Skip to main content

Advertisement

Log in

Mental Health and Stress Among South Asians

  • Original Paper
  • Published:
Journal of Immigrant and Minority Health Aims and scope Submit manuscript

Abstract

Addressing mental illness requires a culturally sensitive approach. As detailed in this literature review, treating mental illness in the South Asian immigrant community necessitates a thorough understanding of the South Asian conceptualization of mental illness. Past research, though limited, has described the different reasons the South Asian community attributes to causing mental illness, as well as the stigma associated with acknowledging the disease. Acculturation of the community also plays a significant role in cultural acceptability and the receipt of quality care. Lessons from local organizations can be applied at the national level to promote cultural responsiveness in treating mental illness in the South Asian immigrant community.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Gater R, Tomenson B, Percival C, et al. Persistent depressive disorders and social stress in people of Pakistani origin and white Europeans in UK. Soc Psychiatry Psychiatr Epidemiol. 2009;44(3):198–207.

    Article  PubMed  Google Scholar 

  2. Anand AS, Cochrane R. The mental health status of South Asian women in Britain: a review of the UK literature. Psychol Dev Soc J. 2005;17(2):195–214.

    Google Scholar 

  3. Taylor R, Brown JS, Weinman J. A comparison of the illness perceptions of North Indian and white British women. J Ment Health. 2013;22(1):22–32.

    Article  PubMed  Google Scholar 

  4. Weich S, Nazroo J, Sproston K, et al. Common mental disorders and ethnicity in England: the EMPIRIC study. Psychol med. 2004;34(8):1543–51.

    Article  PubMed  Google Scholar 

  5. Rehman T. Social Stigma, Cultural Constraints, or Poor Policies: Examining the Pakistani Muslim Female Population in the U.S. and Unequal Access to Professional Mental Health Services. Columbia Undergrad J South Asians stud. 2010;2(1):1–21.

  6. Kemp AH, Quintana DS. The relationship between mental and physical health: insights from the study of heart rate variability. Int J Psychophysiol. 2013;89(3):288–96.

    Article  PubMed  Google Scholar 

  7. Mols F, Husson O, Roukema JA, van de Poll-Franse LV. Depressive symptoms are a risk factor for all-cause mortality: results from a prospective population-based study among 3,080 cancer survivors from the PROFILES registry. J Cancer Surviv. 2013;7(3):484–92.

    Article  PubMed  Google Scholar 

  8. Rahman I, Humphreys K, Bennet AM, Ingelsson E, Pedersen NL, Magnusson PK. Clinical depression, antidepressant use and risk of future cardiovascular disease. Eur J Epidemiol. 2013;28(7):589–95.

    Article  CAS  PubMed  Google Scholar 

  9. Touvier M, Druesne-Pecollo N, Kesse-Guyot E, et al. Demographic, socioeconomic, disease history, dietary and lifestyle cancer risk factors associated with alcohol consumption. Int J Cancer. 2014;134:445–459.

    Article  PubMed  CAS  Google Scholar 

  10. Watkins LL, Koch GG, Sherwood A, Blumenthal J. Association of anxiety and depression with all-cause mortality in indiviuals with conory heart disease. J Am Heart Assoc. 2013;2(2):e000068.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Bhattacharya G, Schoppelrey SL. Preimmigration beliefs of life success, postimmigration experiences, and acculturative stress: South Asian immigrants in the United States. J Immigr Health. 2004;6(2):83–92.

    Article  PubMed  Google Scholar 

  12. Lai DWL, Surood S. Socio-cultural variations in depressive symptoms of ageing South Asian Canadians. Asian J Gerontol Geriatr. 2008;3:84–91.

    Google Scholar 

  13. Gany FM, Gill PP, Ahmed A, Acharya S, Leng J. “Every disease…man can get can start in this cab”: focus groups to identify South Asian taxi drivers’ knowledge, attitudes and beliefs about cardiovascular disease and its risks. J Immigr Minor Health. 2013;15(5):986–92.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Bhugra D, Jones P. Migration and mental illness. Adv Psychiatr Treat. 2001;7:216–23.

    Article  Google Scholar 

  15. Samuel E. Acculturative stress: South Asian immigrant women’s experiences in Canada’s Atlantic provinces. J Immigr Refug Stud. 2009;7:16–34.

    Article  Google Scholar 

  16. Inman AG, Howard EE, Beaumont LR, Walker J. Cultural transmission: Influence of contextual factors in Asian Indian immigrant parent’s experience. J Counsel Psychol. 2007;54:93–100.

