• Absence of association between behavior problems in childhood and hypertension in midlife

      Saad, Sadiq M.; Randhawa, Gurch; Pang, Dong; University of Bedfordshire (Public Library of Science, 2016-12-09)
      Background It is known that behavior in childhood is associated with certain physical and mental health problems in midlife. However, there is limited evidence on the role of childhood behavior problems in the development of hypertension in adulthood. The present study aimed to examine whether behavior problems in childhood influenced the risk of hypertension in midlife in the United Kingdom 1958 birth cohort. Methods The 1958 British birth cohort comprised 17,638 individuals born in the first week of March 1958 in the United Kingdom. Behavior problems were assessed at 7, 11, and 16 years of age by parents and teachers. At age 45, blood pressure was measured and hypertension was recorded if blood pressure was ≥140/90 mm Hg or if the participants were informed by their health professionals that they had high blood pressure. Behavioral information was reported according to the Rutter Children's Behaviour Questionnaire (RCBQ) and the Bristol Social Adjustment Guide (BSAG). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to examine behavior problems in childhood in relation to hypertension at 45 years of age according to logistic regression analysis, with adjustment for sex, social class in childhood and adulthood, childhood cognition, birth weight, gestational age at birth, body mass index (BMI), smoking, alcohol consumption, and physical activity. Results Behavior problems reported by parents at 7, 11, and 16 years were not associated with hypertension in midlife (OR, 0.93; 95% CI, 0.81, 1.07; OR, 0.95; 95% CI, 0.81, 1.11; OR, 0.98; 95% CI, 0.85, 1.12, respectively). Similarly, teacher-reported behavior problems at 7, 11, and 16 years were not associated with hypertension in midlife (OR, 0.92; 95% CI, 0.72, 1.18; OR, 0.92; 95% CI, 0.84, 1.02; OR, 1.03; 95% CI, 0.92, 1.15, respectively). Further separate analyses showed similar results for males and females. Conclusion There is no association between behavior problems in childhood and hypertension in midlife.
    • Access and utilisation of primary health care services comparing urban and rural areas of Riyadh Providence, Kingdom of Saudi Arabia

      Alfaqeeh, Ghadah Ahmad; Cook, Erica Jane; Randhawa, Gurch; Ali, Nasreen (BioMed Central, 2017-02-02)
      The Kingdom of Saudi Arabia (KSA) has seen an increase in chronic diseases. International evidence suggests that early intervention is the best approach to reduce the burden of chronic disease. However, the limited research available suggests that health care access remains unequal, with rural populations having the poorest access to and utilisation of primary health care centres and, consequently, the poorest health outcomes. This study aimed to examine the factors influencing the access to and utilisation of primary health care centres in urban and rural areas of Riyadh province of the KSA.
    • Altruism, gift giving and reciprocity in organ donation: a review of cultural perspectives and challenges of the concepts

      Sharp, Chloe; Randhawa, Gurch; University of Bedfordshire (W.B. Saunders, 2014-10-01)
      Living and deceased organ donation are couched in altruism and gift discourse and this article reviews explores cultural views towards these concepts. Altruism and egoism theories and gift and reciprocity theories are outlined from a social exchange theory perspective to highlight the key differences between altruism and the gift and the wider implications of reciprocation. The notion of altruism as a selfless act without expectation or want for repayment juxtaposed with the Maussian gift where there are the obligations to give, receive and reciprocate. Lay perspectives of altruism and the gift in organ donation are outlined and illustrate that there are differences in motivations to donate in different programmes of living donation and for families who decide to donate their relative's organs. These motivations reflect cultural views of altruism and the gift and perceptions of the body and death.
    • Antenatal care initiation in an ethnically dense socially disadvantaged maternal cohort

