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      Sub-Saharan African migrant youths’ help-seeking barriers and facilitators for mental health and substance use problems: a qualitative study

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          Abstract

          Background

          Many young migrants and their parents are reluctant to seek help for mental health and substance use problems. Help-seeking delays can result in longer duration of untreated problems and poorer outcomes. In this study, we aimed to identify the help-seeking barriers and facilitators for anxiety, depression and alcohol and drug use problems in young people from recently established sub-Saharan African migrant communities.

          Methods

          A qualitative study, incorporating individual, in-depth interviews and focus group discussions, was undertaken in Melbourne, Australia. Twenty-eight young sub-Saharan African migrants participated in the individual interviews, and 41 sub-Saharan African-born parents and key community leaders participated in 4 focus groups. All participants were aged 16 years or over. A thematic analysis of the data was undertaken.

          Results

          Themes and related sub-themes were abstracted from the data, reflecting the young people’s, parents’ and key community leaders’ beliefs about barriers and facilitators to help-seeking for mental health and substance use problems. Four help-seeking barriers were identified: stigma of mental illness, lack of mental health literacy in parents and young people, lack of cultural competency of formal help sources, and financial costs deterring access. Five help-seeking facilitators were abstracted: being open with friends and family, strong community support systems, trustworthiness and confidentiality of help-sources, perceived expertise of formal help-sources, increasing young people’s and parents’ mental health literacy.

          Conclusion

          Programs that identify and build on help-seeking facilitators while addressing help-seeking barriers are needed to address mental health issues among young sub-Saharan African migrants. Strategies to address help-seeking barriers should consider counteracting stigma and increasing mental health literacy in sub-Saharan African communities, increasing health providers’ cultural competency and perceived trustworthiness, and addressing financial barriers to accessing services.

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          Most cited references48

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          Consensual qualitative research: An update.

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            Qualitative research and evaluation methods.

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              "Mental health literacy": a survey of the public's ability to recognise mental disorders and their beliefs about the effectiveness of treatment.

              To assess the public's recognition of mental disorders and their beliefs about the effectiveness of various treatments ("mental health literacy"). A cross-sectional survey, in 1995, with structured interviews using vignettes of a person with either depression or schizophrenia. A representative national sample of 2031 individuals aged 18-74 years; 1010 participants were questioned about the depression vignette and 1021 about the schizophrenia vignette. Most of the participants recognised the presence of some sort of mental disorder: 72% for the depression vignette (correctly labelled as depression by 39%) and 84% for the schizophrenia vignette (correctly labelled by 27%). When various people were rated as likely to be helpful or harmful for the person described in the vignette for depression, general practitioners (83%) and counsellors (74%) were most often rated as helpful, with psychiatrists (51%) and psychologists (49%) less so. Corresponding data for the schizophrenia vignette were: counsellors (81%), GPs (74%), psychiatrists (71%) and psychologists (62%). Many standard psychiatric treatments (antidepressants, antipsychotics, electroconvulsive therapy, admission to a psychiatric ward) were more often rated as harmful than helpful, and some nonstandard treatments were rated highly (increased physical or social activity, relaxation and stress management, reading about people with similar problems). Vitamins and special diets were more often rated as helpful than were antidepressants and antipsychotics. If mental disorders are to be recognised early in the community and appropriate intervention sought, the level of mental health literacy needs to be raised. Further, public understanding of psychiatric treatments can be considerably improved.
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                Author and article information

                Contributors
                terence.mccann@vu.edu.au
                j.mugavin@latrobe.edu.au
                andre.renzaho@westernsydney.edu.au
                dan.lubman@monash.edu
                Journal
                BMC Psychiatry
                BMC Psychiatry
                BMC Psychiatry
                BioMed Central (London )
                1471-244X
                2 August 2016
                2 August 2016
                2016
                : 16
                : 275
                Affiliations
                [1 ]Discipline of Nursing, Centre for Chronic Disease, College of Health and Biomedicine, Victoria University, PO Box 1428, Melbourne, 8001 VIC Australia
                [2 ]Turning Point and Eastern Health, Melbourne, Australia
                [3 ]Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
                [4 ]Western Sydney University, Sydney, Australia
                [5 ]Monash University, Melbourne, Australia
                Article
                984
                10.1186/s12888-016-0984-5
                4971683
                27484391
                42f2bdae-5a75-46ae-b9d6-b838b55868e1
                © The Author(s). 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 18 February 2016
                : 28 July 2016
                Funding
                Funded by: Beyondblue and the Movember Foundation
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2016

                Clinical Psychology & Psychiatry
                sub-saharan african migrants,barriers,facilitators,focus groups,help-seeking,individual interviews,mental health problems,qualitative research,refugees,substance use problems

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