    Article  Google Scholar 

  17. Kaduvettoor-Davidson A, Inman AG. South Asian Americans: perceived discrimination, stress and well-being. Asian Am J Psychol. 2013;4:155–65.

    Article  Google Scholar 

  18. Inman AG. South Asian women: identities and conflicts. Cult Divers Ethn Min Psychol. 2006;12:306–19.

    Article  Google Scholar 

  19. Inman AG, Constantine MG, Ladany N. Cultural value conflict: an examination of Asian Indian women’s bicultural experience. In: Sandhu DS, editor. Asian and Pacific Islander Americans: issues and concerns for counseling and psychotherapy. Commack: Nova Science Publishers; 1999.

    Google Scholar 

  20. McCourt J, Walker G. The influence of sociocultural factors on the eating psychopathology of Asian women in British society. Eur Eat Disord Rev. 1996;4(2):73–83.

    Article  Google Scholar 

  21. Karasz A, Dempsey K, Fallek R. Cultural differences in the experience of everyday symptoms: a comparative study of South Asian and European American women. Cult Med Psychiatry. 2007;31(4):473–97.

    Article  PubMed  Google Scholar 

  22. Nazroo JY. Rethinking the relationship between ethnicity and mental health: the British fourth national survey of ethnic minorities. Soc Psychiatry Psychiatr Epidemiol. 1998;33(4):145–8.

    Article  CAS  PubMed  Google Scholar 

  23. Mackenzie J. Stigma and dementia: East European and South Asian family carers negotiating stigma in the UK. Dementia. 2006;5(233).

  24. Nazroo J, Fenton S, Karlsen S, O’ Conner W. Context, cause and meaning: qualitative insights. In: Sproston K, Nazroo J, editors. Ethnic minority psychiatric illness rates in the community (EMPIRIC). London: National Centre for Social Research; 2002.

    Google Scholar 

  25. Hurwitz EJ, Gupta J, Liu R, Silverman JG, Raj A. Intimate partner violence associated with poor health outcomes in U.S. South Asian women. J Immigr Minor Health. 2006;8(3):251–61.

    Article  PubMed  Google Scholar 

  26. Mahapatra N. South Asian Women in the U.S. and their experience of domestic violence. J Fam Viol. 2012;27(5):381–90.

    Article  Google Scholar 

  27. Mason R, Hyman I, Berman H, Guruge S, Kanagaratnam P, Manuel L. “Violence is an international language”: Tamil women’s perceptions of intimate partner violence. Violence Against Women. 2008;14(12):1397–412.

    Article  PubMed  Google Scholar 

  28. Midlarsky E, Venkataramani-Kothari A, Plante M. Domestic violence in the Chinese and South Asian immigrant communities. Ann N Y Acad Sci. 2006;1087:279–300.

    Article  PubMed  Google Scholar 

  29. Chadda RK, Deb KS. Indian family systems, collectivistic society and psychotherapy. Indian J Psychiatry. 2013;55(Suppl 2):S299–309.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Skillman GD. Intergenerational conflict within the family context: a comparative analysis of collectivism and individualism within Vietnamese, Filipino, and Caucasian families. 1999.

  31. Zagelbaum A, Carlson J, Carlson J, Psyd E. Working with immigrant families: a practical guide for counselors. New York: Routledge; 2011.

    Book  Google Scholar 

  32. Gask L, Aseem S, Waquas A, Waheed W. Isolation, feeling ‘stuck’ and loss of control: understanding persistence of depression in British Pakistani women. J Affect Disord. 2011;128(1–2):49–55.

    Article  PubMed  Google Scholar 

  33. Jambunathan J. Sociocultural factors in depression in Asian Indian women. Health Care Women Int. 1992;13(3):261–70.

    Article  CAS  PubMed  Google Scholar 

  34. Karasz A, Patel V, Kabita M, Shimu P. “Tension” in South Asian women: developing a measure of common mental disorder using participatory methods. Prog Community Health Partnersh. 2013;7(4):429–41.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Frontier Center for Public Policy. Suicide among young women of South Asian origin [press release]. Winnipeg: Frontier Center for Public Policy; 2011.

  36. Cooper J, Husain N, Webb R, et al. Self-harm in the UK: differences between South Asians and Whites in rates, characteristics, provision of service and repetition. Soc Psychiatry Psychiatr Epidemiol. 2006;41(10):782–88.

    Article  PubMed  Google Scholar 

  37. Husain MI, Waheed W, Husain N. Self-harm in British South Asian women: psychosocial correlates and strategies for prevention. Ann Gen Psychiatry. 2006;5:7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Bhugra D. Suicidal behavior in South Asians in the UK. Crisis. 2002;23(3):108–13.

