The most effective population-wide approach to preventive mental health care is necessarily nuanced and tailored to suit the needs of diverse communities. Understanding mental health through a cultural lens is a key focus area, explains health policy professional Theebika Shanmugarasa from the ONE Campaign.
(PART 5 of 5) Re:solve Global Health’s new Q&A series explores strategies to improve mental wellbeing. We asked five experts from diverse backgrounds (health promotion, social media strategy, public health, suicide prevention and international advocacy) to answer this key question: How can we prevent mental health problems at a population level?
How does stigma affect help-seeking behaviour in diverse communities?
There is so much more awareness these days and people are more openly talking about their mental health, but there are particular groups that continue to experience a lot of stigma around mental health, which impacts whether or not they seek help.
In the Sri Lankan community in the UK—a community I’m part of as my parents are from Sri Lanka—people have experienced a lot of trauma from the war [Sri Lankan Civil war 1983-2009] that's never been addressed. They believe they must work hard and keep going in order to build a life, but there are a lot of unresolved issues. Getting rid of the stigma of mental health issues is a massive challenge.
How important is it to be responsive to the needs of diverse communities?
With any mental health services and supports, the first step is to make sure that the whole community has equal access to it. That comes from awareness building, but also making sure that the awareness building includes people from across the community, rather than looking at people as a homogenous group.
For example, something that a lot of organisations and NGOs in London are trying to do is have people representing communities who know about the stigma and the cultural differences within those communities. Do women prefer to speak with other women? Are there religious considerations? Someone from within the community will understand these nuances and how they relate to mental health.
Why is mental health support especially effective when it’s provided at a grassroots level?
When it comes from within the community it has much more impact than the government simply explaining the different services that people can access. It’s a very obvious thing but having someone to talk to who understands your cultural background and isn’t judgmental is really important. It’s empowering to understand, from your own cultural viewpoint, that mental health issues aren’t a sign of weakness or something to feel shameful about.
Part of that can come from a government awareness campaign, but you need that intermediary point from within the community to normalise it and bridge the gap between the community and the government.
Can mental health professionals with a shared cultural background add another layer of support?
Yes, very much so. In a previous role, I worked on a culturally adapted cognitive behavioural therapy (CBT) project that found that if new mothers had healthcare screenings with a health professional from a culturally similar background who spoke the same language and knew the culture, this could encourage more open and meaningful engagement in their own mental health.