      Puthussery, Shuby; Tseng, Pei-Ching; Li, L.; Puthusserry, Thomas (Oxford University Press, 2019-11-20)
      Background: Differential utilisation of antenatal care among ethnic minority mothers is a contributor to their increased risk of poor birth outcomes in developed countries. Links between ethnicity, area deprivation and the timing of antenatal care initiation remain poorly understood. This study investigated patterns of antenatal care initiation among an ethnically dense, socially disadvantaged maternal cohort. Methods: We conducted a retrospective analysis of routinely collected anonymous data of live singleton births in a maternity unit serving an ethnically diverse population. We applied univariate regression models to examine the association between late antenatal care initiation and various predictor variables in particular ethnicity and area deprivation. Results: Gestational week at antenatal initiation was available for 46,089 births. One fifth (20.9%) of mothers initiated antenatal care after 12 weeks of gestation including 11.9% who had their first antenatal appointment at 13 -20 weeks (moderately late) and 8.9% who had it later than 20 weeks (extremely late). Among all the factors considered, late initiation was most strongly associated with non-White British ethnicity. Black African (34.2%) and Black Caribbean (29.0%) mothers were more than twice as likely to initiate antenatal care after 12 weeks of gestation compared to White British mothers [Odds ratio (OR) = 2.69 and 2.15 respectively). The odds did not increase with increasing area deprivation except for moderately late initiation in the most deprived and second most deprived areas [unadjusted OR = 1.54 and 1.24 respectively]. Conclusions: Non-White British ethnicity was the key predictor of late antenatal care initiation in our ethnically dense socially disadvantaged maternal cohort. Impact: Programs and policies should take in to account ethnic variations in antenatal careinitiation while designing programs and policies to improve birth outcomes in ethnically dense socially disadvantaged areas. Key messages: Non-White British ethnicity was the key predictor of late antenatal care initiation. Area deprivation per se appeared to have limited association with late antenatal care initiation.
    • Bereaved donor families' experiences of organ and tissue donation, and perceived influences on their decision making

      Sque, Magi; Walker, Wendy; Long-Sutehall, Tracy; Morgan, Myfanwy; Randhawa, Gurch; Rodney, Amanda; University of Wolverhampton; University of Southampton; King's College London; University of Bedfordshire (Elsevier, 2018-01-16)
      To elicit bereaved families' experiences of organ and tissue donation. A specific objective was to determine families' perceptions of how their experiences influenced donation decision-making. Retrospective, qualitative interviews were undertaken with 43 participants of 31 donor families to generate rich, informative data. Participant recruitment was via 10 National Health Service Trusts, representative of five regional organ donation services in the UK. Twelve families agreed to DBD, 18 agreed to DCD, 1 unknown. Participants' responses were contextualised using a temporal framework of 'The Past', which represented families' prior knowledge, experience, attitudes, beliefs, and intentions toward organ donation; 'The Present', which incorporated the moment in time when families experienced the potential for donation; and 'The Future', which corresponded to expectations and outcomes arising from the donation decision. Temporally interwoven experiences appeared to influence families' decisions to donate the organs of their deceased relative for transplantation. The influence of temporality on donation-decision making is worthy of consideration in the planning of future education, policy, practice, and research for improved rates of family consent to donation. PURPOSE METHODS RESULTS CONCLUSIONS
    • Communication as care at end of life: an emerging issue from an exploratory action research study of renal end-of-life care for ethnic minorities in the UK

      Wilkinson, Emma; Randhawa, Gurch; Brown, Edwina; Gane, Maria Da Silva; Stoves, John; Warwick, Graham; Akhtar, Tahira; Magee, Regina; Sharman, Sue; Farrington, Ken (Wiley-Blackwell, 2014-09-01)
      South Asian people have a higher risk of developing kidney disease, are disproportionately represented in the patient population requiring renal replacement therapy and wait longer to receive a kidney transplant, compared with white Europeans. As a result, there is a demand for end-of-life care, which meets the needs of this group of patients. Providing end-of-life care to patients from different cultures is a challenge for renal services as there can be barriers to communication in the form of language, delegated decision-making within families and reluctance to discuss death. To explore end-of-life care for South Asians with kidney disease, 16 interviews with patients and 14 focus groups with care providers were conducted at four research sites in the UK with large South Asian populations. Using an action research design the data were analysed thematically and fed back to inform the research in a cyclical manner. If patients are not fully aware of their condition or of what end-of-life care is, it is less likely that they will be able to be involved in decision-making about their care and this is compounded where there are communication barriers. Variations in care provider awareness and experience of providing end-of-life care to South Asian patients, in turn, contributes to lack of patient awareness of end-of-life care. Communication as care at the end of life should be explored further. Researching the South Asian patient experience of end of life highlights many relevant and generalisable issues.
    • Constructions of masculinity and help-seeking for prostate cancer

      Ali, Nasreen; Randhawa, Gurch; Bamidele, Olufikayo; Hoskin, Peter; McCaughan, Ellis; University of Bedfordshire; Ulster University Colerain; East and North Hertfordshire NHS Trust (Insight Medical Publishing Group, 2017-09-21)
    • Crowd medical services in the English Football League: remodelling the team for the 21st century using a realist approach