    Article  PubMed  Google Scholar 

  39. Abraham M. Fighting back: abused South Asian women’s strategies of resistance. In: Sokoloff NJ, Pratt C, editors. Domestic violence at the margins: readings on race, class, gender, and culture. New Brunswick: Rutgers University Press; 2005. pp. 253–71.

    Google Scholar 

  40. Abraham M. Isolation as a form of marital violence: the South Asian immigrant experience. J Soc Distress Homeless. 2000;9(3):221–36.

    Article  Google Scholar 

  41. Ahmad F, Riaz S, Barata P, Stewart DE. Patriarchal beliefs and perceptions of abuse among South Asian immigrant women. Violence Against Women. 2004;10(3):262–82.

    Article  Google Scholar 

  42. Kermode M, Bowen K, Arole S, Joag K, Jorm AF. Community beliefs about causes and risks for mental disorders: a mental health literacy survey in a rural area of Maharashtra, India. Int J Soc Psychiatry. 2010;56(6):606–22.

    Article  PubMed  Google Scholar 

  43. Ekanayake S, Ahmad F, McKenzie K. Qualitative cross-sectional study of the perceived causes of depression in South Asian origin women in Toronto. BMJ Open. 2012;2(1):e000641.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Jacob KS, Bhugra D, Lloyd KR, Mann AH. Common mental disorders, explanatory models and consultation behaviour among Indian women living in the UK. J R Soc Med. 1998;91(2):66–71.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Karasz A. Cultural differences in conceptual models of depression. Soc Sci Med. 2005;60(7):1625–35.

    Article  PubMed  Google Scholar 

  46. Diekstra RFW. Suicide and suicide attempts in the European Economic-Community: an analysis of trends, with special emphasis upon trends among the young. Suicide Life Threat Bheav. 1985;15(1):27–42.

    Article  CAS  Google Scholar 

  47. Tummala-Narra P, Sathasivam-Rueckert N, Sundaram S. Voices of older Asian Indian immigrants: mental health implications. Prof Psychol. 2013;44(1):1–10.

    Article  Google Scholar 

  48. Diwan S, Jonnalagadda SS, Gupta R. Differences in the structure of depression among older Asian Indian immigrants in the United States. J Appl Gerontol. 2004;23(4):370–84.

    Article  Google Scholar 

  49. Jonnalagadda SS, Diwan S. Health behaviors, chronic disease prevalence and self-rated health of older Asian Indian immigrants in the U.S. J Immigr Health. 2005;7(2):75–83.

    Article  PubMed  Google Scholar 

  50. Diwan S. Limited English proficiency, social network characteristics, and depressive symptoms among older immigrants. J Gerontol B Psychol Sci Soc Sci. 2008;63(3):S184–91.

    Article  PubMed  Google Scholar 

  51. Diwan S, Jonnalagadda SS, Balaswamy S. Resources predicting positive and negative affect during the experience of stress: a study of older Asian Indian immigrants in the United States. Gerontologist. 2004;44(5):605–14.

    Article  PubMed  Google Scholar 

  52. Diwan S, Jonnalagadda SS. Social integration and health among Asian Indian immigrants in the United States. J Gerontol Soc Work. 2002;36(1–2):45–62.

    Article  Google Scholar 

  53. Ahluwalia KP. Assessing the oral cancer risk of South-Asian immigrants in New York city. Cancer. 2005;104(12 Suppl):2959–61.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Csikar J, Aravani A, Godson J, Day M, Wilkinson J. Incidence of oral cancer among South Asians and those of other ethnic groups by sex in West Yorkshire and England, 2001–2006. Br J Oral Maxillofac Surg. 2013;51(1):25–9.

    Article  PubMed  Google Scholar 

  55. Chaudhry K, Prabhakar AK, Prabhakran PS, Singh K, Singh A. Prevalence of tobacco use in Karnataka and Uttar Pradesh in India. Indian Council of Medical Research and World Health Organziation, SEARO 2002; 2001.

  56. Vora AR, Yeoman CM, Hayter JP. Alcohol, tobacco and paan use and understanding of oral cancer risk among Asian males in Leicester. Br Dent J. 2000;188(8):444–51.

    Article  CAS  PubMed  Google Scholar 

  57. Florentin D, Horsley J, Day M, Strong M. Exploring Breast Cancer Incidence in South Asians and Whites in Leicester in 2000–2009. http://www.ncin.org.uk. Accessed Aug 2013.

