Barts Explanatory Model Inventory : the exploration of cross-cultural variations in perceptions of mental distress
Cultural variations in individuals' perceptions of mental distress are an important issue for health care. They can affect communication between health professionals and mentally distressed individuals and might be one explanation for problematic diagnosis, poor service uptake and negative outcome for individuals from ethnic minorities. This PhD a) explores how cultural variations in perceptions of mental distress have been assessed in the past b) reports the construction and development of a new instrument, the Barts Explanatory Model Inventory (BEMI) and c) uses the instrument to explore associations between illness perceptions and ethnic background, acculturation processes and psychiatric 'caseness' in three different ethnic groups. It was found that significant ethnic variations existed in perceptions about physical complaints, spiritual, physical and psychosocial causes, expected timeline, psychological consequences and helpful treatment. For example individuals from White British background found 'alternative or complementary' treatments helpful (,X 2=1 2.035, p<. 01); individuals from Bangladeshi and Caribbean background on the other hand preferred 'medical' (72 =6.597, p<. 05) or (spiritual' interventions (,X 2=1 7.916, p<. 001). The survey also found that perceptions contribute significantly to predicting psychiatric caseness (R 2= . 577, p<. 0001) and are in turn also helping to predict how long migrants have been in the UK (R 2= . 581 p<. 0001). The findings support the notion of assessing cultural variations in perceptions in health care as a feasible as well as necessary endeavour.