      Leary, Alison; Kemp, Anthony; Greenwood, Peter; Hart, Nick; Agnew, James; Barrett, John; Punshon, Geoffrey; London South Bank University; University of Bedfordshire; British Association for Immediate Care; et al. (BMJ Publishing Group, 2017-12-21)
      To evaluate the new model of providing care based on demand. This included reconfiguration of the workforce to manage workforce supply challenges and meet demand without compromising the quality of care.Currently the Sports Ground Safety Authority recommends the provision of crowd medical cover at English Football League stadia. The guidance on provision of services has focused on extreme circumstances such as the Hillsborough disaster in 1989, while the majority of demand on present-day services is from patients with minor injuries, exacerbations of injuries and pre-existing conditions. A new model of care was introduced in the 2009/2010 season to better meet demand. A realist approach was taken. Data on each episode of care were collected over 14 consecutive football league seasons at Millwall FC divided into two periods, preimplementation of changes and postimplementation of changes. Data on workforce retention and volunteer satisfaction were also collected. The data were obtained from one professional football league team (Millwall FC) located in London, UK. The primary outcome was to examine the demand for crowd medical services. The secondary outcome was to remodel the service to meet these demands. In total, 981 episodes of care were recorded over the evaluation period of 14 years. The groups presenting, demographic and type of presentation did not change over the evaluation. First aiders were involved in 87.7% of episodes of care, nurses in 44.4% and doctors 17.8%. There was a downward trend in referrals to hospital. Workforce feedback was positive. The new workforce model has met increased service demands while reducing the number of referrals to acute care. It involves the first aid workforce in more complex care and key decision-making and provides a flexible registered healthcare professional team to optimise the skill mix of the team.
    • Enhancing the health professional's role in requesting transplant organs

      Randhawa, Gurch; University of Bedfordshire (Mark Allen Healthcare, 1997-04-01)
      The shortfall in organs for transplant continues in the UK. To address this problem, methods of organ procurement are continuously widening with the recent development of protocols in elective ventilation and non-heart beating donors. Until recently, the nurse's role in the success of organ procurement was largely limited to those working in intensive care units involved in cadaveric transplant and community-based nurses working with patients on kidney dialysis who may become involved with live related transplant. Involvement in organ procurement has now extended to nurses working in general wards and accident and emergency centres. It is imperative that health professionals are aware of the large numbers of patients for whom donors have not been found. They need to be aware of the possible reasons which deter relatives from giving consent for potential donors and prevent relatives themselves from becoming potential live donors. Those who are involved in the organ request process need to be alerted to the factors that affect the decision to give consent. It is hoped that these efforts will help to reduce the drastic shortage of available organs for transplant in the UK.
    • Estimation of potential deceased organ donors in Canada

      Rose, Caren; Nickerson, Peter; Delmonico, Francis; Randhawa, Gurch; Gill, Jagbir; Gill, John S.; University of British Columbia (Lippincott Williams and Wilkins, 2016-07-01)
      BACKGROUND: Development of strategies to increase deceased organ donation is dependent on timely, accurate information regarding the number of potential deceased organ donors. Our objective was to estimate the number of potential deceased organ donors in Canada. METHODS: This was a retrospective analysis of information captured from hospital separations in Canadian provinces with the exception of Quebec between 2005 and 2009. We studied individuals 70 years or younger who died in hospital. Our primary outcome measure was potential deceased organ donors (identified by the presence of diagnostic codes compatible with donation, the absence of contraindications to donation defined by Canadian Standards, and the use of mechanical ventilation). RESULTS: Among 335 793 hospital deaths, 8274 potential donors were identified. The study method was 81% sensitive and 93% specific for identification of potential donors, and overestimated potential donors by a factor of 1.6- to 2.1-fold when compared to information from chart audits. After accounting for this overestimation, there are conservatively 400 unrecognized potential deceased donors in Canada annually. CONCLUSIONS: These findings suggest there may be significant potential to increase deceased organ donations in Canada. Further studies to fully characterize the number of potential donors identified by the study method are needed.
    • Ethnic differences in the prevalence of frailty in the United Kingdom assessed using the electronic Frailty Index

