South Asian people are less likely to have their mental health needs recognised and experience inequality in access to services, compared to the White British population in the UK. Attempts through government policy to improve equality in mental health care and outcomes have had limited success. The aim of this study was to explore access to and experiences of services among people of South Asian origin living in the UK who were experiencing distress. An anonymous survey was distributed in GP surgeries and online, collecting a community sample of 103 adults who self-identified as South Asian. The survey contained questionnaires measuring distress, quality of life, acculturation and access to and experience of services for mental health. Between 33% and 50% of the sample was above the threshold for distress, depending on the measure used, while 40% reported a low quality of life. Those who were unemployed had greater levels of distress. Half of the sample had sought help for emotional problems in the past, with the majority seeking help in the NHS. Greater acculturation was associated with reduced distress and a higher quality of life. Seeking help from services was predicted by experiencing distress, being female and having a physical health problem. Clinical implications for mental health service delivery as well as the need for further research relating to the recognition of mental health problems in primary care are discussed.

Yes

Research shows that in the UK, individuals from black and minority ethnic backgrounds are significantly less likely to access mental health services than the general population. In the absence of literature or robust mental health service access figures for Nepalese people living in the UK (NLU) there is little understanding of the mental health needs and help-seeking preferences of this group. This study aimed to examine factors which are associated with professional help-seeking for mental health difficulties in NLU. The Theory of Planned Behaviour (Ajzen, 1985) was used as a guiding theoretical framework to examine the strongest predictors of intention to seek professional help. Potential predictors, shame/izzat, acculturation, beliefs about the causes of mental distress and demographic variables were measured. The sample were 65 NLU recruited from community centres, health events and online groups across the UK. Results indicated that although a significant number of NLU reported having experienced mental health difficulties, very few had sought professional help. A number of variables significantly correlated with intention to seek professional help, including level of acculturation, non-Western physiological causal beliefs and izzat. According to a multiple-regression analysis of the whole sample, izzat was the most strongly related to intention to seek professional help. A number of barriers to help-seeking were identified such as hoping problems would go away or not wanting to burden others. A significant strength of the study was the use of both Nepalese and English language questionnaires which ensured that a large non-English speaking section of the NLU population was not excluded from the study. Limitations include methodological considerations such as the use of one measure which appeared to have limited validity. Furthermore, the exclusion of illiterate individuals by merit of using a self-report questionnaire limits the generalisability of these findings to the NLU more widely. Low mental health service access rates were identified within this sample relative to the prevalence of mental health difficulties. The clinical implications of this study highlight the need for policy and service level strategies to increase service access rates and the need for mental health services which are sensitive to the culturally specific issues within the population.

This research addresses the concern that Anglophone populations in the predominantly French speaking Gaspé region of eastern Québec are experiencing high rates of social problems such as poverty and unemployment. Anglophones in this region, as in other rural regions of Québec, have identified facing difficulties related to access to social services, an aspect which further complicates existing social problems. Using a narrative methodology and post structural, feminist and intersectional lenses, this research explores the experiences of English speaking service users in accessing and engaging with social services on the Gaspé coast. This study also explores the boundaries and reproduction of linguistic categories and identity and offers insight into resisting dominant discourses pertaining to linguistic difference in Québec, specifically within the context of social services. The results of this research demonstrate that service users’ experiences were characterised by disproportionately negative effects in regards to service access and delivery such as intensified logistical problems and social work practice related weaknesses. The research also concludes that experiences involved multiple, intersecting problems, which were irreducible to the singular dimension of language. The intersections of language and race, language and class, and language and ability were raised as critical concerns in terms of access to social services on the Gaspé coast. Finally, the encounters between Anglophones and Francophones in the context of health and social services in the region were found to be entangled and inseparable from the historical and ongoing political struggles over language on this territory. / Graduate

