Mental health and the Gujarati communities: a case study of Leicester

Abstract

This thesis explores the ways in which the Gujarati communities come to understand, experience and conceptualise ‘mental health’. These were explored under the following categories: social, cultural, economic and institutional. Ethnic inequalities and ‘mental health’ have been widely researched but explanations can provide a distorted picture for particular communities (Raleigh, 1995). Published information on measuring rates of inequalities focus use of services and wide categories such as ‘South Asians’ can be misleading in health research (Nazroo et al., 2002). Not only are current epidemiological studies problematic with the categories they utilise to group people together, but also using the medical model to define ‘mental health’ as an universally applied term indeed has its’ pitfalls. The major one that is inherent to this thesis is the complex relationship culture and social factors has in contributing to understandings of ‘mental health’ and how they are managed. Therefore, the crux of this thesis explores practices and beliefs the Gujarati communities have that help ‘mental health’ management but also their limitations that constrain and restrict help-seeking from western health services. This research is informed by two key phenomena and the complex relationship between the two – ‘mental health’ and culture. There is an exploration of social processes such as culture and the range of identity and historical factors such as migration, family, social capital and religion to name a few. A Bourdieusian analytical framework is used, in particular his forms of capital; social, cultural and economic to illustrate how culture influences conceptualisations, experiences and management of ‘mental health’ and how culture contributes to the complexity that cuts across the universality/specificity binary of addressing ‘mental health’. Qualitative interviews with the Gujarati communities in Leicester were used to explore these issues. 35 interviews were conducted with first-generation Gujarati migrants and 15 were conducted with second generation Gujarati migrants. These were all recorded, analysed using various thematic analytical techniques, analytic induction and cognitive mapping. It is argued that, strong forms of social and cultural capital contribute to and strengthen cultural opinions of mental illness as ‘mad’, ‘crazy’ and ‘slow’. Thus, these attitudes and understandings are lived realities for the Gujarati communities. However, it is also strong forms of social capital that contribute to potential ‘mental health’ problems due to the pressure of ‘social obligations’. This entails, behaving in a certain manner that abides to and maintains acceptable norms in the Gujarati communities. Consequently, social and cultural capital are underlying factors that explain the stigmatized nature of ‘mental health’ and their help-seeking trajectories. Additionally, the empirical data from my interviews has begun to demonstrate that attitudes towards ‘mental health’ are not as simple as being educated about it but rooted deeply in social and cultural practices, beliefs and traditions. Rightly so, Dogra et al. (2005) argues conceptualisations and expressions of ‘mental health’ can vary across cultures and thus these need to be considered when looking at ethnic groups. Additionally, due to the changing nature of cultures, continuous research is required to uphold suitable treatment and support for ‘mental health’. Therefore, I argue that research that informs policy in this area, such as cultural components of ‘mental health’ needs to be inductive rather than deductive in nature