Mental health in South Asians living abroad : the role of culture, attitudes and emotional support

Shah, Maria and Perez Algorta, Guillermo and Davies, Jenny (2025) Mental health in South Asians living abroad : the role of culture, attitudes and emotional support. PhD thesis, Lancaster University.

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Abstract

This thesis is comprised of four sections. Section One: A systematic literature review exploring how culture shapes attitudes towards mental health difficulties and help-seeking among South Asian individuals living abroad. Using a systematic mixed-studies review, 22 studies were reviewed. A narrative synthesis was used, and seven key themes were identified: (1) Stigma, (2) Gender roles; (3) Family relations and reputation; (4) Religion and spirituality as coping mechanisms; 5) Generational differences; (6) Acculturation; (7) and Barriers to accessing mental health services and helpseeking behaviour. Findings highlighted that cultural stigma and collective values discourage open conversations and help-seeking, particularly among older generations. Younger individuals showed greater openness, highlighting the impact of acculturation and generational change. Recommendations included culturally tailored interventions that address stigma, integrate religious and familial frameworks, and consider generational and gender differences. Section Two: An empirical study exploring the experience of emotional support among South Asian individuals living in the UK. 11 participants were interviewed using semistructured interviews, and data were analysed using Reflexive Thematic Analysis. Six themes were developed: (1) Mental health is everyone’s yet no one’s business, (2) The support is there but is it in the way I need?, (3) Turning inward – internal strategies for emotional coping and resilience, (4) Navigating professional support – mismatches, cultural gaps, and positive moments, (5) When ES feels right – non-verbal gestures, trust, and feeling understood, and (6) Making ES part of everyday life – expanding awareness and access in meaningful spaces. Findings illustrated a mismatch between cultural norms around emotional expression and participants’ support needs. Section Three: A critical appraisal reflecting on the methodological, ethical, and reflexive aspects of the research, including implications for clinical practice and future research. Section Four: The full ethical application for the empirical study, including supporting documentation such as consent forms, information sheets, and debrief materials.