaho AMN, McCabe M, Sainsbury WJ. Parenting, role reversals and the preservation of cultural values among Arabic speaking migrant families in Melbourne, Australia. Int J Intercult Rel. 2010;35(4):416–24.CrossRef
6.
Australian Institute of Health and Welfare. Young Australians, their health and wellbeing 2011. Canberra: AIHW; 2011.
7.
Reavley NJ, Cvetkovski S, Jorm AF, Lubman DI: Help-seeking for substance use, anxiety and affective disorders among young people: results from the. Australian National Survey of Mental health and Wellbeing. Aust N Z J Psychiatry. 2007;2010(44):729–35.
8.
Kessler RC, Foster CL, Saunders WB, Stang PE. Social consequences of psychiatric disorders, I: Educational attainment. A J Psychiatry. 1995;152(7):1026–32.CrossRef
9.
Centre for Multicultural Youth. Migrant and refugee young people negotiating adolescence in Australia. Carlton: Centre for Multicultural Youth; 2014.
10.
Office of Multicultural Interests. “Not drowning, waving”: culturally and linguistically diverse young people at risk in Western Australia. In: Perth Office of Multicultural Interests. 2009.
11.
Posselt M, Galletly C, de Crespigny C, Procter N. Mental health and drug and alcohol comorbidity in young people of refugee background: a review of the literature. Ment Health Subst Use. 2014;7(1):19–30.CrossRef
12.
Newbold B. Health status and health care of immigrants in Canada: a longitudinal analysis. J Health Serv Res Policy. 2005;10(2):77–83.CrossRefPubMed
13.
de Anstiss H, Ziaian T. Mental health help-seeking and refugee adolescents: qualitative findings from a mixed-methods investigation. Aust Psychol. 2010;45(1):29–37.CrossRef
14.
Edge D, MacKian SC. Ethnicity and mental health encounters in primary care: help-seeking and help-giving for perinatal depression among Black Caribbean women in the UK. Ethn Health. 2010;15(1):93–111.CrossRefPubMed
15.
Patel V, Flisher AJ, Hetrick S, McGorry P. Mental health of young people: a global public-health challenge. Lancet. 2007;369(9569):1302–13.CrossRefPubMed
16.
Teunissen E, Sherally J, van den Muijsenbergh M, Dowrick C, van Weel-Baumgarten E, van Weel C. Mental health problems of undocumented migrants (UMs) in The Netherlands: a qualitative exploration of help-seeking behaviour and experiences with primary care. BMJ Open. 2014;4(11):e005738.CrossRefPubMedPubMedCentral
17.
Lindert J, Schouler-Ocak M, Heinz A, Priebe S. Mental health, health care utilisation of migrants in Europe. Eur Psychiatry. 2008;23 Suppl 1:14–20.CrossRefPubMed
18.
Jorm AF, Korten AE, Jacomb PA, Christensen H, Rodgers B, Pollitt P. “Mental health literacy”: a survey of the public’s ability to recognise mental disorders and their beliefs about the effectiveness of treatment. Med J Aust. 1997;166:182–6.PubMed
19.
Browne JL, Renzaho AMN. Prevention of alcohol and other drug problems in culturally and linguistically diverse communities. In: Issues Paper no13. Melbourne: Drug Info Clearinghouse; 2010.
20.
Donato-Hunt C, Munot S, Copeland J. Alcohol, tobacco and illicit drug use among six culturally diverse communities in Sydney. Drug Alcohol Rev. 2012;31(7):881–9.CrossRefPubMed
21.
Reid G, Crofts N, Beyer L. Drug Treatment Services for Ethnic Communities in Victoria, Australia: an examination of cultural and institutional barriers. Ethn Health. 2001;6(1):13–26.CrossRefPubMed
22.
Corrigan PW, Watson AC. The paradox of self-stigma and mental illness. Clin Psychol Sci Pract. 2002;9:35–53.CrossRef
23.
Sowey H. Are refugees at increased risk of substance misuse? Sydney: Drug and Alcohol Multicultural Education Centre; 2005.
24.
Selvamanickam S, Zgryza M, Gorman D. Coping in the new world: the social and emotional wellbeing of young people from culturally and linguistically diverse backgrounds. Queensland: Queensland Transcultural Mental Health Centre, Queensland Health and Youth Affairs Network of Queensland Inc.; 2001.
25.
House F. Responding to challenges of misuse of alcohol and other drugs by young people of refugee backgrounds: Reflections from two projects. Brunswick: Foundation House; 2013.
26.
Roche A, Bywood P, Borlagdan J, Lunnay B, Freeman T, Lawton L, Nicholas R. Young people and alcohol: the role of cultural influences. Adelaide: National Centre for Education and Training on Addiction, Flinders University; 2007.
27.
Room R. Preventing youthful substance use and harm - between effectiveness and political wishfulness. Subst Use Misuse. 2012;47(8–9):936–43.CrossRefPubMed
28.
McMichael C, Gifford S, Correa-Velez I. Negotiating family, navigating resettlement: family connectedness amonst resettled youth with refugee backgrounds living in Melbourne, Australia. J Youth Stud. 2011;14(2):179–95.CrossRef
29.
Swinburn B. Parenting, family functioning and lifestyle in a new culture: the case of African migrants in Melbourne, Victoria, Australia. Child Fam Soc Work. 2011;16:228–40.CrossRef
30.
McCann TV, Lubman DI. Young people with depression and their experience accessing an enhanced primary care service for youth with emerging mental health problems: a qualitative study. BMC Psychiatry. 2012;12:96.CrossRefPubMedPubMedCentral
31.