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Darbo objektas: fiziškai neįgalių asmenų fizinės aplinkos pritaikymas ir paslaugų prieinamumas. Tiriamieji: fiziškai neįgalūs asmenys. Tyrimo tikslas - išanalizuoti asmenų turinčių fizinę negalę aplinkos pritaikymą viešosios, būsto aplinkos ir paslaugų prieinamumo aspektais. Tikslui įgyvendinti iškelti šie uždaviniai : • Nustatyti su kokiomis problemomis susiduria lengvesnės ir sunkesnės negalios fiziškai neįgalūs asmenys judėdami gyvenamojoje, mokyklos ir darbo aplinkoje. • Išsiaiškinti ir nustatyti kaip pritaikyta būsto aplinka lengvesnės ir sunkesnės negalios asmenims. • nustatyti paslaugų prieinamumą skirtinguose Lietuvos miestuose. Probleminis klausimas: 1. Su kokomis problemomis susiduria sunkesnės ir lengvesnės negalios asmenys judėdami savo kasdieninėje aplinkoje? 2. Su kokiomis paslaugų prieinamumo problemomis susiduria skirtinguose Lietuvos miestuose gyvenantys neįgalieji? Hipotezė: Fiziškai neįgalių asmenų kasdieninė aplinka nepritaikyta jiems laisvai judėti. Rezultatai: Atlikto tyrimo rezultatai sutampa su kitų autorių atliktais tyrimais, susijusiais su aplinkos prieinamumu asmenims su fizine negalia. Savo moksliniuose darbuose atskleidžia Daugėla ir Žukauskas (2005), kad neįgaliesiems juos supanti aplinka sunkiai prieinama, dėl jos nepritaikymo. Pasak ekspertų, Lietuvoje neįgaliesiems nėra pritaikyta dar nė viena aukštoji mokykla (Babinskienė, 2008). Išvados: 1. Nustatyta, neįgaliųjų gyvenamojoje ir darbo / mokyklos aplinkoje atsižvelgiant pagal negalės... [toliau žr. visą tekstą] / Object: of physically disabled persons in daily environment. Subjects: Persons with physical disability Purpose: analysis of individuals with physical disabilities access to the daily environment. Goals set to the following tasks: 1. Identify the problems faced lighter and more severe disability, physically disabled persons moving residential, school and work environments. 2. Identify and establish house adaptation to more and severe disabled people. 3. Determine the availability of services in different cities of Lithuania. Question arises: First, what problems more and severe disabled people facing through their everyday environment? Second, what are the problems of access to services across different cities of Lithuania for people with different disabilities? Hypothesis: Daily environment is unsuitable for physically disabled people. Results: The survey results coincide with other author’s related studies of environmental access for persons with physical disabilities. This research reveals that disabled people surroundings is not easily accessible for them. According to experts, Lithuanian surroundings is not adapted for disabled people and has no higher education institutions that is fully adapted for them. Babinskienės (2008).Daugėla and Žukauskas (2005), Conclusion’s: First It was found that people with disabilities in residential and work / school environment is facing the following problems: • Individuals with more severe physical disabilities are faced with... [to full text]

Women’s access to substance use disorder (SUD) treatment is affected by their social status and policies that present both opportunities and barriers to treatment. Motherhood, including pregnancy, tends to increase participation in health care and thus opportunities for referral to and engagement in SUD treatment. However, the multiple challenges of motherhood along with the social and legal sanctions that may be visited on mothers who use alcohol or drugs may impede access to treatment. Moreover, motherhood and drug use lie at the focus on great public and policy concerns due to the ways it has been construed in health policy discourse. There is a moral connotation regarding the criminalization of substance use during pregnancy. Mothers’ pathways to SUD treatment are complex, at turn they may be positively supported or seek to avoid opprobrium. Moreover, the opportunities and barriers continue to evolve. This dissertation sought to elucidate the contemporary settings in which mothers access SUD treatment, focusing on women’s use of health and social services and macro-level public policies, particularly the expansion of Medicaid with the Affordable Care Act and state laws that specifically criminalize drug use by mothers. In Study 1, I reviewed the literature on access to SUD treatment services among pregnant women and women who have children. I found that women have unique opportunities and barriers to access treatment services. I built a conceptual model of women’s pathways into care according to the type of barriers that may encounter by each “gateway.” Gateways are formal institutions or settings that may act as “gates” between pathways and may refer patients to treatment, but not all gateways may be actively referring patients. These sources became the foundation for Study 2, in which I empirically tested whether women’s engagement in gateways identified in Study 1 would be an effective mechanism for promoting SUD treatment. The findings suggest that Medicaid eligibility and criminal justice involvement increased women’s access to SUD treatment services. In Study 3, I examined the effects of Medicaid Expansion on medications for opioid use disorder (MOUD) and treatment completion as it relates to state laws that criminalize substance use during pregnancy among pregnant women. I found that criminalization policies prevented Medicaid expansion from realizing its full effect on increasing access to MOUD for pregnant women. Altogether, these studies elucidated the need for women-centered and life-course adjusted approaches in engaging women in treatment. / 2023-05-14T00:00:00Z

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