  58. Kadan-Lottick NS, Vanderwerker LC, Block SD, Zhang B, Prigerson HG. Psychiatric disorders and mental health service use in patients with advanced cancer: a report from the coping with cancer study. Cancer. 2005;104(12):2872–81.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Lord K, Ibrahim K, Kumar S, Mitchell AJ, Rudd N, Symonds RP. Are depressive symptoms more common among British South Asian patients compared with British White patients with cancer? A cross-sectional survey. BMJ Open. 2013;3(6). doi:10.1136/bmjopen-2013-002650

  60. Abe-Kim J, Takeuchi D, Hong S, et al. Use of mental health-related services among immigrant and US-born Asian Americans: results from the National Latino and Asian American Study. Am J Public Health. 2007;97(1):91–8.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Meyer OL, Zane N, Cho YI, Takeuchi D. Use of specialty mental health services by Asian Americans with psychiatric disorders. J Consult Clin Psychol. 2009;77(5):1000–5.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Gilbert P, Gilbert J, Sanghera J. A focus group exploration of the impact of izzat, shame, subordination and entrapment on mental health and service use in South Asian women living in Derby. Mental Health Relig Cult. 2004;7(2):109–30.

    Article  Google Scholar 

  63. Randhawa G, Stein S. An exploratory study examining attitudes toward mental health and mental health services among young south asians in the United Kingdom. J Muslim Mental Health. 2007;2(1):21–37.

    Article  Google Scholar 

  64. Tabassum R, Macaskill A, Ahmad I. Attitudes towards mental health in an urban Pakistani community in the United Kingdom. Int J Social Psychiatry. 2000;46(3):170–81.

    Article  CAS  Google Scholar 

  65. Cinnirella M, Loewenthal KM. Religious and ethnic group influences on beliefs about mental illness: a qualitative interview study. Brit J Med Psychol. 1999;72:505–24.

    Article  PubMed  Google Scholar 

  66. Inman AG, Yeh CJ, Madan-Bahel A, Nath S. Bereavement and coping of South Asian families post 9/11. J Multicult Couns Devel. 2007;35:101–15.

    Article  Google Scholar 

  67. Ali OM, Milstein G, Marzuk PM. The Imam’s role in meeting the counseling needs of Muslim communities in the United States. Psych Serv. 2005;56(2):202–5.

    Article  Google Scholar 

  68. Sheikh S, Furnham A. A cross-cultural study of mental health beliefs and attitudes towards seeking professional help. Soc Psychiatry Psychiatr Epidemiol. 2000;35(7):326–34.

    Article  CAS  PubMed  Google Scholar 

  69. Minnis H, Kelly E, Bradby H, Ogelthorpe R, Raine W, Cockburn D. Cultural and language mismatch: clinical complications. Clin Child Psychol Psychiatry. 2003;8(2):179–86.

    Article  Google Scholar 

  70. Ahmad F, Shik A, Vanza R, Cheung A, George U, Stewart DE. Popular health promotion strategies among Chinese and East Indian immigrant women. Women Health. 2004;40(1):21–40.

    Article  PubMed  Google Scholar 

  71. Milstein G. Clergy and psychiatrists: opportunities for expert dialogue. Psychiat Times. 2003;10(3):36–9.

    Google Scholar 

  72. Gater R, Waheed W, Husain N, Tomenson B, Aseem S, Creed F. Social intervention for British Pakistani women with depression: randomised controlled trial. Br j psychiatry. 2010;197(3):227–33.

    Article  PubMed  Google Scholar 

  73. Karasz A. “The ASHA Project: an innovative multi level intervention to address depression in South Asian women.” [Under review].

  74. Inman AG, Devdas L, Spektor V, Pendse A. Psychological research on South Asian Americans: a three-decade content analysis. Asian Am J Psychol. 2014;5(4):364–72.

    Article  Google Scholar 

  75. Lai DW, Surood S. Effect of service barriers on health status of aging South Asian immigrants in Calgary, Canada. Health Soc Work. 2013;38(1):41–50.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This publication was supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health under Award Number R13 MD007147-01A1. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. SAHI staff would like to thank the Steering Committee members, all working group co-chairs, the Memorial Sloan Kettering Cancer Center Library, Rohini Rau-Murthy and the SAHI interns for their assistance in assembling this document.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Francesca Gany.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Karasz, A., Gany, F., Escobar, J. et al. Mental Health and Stress Among South Asians. J Immigrant Minority Health 21 (Suppl 1), 7–14 (2019). https://doi.org/10.1007/s10903-016-0501-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10903-016-0501-4

Keywords

Navigation