Abstract
There is a growing need for cultural and linguistic adaptations within the United Kingdom’s (UK) mental healthcare system, with a specific focus on faith-based inclusion for the South Asian communities, specifically Sikh and Punjabi populations. Current practices within the National Health Services (NHS) are not structured to deliver culturally competent care for diverse service users. Thus, this study aimed to examine how faith-based nonprofit organizations can support the Sikh and Punjabi community in navigating topics of mental healthcare and accessing supportive services, by collating feedback from callers of a telephone helpline. This helpline was staffed by seven trained volunteers providing support for users across the UK. Based on feedback gathered from seventy-five helpline users over a period of 3 years, researchers found that callers engaged more actively in personal help-seeking behaviors when they perceived providers as culturally competent. Findings suggest that statutory organizations could benefit significantly from offering culturally sensitive training to better serve diverse clientele.
References
Adams C, Schembri A, Chauhan A, Walpola R, Harrison R. (2023). Differences in Patient Experiences Among People From Ethnic Minority Backgrounds: A Comparative Analysis of HCAHPS Results. Journal of Patient Experience.10. 10.1177/23743735231218867
Adamson, J., Warfa, N., & Bhui, K. (2011). A case study of organisational cultural competence in mental healthcare. BMC health services research, 11, 1-8.
Adler, P., Otado, J., & Kwagyan, J. (2020). Satisfaction and perceptions of research participants in clinical and translational studies: An urban multi-institution with CTSA. Journal of Clinical and Translational Science, 4(4), 317-322.
Aggarwal, C. (2024, March 25). Mental Health Outreach to the South Asian Community. NAMI. https://www.nami.org/mmham/mental-health-outreach-to-the-south-asian-community/
Ahluwalia, M. K., & Alimchandani, A. (2013). A call to integrate religious communities into practice: The case of Sikhs. The Counseling Psychologist, 41(6), 931-956.
Alegria, M., Atkins, M., Farmer, E., Slaton, E., & Stelk, W. (2010). One size does not fit all: taking diversity, culture and context seriously. Administration and Policy in Mental Health and Mental Health Services Research, 37, 48-60.
Ali, I. (2018). The influence of religion on the understanding of and attitudes to mental health and illness in Muslim patients in the UK. The University of Manchester, United Kingdom.
Baral SP, Prasad P, Raghuvamshi G. (2022). Mental health awareness and generation gap. Indian J Psychiatry. 64(3). doi: 10.4103/0019-5545.341859.
Bansal, N., Karlsen, S., Sashidharan, S. P., Cohen, R., Chew-Graham, C. A., & Malpass, A. (2022). Understanding ethnic inequalities in mental healthcare in the UK: a meta-ethnography. PLoS Medicine, 19(12), e1004139.
Bekalu, M. A., McCloud, R. F., & Viswanath, K. (2019). Association of social media use with social well-being, positive mental health, and self-rated health: disentangling routine use from emotional connection to use. Health Education & Behavior, 46(2), 69S-80S.
Bhangu, J. K. (2021). Sikh men in therapy (Doctoral dissertation, London Metropolitan University).
Bhogal, B. S. (2014). Postcolonial and Postmodern Perspectives on Sikhism. In The Oxford Handbook of Sikh Studies (pp. 282-297). Oxford: Oxford University Press.
Braun, V., & Clarke, V. (2022). Thematic Analysis: A Practical Guide. Sage.
Castillo, E. G., Ijadi-Maghsoodi, R., Shadravan, S., Moore, E., Mensah, M. O., Docherty, M., ... & Wells, K. B. (2019). Community interventions to promote mental health and social equity. Current psychiatry reports, 21, 1-14.
Carbonell, A., Navarro‐Pérez, J. J., & Mestre, M. V. (2020). Challenges and barriers in mental healthcare systems and their impact on the family: A systematic integrative review. Health & social care in the community, 28(5), 1366-1379.
Carr-Hill, R. A. (1992). The measurement of patient satisfaction. Journal of public health, 14(3), 236-249.
Currie, L. N., & Bedi, R. P. (2019). Integrating traditional healing methods into counselling and psychotherapy with Punjabi and Sikh individuals.