      Pradhananga, Shraddha; Regmi, Krishna; Razzaq, Nasrin; Ettefaghian, Alireza; Dey, Aparajit Ballav; Hewson, David (Wiley, 2019-09-13)
      Objective: There have been few studies in which the prevalence of frailty of different ethnic groups has been assessed in multiethnic countries. The aim of this study was to evaluate the prevalence of frailty in different ethnic groups in the United Kingdom. Methods: Anonymized electronic health records (EHR) of 13 510 people aged 65 years and over were extracted from the database of a network of general practitioners, covering 16 clinical commissioning groups in London. Frailty was determined using the electronic Frailty Index (eFI), which was automatically calculated using EHR data. The eFI was used as a categorical variable with fit and mild frailty grouped together, and moderate and severe frailty grouped as frail. Results: The overall prevalence of frailty was 18.1% (95% confidence interval [CI], 17.4%‐18.9%). The prevalence of frailty increased with age (odds ratio [OR], 1.11; 95% CI, 1.10‐1.12) and body mass index (BMI; OR, 1.05; 95% CI, 1.04‐1.06). The highest prevalence of frailty was observed for Bangladeshis, with 32.9% classified as frail (95% CI, 29.2‐36.7); and the lowest prevalence of 14.0% (95% CI, 12.6‐15.5) was observed for the Black ethnic group. Stepwise logistic regression retained ethnicity, age, and BMI as predictors of frailty. Conclusion: This pilot study identified differences in the prevalence of frailty between ethnic groups in a sample of older people living in London. Additional studies are warranted to determine the causes of such differences, including migration and socioeconomic status. It would be worthwhile carrying out a validation study of the eFI in different ethnic populations.
    • Exploring end-of-life care for South Asian kidney patients: interviewer reflections

      Wilkinson, Emma; Waqar, Muhammad; Gill, Balbir; Hoque, Pina; Jetha, Champa; Bola, Kulwinder Kaur; Mahmood, Riffat; Mahmood, Sultan; Saujani, Rita; Randhawa, Gurch; et al. (Mark Allen Healthcare, 2017-03-25)
      The reduction of inequalities in access to quality care has been a central tenet of UK health policy. Ethnic minorities may experience additional inequalities because of language and other cultural barriers. This article reports interviewer reflections of conducting interviews with South Asian kidney patients about their experiences of end-of-life care. It explores themes which emerged from the analysis of a focus group held with eight bilingual research interviewers. The relevance of these themes to understanding inequalities and access to end-of-life care is discussed; together with the potential for the research process to contribute to service improvement.
    • Exploring factors that impact the decision to use assistive telecare: perspectives of family care-givers of older people in the United Kingdom

      Cook, Erica Jane; Randhawa, Gurch; Guppy, Andrew; Sharp, Chloe; Barton, Garry; Bateman, Andrew; Crawford-White, Jane; University of Bedfordshire; University of East Anglia; Cambridgeshire Community Services (Cambridge University Press, 2017-05-01)
      In the United Kingdom (UK), an ageing population met with the reduction of social care funding has led to reduced support for older people marked with an increased demand on family care-givers. Assistive telecare (AT) devices are viewed as an innovative and effective way to support older people. However, there is limited research which has explored adoption of AT from the perspectives of family care-givers. In-depth, semi-structured interviews were conducted with 14 family care-givers of patients who used the Assistive Telehealth and Telecare service in Cambridgeshire, UK. Family care-givers were either the spouse (N = 8) or child of the patient (N = 6). The patients' age ranged from 75 to 98, and either received a telecare standalone device or connected service. Framework analysis was used to analyse the transcripts. This study revealed that family care-givers play a crucial role in supporting the patient's decision to adopt and engage with AT devices. Knowledge and awareness, perceived responsibility, usefulness and usability, alongside functionality of the equipment, were influential factors in the decision-making process. AT devices were viewed positively, considered easy to use, useful and functional, with reassurance of the patient's safety being a core reason for adoption. Efforts to increase adoption and engagement should adapt recruitment strategies and service pathways to support both the patient and their care-giver.
    • Going beyond blame: reporting NHS medication errors in nursing home residents with diabetes

