Barriers and Facilitators of Mental Health Service Utilisation among Bhutanese Refugees in the USA: Findings from a Mixed-Methods Study

Abstract

Although discussions regarding the need to develop culturally responsive mental health services for resettled refugee populations in the USA have been burgeoning, efforts to comprehensively understand the unique barriers and facilitators of mental health services across refugee subpopulations remain fragmented. Our study explored the barriers and facilitators of mental health services experienced by the resettled Bhutanese refugee population in a Midwestern city in the USA using a two-phased sequential explanatory mixed-methods study (N = 46). Study findings draw much needed attention to culturally grounded solutions generated by the community to reduce barriers and increase facilitators of mental health engagement. Building on community-generated solutions and expanding the capacity of local community-based ethnic organisations will be the first step in providing services that are truly responsive to the cultural needs of the Bhutanese refugee population. Recognition of refugee communities’ unique collective strengths will be much needed to holistically collaborate with these new members of the society to promote mental well-being and foster a sense of inclusion and belonging, especially in the post-coronavirus pandemic context. Our study also contributes to emerging knowledge on methodological rigor in research amongst understudied, hard-to-reach populations.

Exploring the Digital Divide among the Bhutanese Refugee Community during COVID-19: Engaged Research in Action

“…While many Bhutanese can communicate in English, less than 25% describe themselves as excellent speakers (see Figure 5 ). Nuances and metaphors can be a challenge as can highly technical speech and medical speech, this challenge is complicated when the native speaker is already coping with discriminatory practices around work and community engagement [ 16 , 34 , 35 ].…”

“…Additionally, the Bhutanese are at risk for high blood pressure, obesity and cardio-metabolic diseases [ 12 ]. Prior studies show that the Bhutanese refugee community also experience poor mental health, high levels of depression, anxiety, PTSD, suicide, and substance abuse [ 13 , 14 ], largely due to cumulative migration disadvantages and lack of culturally responsive services [ 15 , 16 ].…”

A Community-Based Needs Assessment of Resettled Syrian Refugee Children and Families in Canada

“…Numerous services have been developed to help refugees across economic (e.g., establishing financial independence), health (e.g., mental health sup-port), social (e.g., forming a new social network), and cultural (e.g., adjusting to a novel culture) domains (Praznik & Shields, 2018). Although these services provide vital support during a major transitional period, ensuring uptake by refugees remains a challenge because of cultural differences, financial constraints, mistrust, and long wait times (Salami et al, 2019;Soukenik et al, 2022;Tay et al, 2019). Language difficulties, feelings of loneliness, and acculturative stress were also found to impede refugees' engagement with supports (Woodgate et al, 2017).…”