Cuthbertson, S. (2023). The Impact of Staffing Level on Patient Care in Behavioral Health Care Settings. Walden University.
Fish, J. N., & Mittal, M. (2021). Mental health providers during COVID-19: essential to the US public health workforce and in need of support. Public Health Reports, 136(1), 14-17.
Forrester-Jones, R., Dietzfelbinger, L., Stedman, D., & Richmond, P. (2018). Including the ‘spiritual’ within mental health care in the UK, from the experiences of people with mental health problems. Journal of Religion and Health, 57, 384-407.
Ganeri, A. (2003). The Guru Granth Sahib and Sikhism. London: Evans Brothers. pp. 6-7.
Gayet-Ageron, A., Agoritsas, T., Schiesari, L., Kolly, V., & Perneger, T. V. (2011). Barriers to participation in a patient satisfaction survey: who are we missing?. PLoS One, 6(10), e26852.
Good-Thinking. (2023, October 3). Sikhi. Good Thinking. https://www.good-thinking.uk/faith-and-belief-communities/sikhi
Hatala, A. R., & Roger, K. (Eds.). (2021). Spiritual, religious, and faith-based practices in chronicity: an exploration of mental wellness in global context. Routledge.
Hayanga, B., Stafford, M., & Becares, L. (2021). Ethnic inequalities in healthcare use and care quality among people with multiple long-term health conditions living in the United Kingdom: a systematic review and narrative synthesis. International Journal of Environmental Research and Public Health, 18(23), 12599.
Hefti, R. (2011). Integrating religion and spirituality into mental health care, psychiatry and psychotherapy. Religions, 2(4), 611-627.
Hodge, D. R. (2017). Spiritual competence: The key to effective practice with people from diverse religious backgrounds. In The Routledge handbook of religion, spirituality and social work (pp. 282-290). Routledge.
How charities can make the most of social media. Simon on the Streets. (2024, May 24). https://simononthestreets.co.uk/news/how-charities-can-make-the-most-of-social-media
Hsu, B., Hackett, C., & Hinkson, L. (2014). The importance of race and religion in social service providers. Social Science Quarterly, 95(2), 393-410.
Hswen, Y., Hawkins, J. B., Sewalk, K., Tuli, G., Williams, D. R., Viswanath, K., ... & Brownstein, J. S. (2020). Racial and ethnic disparities in patient experiences in the United States: 4-year content analysis of Twitter. Journal of medical Internet research, 22(8).
Improving cultural competence quick guide for clinicians. Substance Abuse and Mental Health Services Administration (SAMHSA). (2019). https://store.samhsa.gov/sites/default/files/sma16-4931.pdf
Ilioudi, S., Lazakidou, A., & Tsironi, M. (2013). Importance of patient satisfaction measurement and electronic surveys: methodology and potential benefits. International Journal of Health Research and Innovation, 1(1), 67-87.
Islam, F., Multani, A., Hynie, M., Shakya, Y., & Kwame, M. (2017). Mental health of South Asian youth in Peel region, Toronto, Canada: A qualitative study of determinants, coping strategies and service access. British Medical Journal, 7, 1-11. doi: 10.1136/bmjopen-2017-018265
Jakobsh, D. (2012). 5. The Sikh Diaspora. In Sikhism (pp. 84-104). Honolulu: University of Hawaii Press. https://doi.org/10.1515/9780824860349-009
Junewicz, A., & Youngner, S. J. (2015). Patient‐Satisfaction Surveys on a Scale of 0 to 10: Improving Health Care, or Leading It Astray?. Hastings Center Report, 45(3), 43-51.
Kapur, P., & Misra, G. (2003). Image of self in the Sikh community: Continuity of the core and global presence. Psychology and Developing Societies, 15(1), 103-116. https://doi.org/10.1177/097133360301500107
Karasz A, Gany F, Escobar J, Flores C, Prasad L, Inman A, Kalasapudi V, Kosi R, Murthy M, Leng J, Diwan S. (2019). Mental Health and Stress Among South Asians. Journal of Immigrant Minority Health. 1. 7-14. 10.1007/s10903-016-0501-4.