32.
Patton MQ. Qualitative research and evaluation methods. 3rd ed. Thousand Oaks: Sage; 2002.
33.
Denzin NK. The research act: a theoretical introduction to sociological methods. 3rd ed. Englewood Cliffs: Prentice Hall; 1989.
34.
Lambert SD, Loiselle CG. Combining individual interviews and focus groups to enhance data richness. J Adv Nurs. 2008;62(2):228–37.CrossRefPubMed
35.
Parahoo K. Nursing research: principles, process and issues. 3rd ed. Basingstoke, Hampshire: Palgrave/Macmillan; 2014.CrossRef
36.
Guba EG, Lincoln YS. Paradigmatic controversies, contradictions, and emerging confluences. In: Denzin NK, Lincoln YS, editors. Sage handbook of qualitative research. 3rd ed. Thousand Oaks: Sage; 2005. p. 191–215.
37.
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.CrossRef
38.
Holloway I, Wheeler S. Qualitative research in nursing and healthcare. 3rd ed. Oxford: Wiley-Blackwell; 2010.
39.
Morse J. The significance of saturation [Editorial]. Qual Health Res. 1995;5(2):147–9.CrossRef
40.
41.
Hill CE, Knox S, Thompson BJ, Nutt Williams E, Hess SA, Ladany N. Consensual qualitative research: an update. J Couns Psychol. 2005;52(2):196–205.CrossRef
42.
Mishra SI, Lucksted A, Gioia D, Barnet B, Baquet CR. Needs and preferences for receiving mental health information in an African American focus group sample. Community Ment Health J. 2009;45(2):117–26.CrossRefPubMed
43.
Clement S, Schauman O, Graham T, Maggioni F, Evans-Lacko S, Bezborodovs N, Morgan C, Rusch N, Brown JS, Thornicroft G. What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol Med. 2015;45(1):11–27.CrossRefPubMed
44.
McCann TV, Lubman DI, Clark E. Responding to stigma: first-time caregivers of young people with first-episode psychosis. Psychiatr Serv. 2011;62(5):548–50.CrossRefPubMed
45.
Amri S. Mental health help-seeking behaviors of muslim immigrnats in the United States: overcoming social stigma and cultural mistrust. J Muslim Ment Health. 2013;7(1):43–63.CrossRef
46.
Gerson R, Davidson L, Booty A, Wong C, McGlashan T, Malespina D, Pincus HA, Corcoran C. Families’ experience with seeking treatment for recent-onset psychosis. Psychiatr Serv. 2009;60(6):812–6.CrossRefPubMedPubMedCentral
47.
Larson JE, Corrigan P. The stigma of families with mental illness. Acad Psychiatry. 2008;32(2):87–91.CrossRefPubMed
48.
Sheikh-Mohammed M, Macintyre CR, Wood NJ, Leask J, Isaacs D. Barriers to access to health care for newly resettled sub-Saharan refugees in Australia. Med J Aust. 2006;185(11–12):594–7.PubMed
49.
Hugo CJ, Boshoff DE, Traut A, Zungu-Dirwayi N, Stein DJ. Community attitudes toward and knowledge of mental illness in South Africa. Soc Psychiatry Psychiatr Epidemiol. 2003;38(12):715–9.CrossRefPubMed
50.
Kelly CM, Jorm AF, Wright A-M. Improving mental health literacy as a strategy to facilitate early intervention for mental disorders. Med J Aust. 2007;187(7):S26–30.PubMed
51.
Bhui K, Warfa N, Edonya P, McKenzie K, Bhugra D. Cultural competence in mental health care: a review of model evaluations. BMC Health Serv Res. 2007;7:15.CrossRefPubMedPubMedCentral
52.
Stark J. Mental health system’s focus on ‘white middle-class Australia’ costs lives. Sydney: Sydney Morning Herald; 2015.
53.
Rowan K, McAlpine D, Blewett L. Access and cost barriers to mental health care by insurance status, 1999 to 2010. Health Aff. 2013;32(10):1723–30.CrossRef
54.
55.
McCann TV, Lubman DI, Clark E. Views of young people with depression about family and significant other support: interpretative phenomenological analysis study. Int J Ment Health Nurs. 2012;21(5):453–61.CrossRefPubMed
56.
Thompson R, Dancy BL, Wiley TRA, Najdowski CJ, Perry SP, Wallis J, Mekawi Y, Knafl K. African American families’ expectations and intentions for mental health services. Adm Policy Ment Health Serv Res. 2013;40(5):371–83.CrossRef
57.
McCann TV, Lubman DI. Young people with depression and their satisfaction with the quality of care they receive from a primary care youth mental health service: a qualitative study. J Clin Nurs. 2012;21:2179–87.CrossRefPubMed
58.
Hutchinson SA. Grounded theory: the method. In: Munhall PL, Oiler Boyd C, editors. Nursing research: a qualitative perspective. 2nd ed. New York: National League for Nursing; 1993. p. 180–212.
59.
Sandelowski M. Rigor or rigor mortis: the problem of rigor in qualitative research revisited. Adv Nurs Sci. 1993;16(2):1–8.CrossRef
60.
Green J. Generalisability and validity in qualitative research. Br Med J. 1999;319:421.CrossRef
Metadata
Title
Sub-Saharan African migrant youths’ help-seeking barriers and facilitators for mental health and substance use problems: a qualitative study
Publication date
01-12-2016
Published in
BMC Psychiatry / Issue 1/2016
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-016-0984-5

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