title: Sub-Saharan African migrant youths' help-seeking barriers and facilitators for mental health and substance use problems: a qualitative study.
abstract: Many young migrants and their parents are reluctant to seek help for mental health and substance use problems. Help-seeking delays can result in longer duration of untreated problems and poorer outcomes. In this study, we aimed to identify the help-seeking barriers and facilitators for anxiety, depression and alcohol and drug use problems in young people from recently established sub-Saharan African migrant communities.
  
  
  
  A qualitative study, incorporating individual, in-depth interviews and focus group discussions, was undertaken in Melbourne, Australia. Twenty-eight young sub-Saharan African migrants participated in the individual interviews, and 41 sub-Saharan African-born parents and key community leaders participated in 4 focus groups. All participants were aged 16 years or over. A thematic analysis of the data was undertaken.
  
  
  
  Themes and related sub-themes were abstracted from the data, reflecting the young people's, parents' and key community leaders' beliefs about barriers and facilitators to help-seeking for mental health and substance use problems. Four help-seeking barriers were identified: stigma of mental illness, lack of mental health literacy in parents and young people, lack of cultural competency of formal help sources, and financial costs deterring access. Five help-seeking facilitators were abstracted: being open with friends and family, strong community support systems, trustworthiness and confidentiality of help-sources, perceived expertise of formal help-sources, increasing young people's and parents' mental health literacy.
  
  
  
  Programs that identify and build on help-seeking facilitators while addressing help-seeking barriers are needed to address mental health issues among young sub-Saharan African migrants. Strategies to address help-seeking barriers should consider counteracting stigma and increasing mental health literacy in sub-Saharan African communities, increasing health providers' cultural competency and perceived trustworthiness, and addressing financial barriers to accessing services.
authors.affiliation: Discipline of Nursing, Centre for Chronic Disease, College of Health and Biomedicine, Victoria University, PO Box 1428, Melbourne, 8001, VIC, Australia. terence.mccann@vu.edu.au.
authors.forename: Terence V
authors.initials: TV
authors.lastname: McCann
authors.affiliation: Turning Point and Eastern Health, Melbourne, Australia.|Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.
authors.forename: Janette
authors.initials: J
authors.lastname: Mugavin
authors.affiliation: Western Sydney University, Sydney, Australia.
authors.forename: Andre
authors.initials: A
authors.lastname: Renzaho
authors.affiliation: Turning Point and Eastern Health, Melbourne, Australia.|Monash University, Melbourne, Australia.
authors.forename: Dan I
authors.initials: DI
authors.lastname: Lubman
mesh_terms: D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D001315:Australia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D008603:Mental Health; D008605:Mental Health Services / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D036301:Qualitative Research; D057545:Social Stigma; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D014171:Transients and Migrants / Q000523:psychology*; D055815:Young Adult
keywords: Barriers; Facilitators; Focus groups; Help-seeking; Individual interviews; Mental health problems; Qualitative research; Refugees; Sub-Saharan African migrants; Substance use problems