Date: 01/02/2024
A survey found that 'cultural and language barriers', 'expensive', and 'busy' were cited as the main obstacles for ethnic minorities to seek help when facing mental health problems. Although public attention to mental health has increased in recent years, it remains challenging for ethnic minorities to seek support. Hong Kong Christian Service (HKCS), the Department of Psychiatry of the Faculty of Medicine at The Chinese University of Hong Kong (CUHK), and the Department of Social Work and Social Administration at The University of Hong Kong (HKU) jointly conducted a survey on 'Mental Health and Barriers to Help-seeking Among Ethnic Minorities' from January to August 2023. They interviewed 273 South and Southeast Asians through questionnaires, revealing that 28.6% of them were at high risk of mental disorders. In response, the research team suggests enhancing ethnic minorities’ understanding of primary mental health services, encouraging cross-sectoral collaboration to support the mental health of ethnic minority employees, and improving existing mental health services.
Feeling Ashamed about Mental Health Problems, Working Male Hesitant to Seek Help
The survey revealed that 37.0% of ethnic minorities did not know where to seek help when facing mental health problems. 32.6% considered mental health problems to be shameful, and 42.9% believed mental health problems would go away by itself. The most common obstacles to seeking help reported by ethnic minorities were 'expensive' (68.9%), 'cultural and language barriers' (56.0%), and 'busy' (48.7%). Besides, 'employed full-time/ self-employed respondents' and 'male respondents' were more likely to be affected by these obstacles and refused to seek help.
Mental High-risk Group Falling into a Vicious Cycle
The survey also found out the mental health status of ethnic minorities. 22.8% were at high risk of depression, and around a tenth were at high risk of anxiety (13.6%) or insomnia (12.2%). Overall, 28.6% were at high risk of at least one disorder. Compared with the low-risk group, the high-risk group had poorer quality of life and health and faced more barriers to seeking help. Mike Cheung, Service Head of Multicultural, Rehabilitation & Community Service, HKCS, stated that the high-risk group, facing more significant difficulties in seeking help, would easily fall into a vicious cycle. He said urgent actions are needed to support them to seek professional services.
Advocating for More Education, Support and Collaboration
Based on the survey results, the research team makes the following recommendations:
1. Enhancing ethnic minorities' understanding of primary mental health services
- The government and various organisations provide different free or low-cost mental health services to the public. However, there is a need to strengthen the dissemination of information about primary mental health services to ethnic minorities to reduce their unnecessary misunderstandings and stigmas about these services.
2. Encouraging cross-sectoral collaboration to support ethnic minority employees' mental health
- Ethnic minority employees, who are mostly male and often work long hours in long-paid jobs , find it harder to seek help when needed. The government should encourage employers to participate in the 'Employee Assistance Programme', especially providing financial support for small and medium-sized enterprises to offer mental health services.
- The 'Employee Assistant Programme' should consider the uniqueness of ethnic minorities and provide culturally appropriate services.
3. Improving existing mental health services
- When developing the 'Primary Healthcare Blueprint', 'District Health Centre' should incorporate mental health support elements and strengthen promotion to ethnic minorities.
- Mental health service providers should recruit more ethnic minority frontline staff or peer support workers to play a bridging role, communicate more effectively with ethnic minorities, and promote mental health education.
- Cultural diversity and sensitivity training should be provided to staff in existing mental health services to enable them to understand cultural differences and provide more accurate and ethnic minority-friendly services.
Paul Wong, Associate Professor & Clinical Psychologist at the Department of Social Work and Social Administration, HKU, said, 'Cultural diversity and sensitivity is about recognising and respecting the differences and protecting the rights of the underprivileged. When social service providers have cultural diversity and sensitivity, it helps avoid prejudices or stereotypes, making the service more friendly. In daily service delivery, we can reflect more on the impact of the social environment on our self-perception, pay attention to whether our "language" is multicultural, and affirm the abilities and strengths of the service recipients, thereby cultivating cultural diversity and sensitivity.'
To promote mental health among ethnic minorities, the Department of Psychiatry of the Faculty of Medicine at CUHK has launched a mental health support platform for ethnic minorities called ‘Salamat’ in collaboration with several organisations, including HKCS. Steven Chau, Assistant Professor (Clinical) from the Department, stated, 'Salamat means peace. The multi-lingual online platform caters for the specific needs of ethnic minorities. Upon accessing the platform, users will first complete a screening, after which they will receive a report on their well-being status, actions to take, and resources on where to seek help. With the user’s consent, they will be referred to collaborating organisations for further services.'
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1According to the Census and Statistics Department, in 2021, the proportion of the ethnic minority working 65 hours or more a week was 6.7%. Additionally, the median monthly income of several working ethnic minority groups, including Filipino, Indonesian, Nepalese, Pakistani, and Thai, is lower than the median monthly income of the whole working population in Hong Kong (HK$19,500).