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These datasets underpin the analysis presented in the agency's work. Most data may be viewed interactively on screen and downloaded in Excel format. All countries. Topics A-Z. The content in this section is aimed at anyone involved in planning, implementing or making decisions about health and social responses. Best practice. We have developed a systemic approach that brings together the human networks, processes and scientific tools necessary for collecting, analysing and reporting on the many aspects of the European drugs phenomenon. Explore our wide range of publications, videos and infographics on the drugs problem and how Europe is responding to it. All publications. More events. More news. We are your source of drug-related expertise in Europe. We prepare and share independent, scientifically validated knowledge, alerts and recommendations. About the EUDA. The content of this summary does not necessarily reflect the official opinions of the European Union, nor the official opinion of the Republic of Tajikistan, and should be seen as the product of CADAP 5. Updated: August Studies on the prevalence of drug use among the population of Tajikistan were not carried out in In total, 5 respondents were interviewed, of which 2 The study found that the female respondents had a slightly higher awareness of the existence of drugs than the males. Some Among all respondents, Some 1. The survey results showed that However, When asked about drug use, 0. The consumption of inhalants was the most prevalent. According to the responses, 1. The use of marijuana or hashish was second most popular, with 0. The first experience with drugs most often took place at the age of 16 and usually the drug was marijuana, amphetamines, or tranquillisers. In a series of educational, sports and cultural events aimed at promoting a healthy lifestyle were organised. Participants were given information about the problems of drug use in modern society and its consequences. Health bulletins were issued and health information prepared in both the Tajik and Russian languages. Articles were published in newspapers and magazines and awareness-raising programmes were broadcast on three TV channels Channel One, Safina, and Jahonnamo and on the Republican radio. Anti-drug events are also organised annually to coincide with the International Day against Drug Abuse and Illicit Trafficking 26 June. Studies to estimate the population of opiate users, including injecting drug users IDUs , were not carried out in Drug treatment is carried out in the Republic of Tajikistan in specialised drug treatment facilities. The State guarantees anonymous drug treatment. In a total of 1 people received inpatient treatment in substance abuse treatment centres. Of these, The number of drug addicts who received hospital treatment in increased by The main strategic focus of this programme included:. As of 31 December , the country had 3 officially registered HIV cases cumulative number , of which The HIV prevalence rate was HIV cases have been registered in 66 of the 68 districts of the country. The average estimated number of HIV-positive people in the country ranges between 6 —10 Moreover, in recent years, the number of newly reported HIV cases among females has increased almost 2. Thus, in the proportion of women among registered new cases was 8. In , of the total number of registered HIV cases, In the country registered new cases of HIV infection, of which Among the newly registered HIV cases, people The number of reported cases of hepatitis C virus HCV in was According to the Centre for Health Statistics of the Ministry of Health of Tajikistan, in there were cases of syphilis infection among the general population, of which were male and were female. The official data from Tajikistan provide very limited information on the number of deaths related to drug use. Drug treatment is carried out in the Republic of Tajikistan at specialised drug treatment facilities. Services provided by specialised drug treatment agencies in the country include inpatient and outpatient care, anti-relapse therapy, rehabilitation programmes, work with drug addicts and efforts to prevent substance abuse. Treatment of drug dependence in the Republic of Tajikistan is conducted mainly at public drug treatment facilities, including:. The availability of substance abuse treatment beds in the Republic of Tajikistan is 4 per inhabitants. Harm reduction programmes are implemented to minimise the consequences of drug use. Geographically, the HR programme covers almost the whole of the country. In the Government of the Republic of Tajikistan reviewed and supported the letter of the Ministry of Health of the Republic of Tajikistan asking it to consider a pilot implementation of a programme of OST. Up to patients have received OST at this centre. This is the first gender-sensitive project in the Republic of Tajikistan. The centre provided low-threshold services laundry, showers, communication, leisure, food, sanitary napkins and legal advice and referral to doctors. In