Jain Ruchika, Kakuma Ritsuko, Singla Daisy R, Andresen Kirsty, Bahkali Khawater, Nadkarni Abhijit
Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto, Canada.
Transcult Psychiatry. 2025 Apr;62(2):241-264. doi: 10.1177/13634615241296302. Epub 2025 Jan 9.
Mental health service use by individuals of South Asian origin living outside of South Asia is influenced by cultural factors such as endorsing psycho-social-spiritual over biological explanations, somatisation, and stigma. The aim of this review is to synthesise the evidence about (a) explanatory models of common mental disorders (CMDs) among people of South Asian origin residing in high-income countries, and (b) their help-seeking for CMDs, including formal and informal care. The systematic review protocol was registered a priori on Prospero (registration number CRD42021287583). We ran extensive searches on explanatory models and help-seeking of people of South Asian origin across five databases (MEDLINE, Embase, Cumulated Index to Nursing and Allied Health (CINAHL), PsycINFO, and Global Health). We extracted the data and conducted a narrative synthesis. We included 33 reports and 29 studies (9,030 participants). The participants in the included studies viewed CMDs through a psychosocial rather than a biological lens (e.g., resulting from family issues vs. neurotransmitters). Causal attributions included life stressors and attitudinal and religious/spiritual factors. Commonly used help-seeking strategies included private coping (i.e., crying or praying), speaking to friends and family, and visiting their General Practitioner. We can conclude that cultural factors play an important role in how South Asian individuals experience and understand CMDs. To cope, they use pluralistic help-seeking strategies. Implications for clinical practice and policy include increasing research on the explanatory models of CMDs, involving family in services, and developing community-based interventions for individuals who do not engage with formal care.
生活在南亚以外地区的南亚裔个体对心理健康服务的使用受到文化因素的影响，比如倾向于从心理社会 - 精神层面而非生物学角度进行解释、躯体化以及污名化。本综述的目的是综合有关以下两方面的证据：（a）居住在高收入国家的南亚裔人群中常见精神障碍（CMDs）的解释模型；（b）他们针对CMDs的求助行为，包括正式和非正式护理。该系统综述方案已事先在国际系统评价注册库（Prospero）上注册（注册号CRD42021287583）。我们在五个数据库（医学文献数据库（MEDLINE）、荷兰医学文摘数据库（Embase）、护理及相关健康累积索引数据库（CINAHL）、心理学文摘数据库（PsycINFO）和全球健康数据库）中对南亚裔人群的解释模型和求助行为进行了广泛检索。我们提取了数据并进行了叙述性综合分析。我们纳入了33份报告和29项研究（9030名参与者）。纳入研究中的参与者通过心理社会而非生物学视角看待CMDs（例如，认为是由家庭问题而非神经递质导致）。因果归因包括生活压力源以及态度和宗教/精神因素。常用的求助策略包括私下应对（如哭泣或祈祷）、与朋友和家人交谈以及拜访全科医生。我们可以得出结论，文化因素在南亚裔个体如何体验和理解CMDs方面起着重要作用。为了应对，他们采用多元化的求助策略。对临床实践和政策的启示包括增加对CMDs解释模型的研究、让家庭参与服务，以及为不接受正式护理的个体制定基于社区的干预措施。