      Milligan, Frank; Gadsby, Roger; Ghaleb, Maisoon; Ivory, Philip; McKeaveney, Colette; Newton, Kathryn; Smith, Jackie; Randhawa, Gurch; University of Bedfordshire; Warwick Medical School; et al. (Royal College of General Practitioners, 2015-07-01)
      It is widely accepted in literature on patient safety that an open culture — one that seeks to understand the multiple reasons for error — is required to promote incident reporting and maximise learning for system improvement.1 In the attempt to deliver the research described here we encountered a culture of blame. Such a culture leads to low levels of medication error reporting with regard to NHS systems supplying the nursing home setting. This article explores the problem of this low level of reporting being detrimental to future learning on NHS medication errors.2 The study we undertook, ‘Root causes of medication errors in nursing home residents with diabetes: enhancing safety in NHS medicines management’, was funded by the Research for Patient Benefit (RfPB) programme. It focused on residents with diabetes in nursing homes, as defined by the Care Quality Commission (CQC),3 and involved consenting homes in Bedfordshire and Hertfordshire. Nursing homes were selected because medication delivery processes are slightly different from residential care home provision, although the incident reporting systems are similar. The aim of the study was to gather data on NHS errors, and report on and analyse them for learning purposes and solution development. The comments made here relate to the data collection process. The final research findings will be summarised in future publications.
    • Health care providers’ perspectives of disrespect and abuse in maternity care facilities in Nigeria: a qualitative study

      Orpin, Joy; Puthussery, Shuby; Burden, Barbara; University of Bedfordshire (Springer, 2019-10-31)
      Objectives To explore healthcare providers’ perspectives of disrespect and abuse in maternity care and the impact on women’s health and well-being. Methods Qualitative interpretive approach using in-depth semi-structured interviews with sixteen healthcare providers in two public health facilities in Nigeria. Interviews were audio-recorded, transcribed, and analysed thematically. Results Healthcare providers’ accounts revealed awareness of what respectful maternity care encompassed in accordance with the existing guidelines. They considered disrespectful and abusive practices perpetrated or witnessed as violation of human rights, while highlighting women’s expectations of care as the basis for subjectivity of experiences. They perceived some practices as well-intended to ensure safety of mother and baby. Views reflected underlying gender-related notions and societal perceptions of women being considered weaker than men. There was recognition about adverse effects of disrespect and abuse including its impact on women, babies, and providers’ job satisfaction. Conclusions Healthcare providers need training on how to incorporate elements of respectful maternity care into practice including skills for rapport building and counselling. Women and family members should be educated about right to respectful care empowering them to report disrespectful practices.
    • The impact of social prescribing services on service users: a systematic review of the evidence

      Pescheny, Julia Vera; Randhawa, Gurch; Pappas, Yannis; University of Bedfordshire (Oxford University Press, 2019-06-14)
      Social prescribing initiatives are widely implemented in the UK National Health Service to integrate health and social care. Social prescribing is a service in primary care that links patients with non-medical needs to sources of support provided by the community and voluntary sector to help improve their health and wellbeing. Such programmes usually include navigators, who work with referred patients and issue onward referrals to sources of non-medical support. This systematic review aimed to assess the evidence of service user outcomes of social prescribing programmes based on primary care and involving navigators. We searched 11 databases, the grey literature, and the reference lists of relevant studies to identify the available evidence on the impact of social prescribing on service users. Searches were limited to literature written in English. No date restrictions were applied, and searches were conducted to June 2018. Findings were synthesized narratively, employing thematic analysis. The Mixed Methods Appraisal Tool Version 2011 was used to evaluate the methodological quality of included studies. Sixteen studies met the inclusion criteria. The evidence base is mixed, some studies found improvements in health and wellbeing, health-related behaviours, self-concepts, feelings, social contacts and day-to-day functioning post-social prescribing, whereas others have not. The review also shows that the evaluation methodologies utilized were variable in quality. In order to assess the success of social prescribing services, more high quality and comparable evaluations need to be conducted in the future.International Prospective Register of Systematic Reviews number: CRD42017079664.
    • Life after prostate cancer: a systematic literature review and thematic synthesis of the post-treatment experiences of Black African and Black Caribbean men

      Bamidele, Olufikayo; McGarvey, Helen E.; Lagan, Briege M.; Ali, Nasreen; Chinegwundoh, Frank; Parahoo, K.; McCaughan, Ellis (Wiley, 2017-10-16)
      Evidence shows that there are significant ethnic variations in prostate cancer prevalence and outcomes. Specifically, Black African and Black Caribbean men may encounter different post-treatment experiences than Caucasian men due to their disproportionately higher risk of being diagnosed with advanced prostate cancer. But to date, no review of these experiences has been undertaken. This review synthesised findings from existing literature on the post-treatment experiences of Black African and Black Caribbean men with prostate cancer and identified pertinent issues which may be useful to inform practice and future research. Seven databases were systematically searched using developed search terms. Four qualitative studies were identified and critically appraised. Findings are summarised under four main themes: symptom experience, healthcare experience, marital and social relationships and coping strategies. Cultural definitions of masculinity influenced the meanings men gave to their post-treatment experiences. While men's experiences of healthcare varied, the provision of professional support to address their post-treatment distress was lacking. Men derived most support from wives, peers and church communities. A culturally sensitive approach which recognises diversity among Black African and Black Caribbean populations and treats individuals within their religious and socio-cultural contexts could potentially improve men's post-treatment experiences. Areas for further research were also identified.
    • Methodological and practical viewpoints of qualitative-driven mixed method design: The case of decentralisation of primary healthcare services in Nepal

