A qualitative study exploring perspectives of emotional distress in men of south Asian origin and GPs serving them
Background:
People with physical-mental comorbidity have a poorer quality of life, worse clinical outcomes and increased mortality than those with physical conditions alone.
People from some ethnic groups are less likely to recognise and seek help for symptoms which may represent mental health problems, and are an under-served group within healthcare services. South Asians (SAs) are the largest minority group in the UK, and are more likely to have certain long-term conditions (LTCs) such as diabetes and heart disease.
The approach:
Qualitative study using semi-structured interviews to explore the perspectives of men of SA origin with LTCs, on the experiences and help-seeking, for emotional distress. The term emotional distress was chosen as it encompasses distress which can cause significant suffering, yet may not be diagnosed. Recruitment from community settings is ongoing. Interviews also conducted with GPs. Thematic analysis and iterative modification of topic guides.
An ethnically appropriate PPIE group has been convened and is working according to the INVOLVE principles.
Findings:
Initial analysis suggests the following themes are important. De-medicalising distress is central, including distress associated with physical illness, the importance of the social determinants of distress, challenges of living between two cultures, and concepts of black magic. Help-seeking behaviour is influenced by trust in religion, and a lack of trust in medical professionals. Priorities to improve care include building trust in GPs, overcoming prejudice and working towards relationship-based holistic care. Participants described the need for culturally and linguistically-appropriate services.
Implications:
This study will increase awareness of emotional distress, which should inform the recognition, management for emotional distress in men of SA origin with LTCs. As well as academic routes of dissemination which may influence policy-makers and commissioners about service provision, learning will be shared with the SA community via a community event, written resources and an animation video.
Statement of funding (if appropriate):