"A sinking heart" : beliefs of distress in the Punjabi community

Abstract

As the challenge of providing culturally appropriate care in the NHS becomes more apparent there is more research being invested into looking at the relationship between mental health and culture. Due to migration numbers, there is particular growing interest in the mental health of South Asians who significantly underutilise mental health services. There are several known barriers to access including stigma and shame, fear of breaching confidentiality, and perceiving Western services as being culturally incompetent. The term ‘South Asian’ is often used to refer to individuals who originate from countries of the Indian subcontinent: India, Pakistan, Sri Lanka, Bangladesh, Nepal, Maldives, and Bhutan. Current literature assumes that all needs of the South Asian community are the same. Hence this term is problematic; used to represent a range of beliefs, practices, religions, and cultures. This study focused specifically on the Punjabi Sikh community in the UK and sought to explore beliefs about psychological wellbeing and an understanding of mental health issues. Eight Punjabi Sikh members of the community were interviewed; participants were a non-clinical population and had not accessed mental health services prior to this research. A thematic analysis was conducted and three themes were identified; ‘We are Warriors!’, ‘The Importance of Family Expectations’, and ‘Understanding Mental Health Issues’. Findings suggested that the Punjabi Sikh community may not perceive mental health services as being relevant to them as they believe they do not suffer from ‘ill mental health’. Psychological wellbeing was believed to be an integral part of a Punjabi Sikh lifestyle that Punjabi people already practise. This community is also likely to be strongly influenced by their Sikh history and believe they are capable of managing hardships without the input of external services. The research concludes with some methodological considerations and implications for clinical practice.