      Regmi, Krishna (Cambridge University Press, 2017-09-11)
      Background Although considerable attention has been paid to the use of quantitative methods in health research, there has been limited focus on decentralisation research using a qualitative-driven mixed method design. Decentralisation presents both a problematic concept and methodological challenges, and is more context-specific and is often multi-dimensional. Researchers often consider using more than one method design when researching phenomena is complex in nature. Aim To explore the effects of decentralisation on the provision of primary healthcare services. Methods Qualitative-driven mixed method design, employing three methods of data collections: focus group discussions (FGDs), semi-structured interviews (SSIs) and participant observations under two components, that is, core component and supplementary components were used. Four FGDs with health service practitioners, three FGDs with district stakeholders, 20 SSIs with health service users and 20 SSIs with national stakeholders were carried out. These were conducted sequentially. NVivo10, a data management program, was utilised to code the field data, employing a content analysis method for searching the underlying themes or concepts in the text material. Findings Both positive and negative experiences related to access, quality, planning, supplies, coordination and supervision were identified. Conclusion This study suggests some evidence of the effects of decentralisation on health outcomes in general, as well as filling a gap of understanding and examining healthcare through a qualitative-driven mixed methods approach, in particular. Future research in the area of qualitative in-depth understanding of the problems (why decentralisation, why now and what for) would provoke an important data set that benefits the researchers and policy-makers for planning and implementing effective health services.
    • Organ donation as an 'altruistic gift': Incentives and reciprocity in deceased organ donation from a UK Polish migrant perspective

      Sharp, Chloe; Randhawa, Gurch; University of Bedfordshire (Springer, 2014-01-01)
      Background: Incentives and reciprocity have been widely debated within the literature as an alternative to altruism to motivate the public to register and consent to organ donation. This pilot study was the first to examine the views of the UK Polish migrant community toward these issues. Material and Methods: One-to-one and small group interviews were conducted in English and Polish to collect data. The interviews were recorded and transcribed and interviews in Polish were translated into English. All transcripts were coded, codes were grouped by theme and emergent themes were constantly compared to the new data until saturation. Results: Participants were motivated to donate altruistically but would accept reciprocity for organs once consent was given. Payment for organs was viewed as unfavourable but participants would accept contribution toward funeral expenses. Conclusions: Deceased organ donation was viewed as an ‘altruistic gift’. ‘Altruism’ and ‘gift’ are problematic in deceased organ donation and could explain the challenges that arise in the incentives and reciprocity debate. Mauss’s gift exchange theory could frame incentives as forming the ‘obligation to give’ and could encourage registration but could lead to coercion. Reciprocity could benefit families and be viewed as ‘fair’ and a token of gratitude.
    • Pakistani young people’s views on barriers to accessing mental health services

      Ali, Nasreen; Mclachlan, Niel; Kanwar, Shama; Randhawa, Gurch (Taylor & Francis, 2016-11-08)
      There is extensive literature acknowledging inequalities in health, particularly mental health services for adults, children and young people from Black and minority ethnic communities in the UK. However, there is little existing evidence on UK Pakistani young people’s views of mental health and mental health services. Four focus-group discussions were carried out (n = 33 participants) at local schools, madrasas and a youth group; and data analysed using a framework approach. The findings from this study highlighted a number of barriers to accessing mental health services. Participants had a poor awareness of mental health services and treatment options. Most respondents referred to GPs as their first point of contact for mental health concerns. Knowledge of treatment options for mental illness focused mainly on counselling. There was little awareness of cognitive behavioural therapy (CBT) or family-based CBT as a therapeutic regime. Based on the findings of this study it is clear that young people have a poor awareness of mental health services, specifically child and adolescent mental health services services and treatment options for mental illness. Participants suggested a culturally appropriate mental health awareness intervention for young people. It was proposed that this took the form of community-based ambassadors facilitating knowledge exchange and discussion at community level