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Disparities in the Diaspora: A Systematic Review of Mental Health in South Asian Communities in the West

Paavani    Reddy, Northwestern University, MS4
[email protected]
Paavani Reddy is a medical student at Northwestern University Feinberg School of Medicine in Chicago, IL. She graduated from Northwestern University with a Bachelor of Arts in Anthropology. After graduation, she spent a year in South Korea with the Fulbright Program, where she worked as a teaching assistant and collaborated on a research project related to intergenerational perspectives of mental health. She is passionate about health equity, education, and the arts
Suvidya Lakshmi Pachigolla, BA, MS, UIC MS4
[email protected]
Suvidya Lakshmi Pachigolla is a medical student at the University of Illinois College of Medicine in Peoria. She graduated from the University of Illinois in Chicago with a bachelor’s degree in bioengineering. She is also currently obtaining a Master of Science in Clinical Investigation at Washington University in St. Louis. She will be pursuing research at the Paul Scherrer Institute in Villigen, Switzerland studying radiation therapy for pediatric brain cancer. Her research interests include cancer, radiation therapy, and health disparities. She is of Indian descent and has an interest in mental health in South Asian in western diaspora.

Bushra Anis MD, Northwestern University/Department of Family Medicine/PGY3
Bushra Anis is a third-year family medicine resident at the Northwestern Humboldt park program. She graduated from Smith college with a BA in neuroscience and went to the Lewis Katz School of Medicine at Temple University. She has an interest in reproductive care, and community-based medicine.

Anuj Shah MD, MPH, Northwestern University/Heartland Alliance/Family Medicine Physician
[email protected]
Anuj Shah is an Integrative Family Physician, based out of Heartland Health Center’s Lakeview Clinic. Dr. Shah graduated from Loyola’s Stritch School of Medicine and completed his residency at the Greater Lawrence Family Medicine Center in Lawrence, Massachusetts. He continued onto a family medicine fellowship at MacNeal Family Medicine Residency and received his master’s in public health at UIC. For almost 10 years, he worked as a family physician and educator at Erie Family Health Center in Humboldt Park.

•    On completion of this session, the participants should be able to identify which aspects of South Asian mental health are most commonly studied.
•    Participants will know which South Asian demographics in the Western diaspora are most well studied, as well as which are understudied.
•    Participants should be able to identify the gaps in research of mental health in the South Asian diaspora.

We performed a systematic search of articles examining the mental health of South Asians (Indian, Pakistani, Bangladeshi, Bhutanese, Sri Lankan, and Nepalese) living in the “West” (United States, Canada, Australia, and Western Europe. Our inclusion criteria included the following: (1) the study must directly examine outcomes on the South Asian diaspora, including all ages and genders, (2) the study must take place after 1999, (3) the study must include a mental health perspective, and (4) the study must not be a case study or review. We divided 4,250 articles to screen in pairs, and for inclusion, both parties must have agreed on inclusion; articles in conflict for inclusion were evaluated by third-party screeners.    

The search criteria identified 4,250 articles of which only 70 were confirmed to meet inclusion criteria. Of the studies included there were 39 Western European, 19 American, 13 Canadian, and 1 Australian.

The majority of South Asians included in said papers appear to be of Indian, Pakistani, or Bangladeshi origin — with less representation of other South Asian countries such as Nepal, Bhutan, and The Maldives.

Study sizes ranged from 8 participants to 1,262,763 participants.

23 articles were solely focused on females, but only 1 focused on males. Preliminary themes include epidemiology (24 studies), screening (32 studies), physical and mental health (5 studies), acculturation (19 studies), and reproductive health (7).

29 studies specifically mentioned investigating depression or depressive symptoms; 10 studies specifically mentioned investigating anxiety or stress symptoms; 6 studies specifically mentioned studying psychosis or schizophrenia."    

While there is currently growing literature on South Asian Mental health in the diaspora, there are many inequities in this research. Our review highlights the need for further, diversified research on the South Asian Western diaspora in order to provide culturally competent care.  

Current research is mostly skewed to South Asian Europeans, primarily in the UK. Depression is the most common mental illness studied. Further research is needed on other mental illnesses; some studies have also attempted to investigate South Asian cultural conceptualizations of mental illness, such as “Tension.” Moreover, the studies themselves need to practice culturally competent research, with few discussing translation, validation of their screening tools, and other needs of this population.