BackgroundStigma related to mental illness affects all ethnic groups, contributing to the production and maintenance of mental illness and restricting access to care and support. However, stigma is especially prevalent in minority communities, thus potentially increasing ethnically based disparities. Little is known of the links between stigma and help‐seeking for mental illness in African‐descended populations in the UK.Objective and study designBuilding on the evidence that faith‐based organizations (FBOs) can aid the development of effective public health strategies, this qualitative study used semi‐structured interviews with faith groups to explore the complex ways in which stigma influences help‐seeking for mental illness in African‐descended communities. A thematic approach to data analysis was applied to the entire data set.Setting and participantsTwenty‐six men and women who had varying levels of involvement with Christian FBOs in south London were interviewed (e.g. six faith leaders, thirteen ‘active members’ and seven ‘regular attendees’).ResultsKey factors influencing help‐seeking behaviour were as follows: beliefs about the causes of mental illness; ‘silencing’ of mental illness resulting from heightened levels of ideological stigma; and stigma (re)production and maintenance at community level. Individuals with a diagnosis of mental illness were likely to experience a triple jeopardy in terms of stigma.Discussion and conclusion‘One‐size‐fits‐all’ approaches cannot effectively meet the needs of diverse populations. To ensure that services are more congruent with their needs, health and care organizations should enable service users, families and community members to become active creators of interventions to remove barriers to help‐seeking for mental illness.
the importance of social positioning of migrants in terms of the cluster of negative aspects and environmental disadvantage generally experienced by most immigrants in the host country is raised in this paper. Care practices of pregnant women with complex social factors were little observant of woman-centred care approaches.
Over the last decade, Britain has undergone reforms to promote engagement in local structures of governance. These reforms have encouraged the promotion of active citizenship and have been central to the government's public service modernisation agenda. This article presents the findings from a study evaluating a pilot outreach intervention which adopted a community engagement model to address the mental health needs of African and African Caribbean groups, which entailed a partnership between faith‐based organisations, local public services and community organisations to co‐produce the pilot project. Lay people were trained to raise awareness about mental health among these communities in South London. Between 2012 and 2013, a qualitative participatory approach was used to evaluate the pilot project, which enabled a researcher to take part in the engagement phase of the pilot project, and the project co‐ordinators to be involved in the research process. Semi‐structured, one‐to‐one interviews were carried out with 13 community and well‐being champions (CWBCs) recruited from African and African Caribbean communities (seven male and six female). This study examines the impact of the relationship between the intervention and community through the participants’ engagement in the pilot outreach project and the action undertaken as champions. We found that although CWBCs used circles of influence to share ideas about mental health and well‐being and to encourage change, they encountered resistance on the part of the people they engaged with, which resulted from a lack of knowledge about mental health, taboos and ascribed stigma. We argue that CWBCs acted as healthy examples to communicate mental health knowledge to those approached, but that they needed to be equipped with bespoke communication skills to be able to talk about such sensitive issues as mental health.
In this study, we explore the role that isolation and loneliness play in the narratives of women diagnosed with perinatal depression. Isolation and loneliness are increasingly seen as risk factors for depression, including in the perinatal period, but little is known about whether, and in what ways, women themselves associate isolation or loneliness with perinatal distress. Based on the thematic analysis of semi-structured interviews with fourteen mothers in England, we found that women often connected feelings of depression during and after pregnancy to feeling dislocated from their previous identities and relationships. Women felt lost, confined to their homes, and often unsupported by their partners and families. However, fears of being judged to be inadequate mothers made it difficult for women to make authentic connections with others or to express negative feelings, increasing isolation and depression. We drew on the intersectionality theory to illustrate how the intersect between motherhood and other aspects of women’s identities (being young, single, deprived and/or from an ethnic minority) could leave some women particularly isolated and marginalised. Our conclusions emphasise the need to challenge social constructions of the good/bad mother, advocate for social change to lessen pressures on mothers, and develop support that addresses women’s interpersonal contexts and social networks.
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