Karlsen, S., Nazroo, J. Y., McKenzie, K., Bhui, K., & Weich, S. (2005). Racism, psychosis and common mental disorder among ethnic minority groups in England. Psychological Medicine, 35(12), 1795-1803. https://doi.org/10.1017/S0033291705005830
Kaur, M. (2020, October 3). Mental health in the Punjabi community: 'I see stigma everywhere'. BBC News. Retrieved from https://www.bbc.co.uk/news/ukengland-london-54170902
Kirmayer, L. J., & Jarvis, G. E. (2019). Culturally responsive services as a path to equity in mental healthcare. Healthcare Papers, 18(2), 11-23.
Knifton, L. (2012). Understanding and addressing the stigma of mental illness with ethnic minority communities. Health Sociology Review, 21(3), 287-298. https://doi.org/10.5172/hesr.2012.21.3.287
Kramer, S. (2021, September 21). Key findings about the religious composition of India. Pew Research Center. https://www.pewresearch.org/short-reads/2021/09/21/key-findings-about-the-religious-composition-of-india/
Lainson, K., Braun, V., & Clarke, V. (2019). Being both narrative practitioner and academic researcher: A reflection on what thematic analysis has to offer narratively informed research. International Journal of Narrative Therapy and Community Work, 4, 86-98.
Long, J. D. (2024). An Appreciation of Arvind Mandair's Sikh Philosophy: Exploring Gurmat Concepts in a Decolonizing World. Philosophy East and West, 74(2), 353-363.
Malhi, N. K., Sidhu, S. S., Singh, R., & Singh, M. K. (2024). Sikh Tenets and Experiences That Relate to Mental Health and Well-Being. In Eastern Religions, Spirituality, and Psychiatry: An Expansive Perspective on Mental Health and Illness (pp. 151-166). Cham: Springer Nature Switzerland.
McCarthy, R. G. (2013). The Sikh diaspora in Australia: Migration, multiculturalism and the imagining of home. University of Pittsburgh.
Mesquita, B. (2001). Emotions in collectivist and individualist contexts. Journal of personality and social psychology, 80(1), 68-74. https://doi.org/10.1037/0022-3514.80.1.68
Miller, H. M. (2005). The experiences of Sikh spirituality in relation to health and well-being (Doctoral dissertation, University of British Columbia).
NHS. (2024). Social care and support guide. NHS choices. https://www.nhs.uk/conditions/social-care-and-support-guide/
Omer, A. (2020). Decolonizing religion and the practice of peace: Two case studies from the postcolonial world. Critical research on religion, 8(3), 273-296.
Palinkas, L. (2014). Qualitative and mixed methods in mental health services and implementation research. Journal of Clinical Child Adolescence Psychology. 43(6). 851-61. 10.1080/15374416.2014.910791.
Pinder, R. J., Ferguson, J., & Møller, H. (2016). Minority ethnicity patient satisfaction and experience: results of the National Cancer Patient Experience Survey in England. BMJ open, 6(6).
Quraishi, Z. (2023). Addressing mental health, misinformation, & religious tensions among South Asian students across California higher education during the COVID-19 pandemic: A qualitative research study. Heliyon, 9(6).
Radey, M., & Figley, C. R. (2007). The social psychology of compassion. Clinical Social Work Journal, 35, 207-214.
Rajan, S. I., Varghese, V. J., & Nanda, A. K. (2016). Migration, mobility and multiple affiliations. Cambridge University Press.
Sandhu, J. S. (2004). The Sikh model of the person, suffering, and healing: implications for counsellors. International Journal for the Advancement of Counselling, 26(1), 33-46. https://doi.org/10.1023/B:ADCO.0000021548.68706.18
Sandhu, J. S. (2005). A Sikh perspective on life-stress: Implications for counselling. Canadian Journal of Counselling and Psychotherapy, 39(1), 40- 50.
Schultz, M., Lulav-Grinwald, D., & Bar-Sela, G. (2014). Cultural differences in spiritual care: findings of an Israeli oncologic questionnaire examining patient interest in spiritual care. BMC palliative care, 13, 1-11.
Sharma, S. (2012). ‘The church is… my family’: exploring the interrelationship between familial and religious practices and spaces. Environment and Planning A: Economy and Space, 44(4), 816-831. https://doi.org/10.1068/a4447
Stahre, M. K. (2023). Restricted entry: do Punjabi Sikhs have equal immediate access to counselling and psychotherapy services?. University of British Columbia.
