Pakistani Muslim teenage girls' constructions of help-seeking from mental health professionals and their understanding of its relationship to ethnic identity.

The under-use of out-patient mental health services by people from 'ethnic minority groups' is widely documented. Most of the literature refers to adults, but there is also evidence that it is equally relevant to adolescents. Models and hypotheses have been developed to explain the underuse of services, help- seeking by adolescents and people's health behaviour. These have tended to take an individualistic perspective in which cognitions are given a high priority and social and cultural influences are reduced to the status of 'variables' This study, however, aimed to take a social constructionist perspective to part of the process of mental health service use. Using a grounded theory methodology, this study set out to investigate the meanings of seeking help from a mental health professional for Pakistani teenage girls in Derby and their understanding of the relationship between these and their ethnic identity. The Multi-group Ethnic Identity Measure (Phinney, 1992) was used to describe the teenagers' ethnic identity. In depth interviews were conducted with twenty Pakistani teenagers in which they were encouraged to discuss how they would go about seeking help from a mental health professional for an emotional problem and the influences on them in the process. Eating disorders were chosen as a focus for the discussions as they have a high popular profile and there is concern about high levels of eating disorders among Asian girls. The analysis illustrated how seeking help from professionals is a social process, shaped by the cultural meaning associated with emotional distress and wider social and cultural practices, values and structures. Of prime importance for the teenagers interviewed was the relationship between their family and the Pakistani community, and their roles as females in maintaining the family's social position. Also of importance were their relationships with their parents and their fears about the client-professional interaction. The research suggests that all levels of influence need to be considered in the planning and provision of services, which should involve Pakistani teenagers and their families, as well as key members of the community.