this centre, 62 were re-adaptation clients, 40 of whom abstained during the reported period, and two patients were referred for further rehabilitation to the Tangai Republican Rehabilitation Centre. These clients received low-threshold services and advice at the drop-in centre. Five hundred motivational packages were given to the most active clients. Harm reduction programmes were first introduced in the Republic of Tajikistan in in Dushanbe, Khujand and Khorog, mainly in the form of needle exchange programmes NEPs and via the distribution of information materials. In Kulyab a hour drop-in centre for drug users was opened by the non-government organisation NGO Anis. The NGO Volunteer, which implemented a programme in the Gorno-Badakhshan Autonomous Oblast GBAO , provided services 9 times during the reporting period, including services related to: social support 1 ; prevention 2 ; healthcare 2 ; information and counselling 1 ; psychological care and support ; legal services ; and social services The Social Bureau covered 1 clients people injecting drugs, 9 sex workers, 24 people living with HIV, 89 people with tuberculosis, 52 ex-prisoners with HBV and 15 with HCV, 1 minor at risk, and vulnerable women. As part of this programme, one mobile trust point and four NSPs were established, located on the premises of the National Tuberculosis Hospital in urban health centres Nos 2, 12 and During the reporting period, RAN served 1 clients. A total of syringes were exchanged and 23 condoms were distributed. In a total of 4 The steady increase in seizures of cannabis, primarily hashish, continued in , with the result that cannabis comprised This significant change in the type of drug seized was a result of an increase in the areas sown with cannabis in Afghanistan in recent years. The impurities in the samples of heroin that were seized were found to be from the manufacturing process — 6-monoacetylmorphine and acetylcodeine — and cutting agents of extrinsic origin — caffeine, acetaminophen paracetamol and dextromethorphan. No extrinsic substances were found in the narcotic opium seized in Starch-containing substances were found in just a few samples. The physical appearance of the cannabis resin that was seized was either in the form of a rod or of material compressed into rectangular tiles. The dimensions of tiles varied within the following ranges: width 14—16 cm, length 21—23 cm, thickness 2—3 cm. Drug prices in Tajikistan increase in proportion to the distance from the state border. The legislation of the Republic of Tajikistan in the field of drug control is based on the rules and recommendations of the United Nations Drug Treaties and Conventions , , , of which Tajikistan became a signatory in and The main purpose of Law No. Law No. The main objectives of the law are the protection of the rights and legitimate interests of people suffering from substance abuse and addiction, establishing bases and procedures for the provision of substance abuse treatment, and the protection and security of professionals providing drug treatment services. Article 6 of the Constitution guarantees the following types of drug treatment and social protection:. The main objective of this law is the realisation of the national policy and international agreements of Tajikistan in the sphere of licit trafficking of narcotic substances, psychotropic substances and precursors, countermeasures of their illicit trafficking, prevention of drugs and toxicomania and rendering of narcological assistance to people suffering from drug addiction and toxicomania. The main task of the law is to protect the rights and legal interests of people suffering from narcological diseases, establish grounds and a procedure for rendering narcological assistance and to protect the rights of medical and other workers rendering narcological assistance. According to Article 6 of the Law, the Government guarantees the following kinds of narcological assistance and social protection:. Chapter 22 of the Criminal Code of the Republic of Tajikistan effective from 1 September stipulates responsibility for the following violations of the law related to drug issues:. The National Strategy of the Republic of Tajikistan in the field of the control of narcotic drugs is aimed at preventing the use of the territory of the state by transnational organised drug traffickers to smuggle narcotics, international commitments and the establishment of strict control over the licit movement of narcotic drugs, ensuring the effective fight against drug trafficking, guaranteeing the medical care of patients with drug addiction and increasing international cooperation in this area. One of the measures taken by the Government of the Republic of Tajikistan in the field of drug control is the coordination of bodies at all levels of society in order to synchronise the activities of law enforcement agencies in the fight against drug trafficking, as well as the relevant ministries and agencies in the control of drug trafficking, psychotropic substances and precursors, and drug prevention. The main body that coordinates