Experiences with Counselling for Individuals Within the South Asian Community I: Rationale and Literature
by Alisha Mann, MPsy
This series was originally completed as a Major Research Project in partial fulfillment of Adler Graduate Professional School’s Master of Psychology degree.
Purpose and Rationale
This is a study of experiences. As an active participant of the South Asian (SA) community, this researcher was interested in understanding the experience of counselling for SA individuals. From personal experience, this researcher developed an understanding that mental health concerns were apparent not only in other communities but also within her South Asian community. However, people did not speak of them, and thus they did not seek the care they required. This led to many questions of why, which, as shown later in this paper, most researchers have also asked. Why do South Asian individuals not talk about mental health? Why were they not interested in counselling?
Also, why were some people able to seek counselling and not others? Several of these questions have multiple answers, yet the majority of research has focused on stigmatization (Chew-Graham, Bashir, Chantler, Burman, & Batsleer, 2002; Gilbert, Gilbert, & Sanghera, 2004; Hess & Tracey, 2013; Johnson, & Nadirshaw, 1993; Knaak & Patten, 2014; Rehman, 2010); cultural differences (Assanand, Dias, Waxler-Morrison, & Richardson, 1990; Chadda & Deb, 2013; Chandras, Chandras, & DeLambo, 2013; Fairchild & Mistler, 2005; Hamid, Simmonds, & Bowles, 2009; Hess & Tracey, 2013; Hussain & Cochrane, 2003; Johnson & Nadirshaw, 1993); and intergenerational differences in help-seeking behaviours (Chew-Graham et. al., 2002; Hess & Tracey, 2013; Islam, Khanlou, & Tamim, 2014; Johnson & Nadirshaw, 1993; Rehman, 2010; Shariff, 2009; Hamid et al., 2009; Thakore-Dunlap, & Velsor, 2014).
Mental health stigma is very debilitating to individuals in any community, including the South Asian community. Such stigma, in its most basic form, is a negative perception about mental health illnesses or concerns (Mental Health Commission of Canada [MHCC], & Center for Addictions and Mental Health [CAMH], 2009), or a mark of disgrace (Merriam-Webster.com, 2015). Thus, the stigmatization of mental health results in locating or describing mental health disorders in a negative context. It can be considered one of the biggest barriers for someone wanting to seek help in any community, and these negative stereotypes generally lead to discrimination or ill treatment of those with mental health concerns (MHCC & CAMH, 2009).
This research was narrowed to individuals who were active participants of the SA community in that they associated themselves with the culture or religion, or both, of a South Asian country (e.g., Pakistan, India, Bangladesh, Sri Lanka, Nepal, and Bhutan).
Although the notion of counselling is rarely spoken of, there are individuals within the community who actively seek psychological help.
There appears to be a need for understanding what helps SA individuals in Canada to seek and participate in counselling. According to a study by the MHCC and CAMH (2009), the majority of research has been conducted on immigrant, refugee, ethnocultural, and racialized (IRER) groups in the United Kingdom (UK) or United States of America (USA). Although research in Canada has been increasing over the past 20 years, it has not caught up with the increasing rate of diversification. As Canada becomes more culturally diverse, the creation of policies and procedures providing equitable mental health support is becoming much more important.
The purpose of this research is to change the conversation about the use of mental health counselling services through examining the lived experiences of a sample of those who have been on this journey. The purpose was not to ask why counselling was or was not sought, but to ask what their experiences taught them. What was their understanding of and attitude towards the stigmatization? What were the internal and external barriers they experienced? What were they able to overcome? What supports or resources were available to them? What were the consequences of seeking counselling, if any?
Underlying all the above questions were notions of how gender, education, religion, and cultural practices influenced the experiences. This research also questioned the importance of ethnically identical therapists to see what changes may need to be implemented to assist in the help-seeking process.
As a qualitative article that utilizes a grounded theory approach, the results answered a question that may not have been asked within the interviews. Based on this, the actual question, or Aha moment, led to the following question: What change(s) allowed these South Asian individuals to seek and participate in counselling?
Altering the types of questions asked by researchers, policy makers, social workers, educators, and health care providers might have a positive effect on the resources available to SA individuals. Thus, asking what allows them to seek counselling, as opposed to what stops them, may change the dialogue and create a more positive outlook for such individuals. This may also set up a platform for newer educational programs in schools and for health care providers. With the constant push to keep mental health concerns private, the importance of actively seeking and participating in counselling may provide a sense of relief for individuals and a sense that they are not alone.
Overall, as outlined later in this study, current research has asked the question of why South Asian individuals avoid seeking mental health counselling or what barriers they face. Although this research initially attempted to understand a similar notion through understanding their experiences, the data informed the actual question and thus led to suggestions of what allows such individuals to seek counselling.