Perceptions and experiences of distress among older Pakistanis in Bradford

This study focuses on Punjabi immigrants in Bradford who immigrated in the 1960s to meet a labour shortage. While this group had initially been almost entirely men who had planned on earning money and then returning to Pakistan relatively wealthy, changes in laws in the 1970s compelled them to bring their entire families to Britain. Changes in the local economy, and younger generations putting down roots in Bradford has left this group impoverished and unable to return to Pakistan, but many have been unable or unwilling to acculturate to British society. The life expectations these Punjabi immigrants have been unmet, and there is widespread emotional distress among them. While there are statutory mental healthcare services available to them which could help manage this distress, almost none of them male voluntary use of these services, and those that use them on an involuntary or semi-voluntary basis make as little use as possible. This study investigates this issue by blending theories and concepts from the social sciences, social work and the literature on race, culture and psychiatry. It uses a qualitative methodology of narrative and semi-structured interviewing to understand why the uptake of local state-offered mental health care services is so low. Samples from three sources were used in order gain perspective on this issue: Punjabi immigrants, medical and social care personnel, and lay healers using techniques traditional in the area of Pakistan from which immigration occurred. The study found that there were radical differences between the narratives of distress offered by the Punjabis and the understanding of the professionals; this undermined trust and created barriers to communication. The statutory services, in the form in which they were provided, could not meet the culturally specific needs of the Punjabis effectively and the services of the healers were often the preferred option. There has been little previous investigation into the narratives and cultural beliefs held by Punjabi immigrants previous to this thesis, or how these beliefs inform their experience of emotional distress, their help-seeking behaviour, or their understanding and interaction with- as well as the efficacy of- statutory services. Some cultural phenomena, such as the religious belief in kismet have not been thoroughly explored in a healthcare context previously