Stanton, A. G., Jerald, M. C., Ward, L. M., & Avery, L. R. (2017). Social media contributions to strong Black woman ideal endorsement and Black women’s mental health. Psychology of Women Quarterly, 41(4), 465-478.
Stanisch, J. L. (2019). Promoting Volunteerism for a Private Non-Profit Charitable Organization that Provides Free Healthcare Services, Community Food Pantry, and Housing for Displaced Community Members (Doctoral dissertation, Bradley University).
Sudarsan, I., Hoare, K., Sheridan, N., & Roberts, J. (2022). South Asian immigrants’ and their family carers’ beliefs, practices and experiences of childhood long‐term conditions: An integrative review. Journal of Advanced Nursing, 78(7), 1897–1908. https://doi.org/10.1111/jan.15217
Sidhu, M. S., Griffith, L., Jolly, K., Gill, P., Marshall, T., & Gale, N. K. (2016). Long-term conditions, self-management and systems of support: an exploration of health beliefs and practices within the Sikh community, Birmingham, UK. Ethnicity & health, 21(5), 498-514.
Singh, K. (2008). The Sikh spiritual model of counselling. Spirituality and Health International, 9(1), 32-43. https://doi.org/10.1002/shi.331
Singh, M. (2003). Power in Punjab. Christianity Today, 47(7), 24-25.
Singh, R. (2022, March 9). Origin of world’s largest migrant population, India seeks to leverage immigration. migrationpolicy. https://www.migrationpolicy.org/article/india-migration-country-profile
Thapar, A., & Rutter, M. (2019). Do natural experiments have an important future in the study of mental disorders?. Psychological Medicine, 49(7), 1079-1088.
Verster, J. C., van de Loo, A. J., Adams, S., Stock, A. K., Benson, S., Scholey, A., ... & Bruce, G. (2019). Advantages and limitations of naturalistic study designs and their implementation in alcohol hangover research. Journal of clinical medicine, 8(12), 2160.
Weich S, Nazroo J, Sproston K, McManus S, Blanchard M, Erens B, Karlsen S, King M, Lloyd K, Stansfeld S, Tyrer P. (2004). Common mental disorders and ethnicity in England: the EMPIRIC study. Psychol Med. 34(8), 1543-51. doi: 10.1017/s0033291704002715.
What do I need to know about sikhism?. Talking faith in suicide prevention. (n.d.-b). https://suicideprevention.faithaction.net/what-do-i-need-to-know-about-specific-faiths/sikhi/?_gl=1%2A1hldlf5%2A_up%2AMQ..%2A_ga%2AMTk3MDM2MDI3MS4xNzIwNzE0NDE4%2A_ga_SQYESYPWVS%2AMTcyMDcxNDQxNy4xLjAuMTcyMDcxNDQxNy4wLjAuMA.
Whitley, R. (2012). Religious competence as cultural competence. Transcultural psychiatry, 49(2), 245-260.
Why is cultural competence important in mental health care?. Fountain House. (2022, October 14). https://www.fountainhouse.org/news/why-is-cultural-competence-important-in-mental-health-care#:~:text=Not%20knowing%2C%20or%20asking%2C%20about,treatment%2C%20particularly%20for%20Black%20Americans.
Willis, H. A., Gonzalez, J. C., Call, C. C., Quezada, D., Scholars for Elevating Equity and Diversity (SEED), & Galán, C. A. (2022). Culturally Responsive Telepsychology & mHealth Interventions for Racial-Ethnic Minoritized Youth: Research Gaps and Future Directions. Journal of Clinical Child & Adolescent Psychology, 51(6), 1053–1069. https://doi.org/10.1080/15374416.2022.2124516
Zaman, M. J. S., & Mangtani, P. (2007). Changing disease patterns in South Asians in the UK. Journal of the Royal Society of Medicine, 100(6), 252-255.
Zamora, B., Gurupira, M., Rodes Sanchez, M., Feng, Y., Hernandez-Villafuerte, K., Brown, J., & Shah, K. (2019). The value of international volunteers experience to the NHS. Globalization and Health, 15, 1-12.

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