Factors Influencing Beliefs about Mental Health Difficulties and Attitudes Towards Seeking Help Amongst Nepalese people in the United Kingdom

Abstract

Research shows that in the UK, individuals from black and minority ethnic backgrounds are significantly less likely to access mental health services than the general population. In the absence of literature or robust mental health service access figures for Nepalese people living in the UK (NLU) there is little understanding of the mental health needs and help-seeking preferences of this group. This study aimed to examine factors which are associated with professional help-seeking for mental health difficulties in NLU. The Theory of Planned Behaviour (Ajzen, 1985) was used as a guiding theoretical framework to examine the strongest predictors of intention to seek professional help. Potential predictors, shame/izzat, acculturation, beliefs about the causes of mental distress and demographic variables were measured. The sample were 65 NLU recruited from community centres, health events and online groups across the UK. Results indicated that although a significant number of NLU reported having experienced mental health difficulties, very few had sought professional help. A number of variables significantly correlated with intention to seek professional help, including level of acculturation, non-Western physiological causal beliefs and izzat. According to a multiple-regression analysis of the whole sample, izzat was the most strongly related to intention to seek professional help. A number of barriers to help-seeking were identified such as hoping problems would go away or not wanting to burden others. A significant strength of the study was the use of both Nepalese and English language questionnaires which ensured that a large non-English speaking section of the NLU population was not excluded from the study. Limitations include methodological considerations such as the use of one measure which appeared to have limited validity. Furthermore, the exclusion of illiterate individuals by merit of using a self-report questionnaire limits the generalisability of these findings to the NLU more widely. Low mental health service access rates were identified within this sample relative to the prevalence of mental health difficulties. The clinical implications of this study highlight the need for policy and service level strategies to increase service access rates and the need for mental health services which are sensitive to the culturally specific issues within the population.