Suffering in Silence: Understanding the Underutilization of Mental Health Services Among South Asian Women With Depression

Major depressive disorder (mdd) is among the most prevalent mental illnesses in Canada. Though prevalence rates for depression are similar among minority and non-minority populations, recent empirical evidence has shown that ethnic minorities underutilize mental health services in Canada (Tiwani & Wang, 2008; Klimid et al, 2000; Mojtabi & Olfson 2006; Hu et al, 1991 & Gadalla, 2010). This trend is reflected in the persistent underutilization of mental health treatment services among South Asian women in the city of Vancouver (Peters, 1988; Johnson, 1992; & Chiu et al, 2005). This paper examines the underlying causes behind the underutilization of mental health services among South Asian women in Vancouver through an analysis of stakeholder perspectives on the issue. Nine semi- structured interviews with mental health service providers and immigrant settlement workers in the Vancouver area were conducted to identify the perceived reasons behind the underutilization of mental health services among South Asian women with depression. The stakeholders perceived stigma, lack of awareness, time and family obligations, language barriers and lack of culturally appropriate services for South Asian women to be the main reasons behind the underutilization of services among the South Asian female population. The paper also presents and evaluates a set of policy options to address the problem. These policy options include; a local media campaign coupled with annual information sessions for the South Asian community, cross cultural mental health seminars for general practitioners (gps) and other interested health care providers, and the provision of culturally appropriate group psychotherapy services for South Asian women. The implementation of all three strategies is recommended as a cost-effective and equitable approach to addressing the problem.