South Asian youth mental health in Peel Region, Canada: Service provider perspectives

Abstract

The Peel Region of Toronto, Canada is home to over a third of the province's South Asian population. Youth are at a vulnerable time period in terms of their mental health. South Asian youth populations may face additional challenges to their mental health such as acculturative stress, intergenerational conflict, and racism and discrimination. This qualitative study set out to understand the mental health concerns and service access barriers experienced by South Asian youth populations in the Peel Region of Toronto, Canada from the perspective of mental health service providers. In-depth semi-structured interviews were carried out with mental health service providers (n = 22) who work with South Asian youth living in Peel Region. Thematic analysis was used to elucidate themes related to mental health stressors and service access barriers experienced by youth. According to mental health service providers, South Asian youth navigate a number of unique stressors related to the domains of culture, religion, and family dynamics, experiences of discrimination, the impact of migration, beliefs around mental illness and help-seeking, help-seeking trajectories and therapy recommendations, and lastly, sex differences. Mental health service providers outlined steps needed to effectively address the unique mental health challenges, best practice guidelines, and recommendations for working with South Asian youth, families, and communities to provide a practical and nuanced overview on how a multi-level strategy for mental health care can effectively meet the needs of South Asian youth populations.

A scoping review to identify opportunities and challenges for communities of South Asian (SA) origin in accessing mental health services and support in high- income countries

“…SA culture and stigma informed dominant MH beliefs, negative attitudes (questioning e cacy of socially stigmatised HCPs -psychiatrists), treatment acceptability (i.e. discordance with rigid care models like CBT even when ethnically-matched), poor MH self-acceptance and limits suitable alternatives (religious or cultural constraints) (43,44,(47)(48)(49)54,56,58).…”

“…Accessibility challenges included provider's preconceived notions and limited research on CALD people causing pathologisation of cultural experiences, in exible and untailored practice and limited recognition of MH-associated co-morbidities (i.e. eating disorder) resulting in poor self-acceptance of illnesses (44,47,48,50,58). These experiences foster mistrust and internalised stigma, compromise patient safety, amplify the burden on support networks and delay MH care (40,44,54,56,58) (40, 44,54,56,58).…”

“…eating disorder) resulting in poor self-acceptance of illnesses (44,47,48,50,58). These experiences foster mistrust and internalised stigma, compromise patient safety, amplify the burden on support networks and delay MH care (40,44,54,56,58) (40, 44,54,56,58). SA service users felt expected to become "cultural experts" to assist healthcare staff, which was associated with cultural and language challenges (43,50,56,58).…”

“…Amongst SA CALD people, the perceived needs and desire for care are not solely con ned to the individual experiencing MH issues; it can often be a projection of familial values and religious beliefs or re ect the collectivist SA culture (40- 42,44,48). Gendered burdens of shame in SA culture were found to silence women, reinforce gender roles and obstruct access to MH, portrayed as women's "shame" (39,40,48).…”

“…Gendered burdens of shame in SA culture were found to silence women, reinforce gender roles and obstruct access to MH, portrayed as women's "shame" (39,40,48). In SA communities, males and parents may control women's MH care by governing medical history, treatment and MH care re-engagement (39,44,54). This is especially relevant to SA marriage culture, which encourages hiding MH conditions (39,47,55).…”