The British Association for Counselling and Psychotherapy (2015) found that people with diverse histories, cultures, beliefs and languages have settled in Britain experience an ongoing challenge which is faced within mental health services is that research shows that minority ethnic groups are least likely to access counselling services. South Asians are one of the fastest growing immigrant groups.

Included in this group are people from India, Sri Lanka, Bangladesh and Pakistan. Although there is a significant heterogeneity within and between the population of these countries, there are many cultural similarities which are faced when individuals from a south Asian community’s access counselling or even discuss counselling. Ahmed and Lemkau (2000) discuss in their article that due to cultural knowledge and sensitivity could be one of the issues which link to south Asians not being able to discuss medical problems. However, in spite of the variability within the countries of south Asian, the similarities of family values play an important role across all religions. A series of studies have been designed to investigate the cultural beliefs in the south Asian community, Jimenez, Bartels, Cardenas, Daliwal and Alegría (2012) conducted a study and looks at the beliefs concerning the causes of mental illnesses and they explain why there may be significant disparities in the rates formal mental health service use among racial and ethnic minority compared to Caucasian counterparts. Analyses were conducted using baseline data which was collected from participants who had completed the Cultural Attitudes toward Healthcare and Mental Illness Questionnaire. A number of questionnaires were used in this study such as sociodemographic questionnaire, diagnostic assessments, a service use questionnaire, a stigma questionnaire, and a cultural beliefs and preferences questionnaire. The final sample consisted off 1247 participants (what is1247).

The results of this study show that there are racial / ethnic differences among older adults with mental illness and each group such as African Americans, Asian Americans all had different beliefs regarding the causes of mental health. The Asian Americans expresses the belief that mental illness is caused by medical illness, cultural differences and family issues. They concluded that again that Asians are less likely to report distress in psychological terms. The limitations of using baseline data is that it can be quite time consuming and needs a lot of resources in order to fulfil the necessary steps. They identified the participants backgrounds, however did not look into the religions which would have been interesting to see the differences. As mentioned this data collection is time consuming, as well as for the participants too due to the required information needed. The main limitation of doing questionnaires is, it lacks personal touch and will not gain a insight into individuals life experiences. Further research by Hwang, Myers, Abe, Ting (2008) conducted a study and agree with the Jimenez et al (2012) and believe that there are a lot of stresses in the south Asian community compared to those from a white ethnic background, it is believed that their experiences may affect different groups differently, and as a result may have biased findings such as between certain groups such as African Americans, Asian Americans, there may be a higher burden of poverty in the US. Hofstede (1998) looked at the concept of ‘I, we and they’ and looked at how these simple words differ dramatically across the individualistic cultures.

For example, extended families are very common amongst south Asian families, these families tend to be very close so can sometime become reluctant on sharing information or problems with other people, such as health care professionals. Sue (1998) agrees and discusses that south Asians who live in an extend family tend to have a strong patriarchal family structure and a sense of family pride and shame to mould behaviours of individuals. The sense of family obligations to parents and extended family is very strong. She discusses that family needs tend to be more important than individual needs. Shariff (2009) also states that the south Asian culture is one in which family obligations and loyalty exists. He continues to compare how the south Asian culture differs from a Euro Canadian culture. His article discusses that if South Asians do seek counselling it is related to challenges such as depression, anxiety, academic difficulties, relationship issues and parenting stress. Sue and Sue (1977) reported that many mental health professionals have noticed that ethnic factors could act as barriers to counselling. Furthermore, it is argued that parents from a South Asia rely on the inculcation of shame and guilt and reminding the children of family obligations. It is believed that occupational and educational success of the family can be seen as far more importance rather than issues around mental health. Specific cultural belief and practices in the South Asian communities can have an impact on individual’s health can be very diverse. Ramakrishna (1981) looked at superstitious beliefs, such as the evil eye (najar). These are things which are very common in this culture.