"God is my psychologist": How explanatory models of mental health influence healthcare-seeking behaviour among first generation East-African migrants in Belgium

Abstract

Abstract Background: Explanatory models of mental health are culturally and socially defined and influence mental healthcare-seeking behaviour. This qualitative study explores the explanatory models of mental health among first-generation East-African migrants in Belgium and how these models influence their mental healthcare-seeking behaviour. Methods: Thirty in-depth interviews were conducted and analysed in a reflexive, thematical manner. Results: Results show that participants perceived discrepancies in how mental health is conceptualised between their region of origin and Belgium. In their cultures of origin, mental health is associated with 'craziness', and causes are rather sought in social, religious, or supernatural contexts. Participants also experienced differences in the openness to discuss mental health. Most participants held on to the mental healthcare-seeking behaviour of their country of origin: they relied on informal social and religious support systems and did not seek conventional mental healthcare. Participants who were more familiar with the prevailing explanatory models within Belgium, were more likely to use conventional mental health services. Conclusions: Participants generally hold on to help-seeking strategies as applied in their countries of origin, but are more prone towards using conventional services if they are more familiar with or are positively oriented towards adopting aspects of the dominant explanatory model of mental health. Further research is needed to study the link between integration processes and mental healthcare-seeking behaviour.