Psychosocial Interventions for Common Mental disorders in British South Asians: Systematic Review

Problem

Published research has demonstrated that there is high prevalence of common mental disorders (mainly anxiety and depression) in British south Asians and is associated with increased episodes of self harm and suicide particularly amongst women. Lack of help seeking, poor recognition of symptoms in primary care, lack of appropriate services and under treatment is cited as major reasons behind this high prevalence. This is further compounded by lack of provision of evidence based psychosocial interventions for this hard to reach ethnic group as majority of clinical trials exclude participants who do not speak English. There is an immediate need to address this gap in service provision by developing psychosocial interventions that meet the cultural and linguistic needs of this ethnic group. Our review aimed to systematically search for all published studies that report evaluation of a culturally sensitive psychosocial intervention for common mental disorders among British South Asians. This will help in understanding what is the current availability of evidence based interventions, what has been the researchers past experience in developing these interventions and guide further reach into culturally sensitive intervention development and evaluation design.

Approach

We systematically searched PsycINFO, PubMed, and Medline databases from inception through December 2016. Inclusion criteria were psychosocial intervention studies reporting treatment of common mental disorder amongst British South Asians.

Findings

We identified 6 studies that met inclusion criteria. Four studies were small scale evaluations focusing on preliminary intervention development. Remaining two studies described RCT to evaluate effectiveness of an educational pamphlet in Indian women and psychosocial group intervention for Pakistani women, both in primary care. All studies described how the interventions addressed cultural aspects in design of intervention, recruitment, intervention delivery and retention of participants. Both interventions lead to reduction in depressive symptoms and were described to be acceptable by participants. There is no current evidence for any psychological therapy using cognitive behavioural or interpersonal approach amongst British South Asians.

Consequences

The limited evidence for psychosocial interventions to address common mental disorders among British South Asians appears promising but further research is needed. Both tested interventions need to be further evaluated in primary care based large multi centre trials to judge their effectiveness. It is also important to develop psychological interventions for these ethnic groups as currently there is not a single intervention available. The interventions need to be cultural sensitive and offer multi methods of delivery to improve access to these therapies. Inclusion of non English speaking research participants needs to be facilitated by training and supporting clinical researchers.