ABSTRACT
220 Objective: This chapter examines issues related to research and policy on common mental disorders in South Asian communities in Western countries, including depression, anxiety, and somatic distress. The prevalence, social context, symptom expression, treatment utilization, and conceptual representations of common mental disorders are reviewed, as well as the relevance of current treatment approaches. Strategies are suggested for creating culturally appropriate treatments that address the social adversity underlying common mental disorders in South Asian Americans.
Key Findings: Several key findings emerge from current research. First, multiple social factors have been shown to be associated with common mental disorders, including low acculturation, discrimination, and immigration stress. Second, evidence suggests differential vulnerability of subgroups within the South Asian community. For example, South Asian American children are more psychologically resilient as compared to White children, which is likely to do with benefits associated with traditional extended family life. Evidence also shows that South Asian women experience higher rates of depression, anxiety, and somatic distress, in addition to self-harm and completed suicide rates, when compared to White women and South Asian men. Social factors, particularly marital and family conflict, are the key cause of a woman's increased burden of distress and disorder. A third key finding indicates very low mental health treatment utilization among South Asian immigrants. Review of the evidence suggests that the key factor underlying low utilization is a lack of “match” between the types of treatments currently available—psychotherapy and medication—and the social models of distress and suffering held by many South Asian immigrants. The weakness of current treatment models to address social suffering in low-income South Asian groups is also highlighted.
Recommendations: There is an urgent need to adapt current mental health treatment models to better address the public health burden of common mental disorders in vulnerable subgroups. A promising strategy is the development of culturally appropriate treatment models that can achieve a conceptual match with South Asian models of distress and address underlying social causes of common mental disorders. This chapter describes innovative treatment models currently under development in both the United Kingdom and the United States.