ministries, departments and organisations in the prevention of drug abuse, regardless of their form of ownership, is the Coordinating Council on the prevention of drug abuse, approved by Decree No. According to the decree, regional, city, and district councils for the coordination of drug prevention activities were established under republican subordination in the Gorno-Badakhshan Autonomous Oblast, Sughd and Khatlon regions, the city of Dushanbe, and other cities and districts. The Coordinating Council is recognised as the supervisory body of the interaction of ministries, departments and state bodies in the conduct of activities aimed at the prevention of the non-medical use of narcotic drugs and psychotropic and other drugs. Homepage Quick links Quick links. GO Results hosted on duckduckgo. Main navigation Data Open related submenu Data. Latest data Prevalence of drug use Drug-induced deaths Infectious diseases Problem drug use Treatment demand Seizures of drugs Price, purity and potency. Drug use and prison Drug law offences Health and social responses Drug checking Hospital emergencies data Syringe residues data Wastewater analysis Data catalogue. Selected topics Alternatives to coercive sanctions Cannabis Cannabis policy Cocaine Darknet markets Drug checking Drug consumption facilities Drug markets Drug-related deaths Drug-related infectious diseases. Recently published Findings from a scoping literature…. Penalties at a glance. Frequently asked questions FAQ : drug…. FAQ: therapeutic use of psychedelic…. Viral hepatitis elimination barometer…. EU Drug Market: New psychoactive…. EU Drug Market: Drivers and facilitators. Statistical Bulletin home. Quick links Search news Subscribe newsletter for recent news Subscribe to news releases. Breadcrumb Home Publications Tajikistan country overview Tajikistan country overview Contents Drug use among the general population and young people Prevention Problem drug use Treatment demand Drug-related infectious diseases Drug-related deaths Treatment responses Harm reduction responses Drug markets and drug-law offences National drug laws National drug strategy Coordination mechanism in the field of drugs References. Agency on Statistics under the President of the Republic of Tajikistan.

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Official websites use. Share sensitive information only on official, secure websites. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. Structural and cultural barriers have led to limited access to and use of mental health services among immigrants in the United States U. This study provided a systematic review of factors associated with help-seeking attitudes, intentions, and behaviors among immigrants who are living in the U. Qualitative and quantitative studies examining mental help-seeking among immigrants in the U. After removing duplicates and screening by title and abstract, a total of articles were eligible for full-text review and a total of 19 studies were included. Immigrants are more reluctant to seek help from professional mental health services due to barriers such as stigma, cultural beliefs, lack of English language proficiency, and lack of trust in health care providers. During the pandemic, In addition, more than one out of four U. These high rates of mental distress have clinical implications for mental health and well-being, including seeking professional care services. Notably, finding accessible mental health care was difficult before the pandemic for many Americans. According to the U. Census Bureau report, individuals in a racial minority communities will account for more than half of the population by which will make the U. New American Economy reported that more than Although underrepresented minority groups showed a greater tendency to develop anxiety, depression, and somatic disorders, there are contradictory findings about this greater tendency \[ 10 — 12 \]. For example, Arab Americans reported higher levels of depression and anxiety compared to the U. S-born Arab Americans while U. S-born Latinos showed higher rates of mental issues than Latino immigrants \[ 13 , 14 \]. Mental health concerns among asylum seekers and refugees in the U. Besides, undocumented immigrants are more likely to experience mental disorders due to additional stressors such as unpaid salaries, limited institutional supports, forced labor, and legal issues \[ 16 — 18 \]. Mental problems among minorities also may result in increasing disability, reducing quality of life, and rising premature death rates, which are linked to the huge cost of care and economic loss \[ 19 \]. The mental help-seeking process may be affected by different factors such as individual, social, and cultural aspects \[ 22 \]. Professional or formal mental health services can be provided by a wide array of mental health professionals, while nonprofessional or informal services may be provided by family members, relatives, friends, and online resources. Immigrants are less likely to seek professional services than U. For example, a review study highlighted the importance of cultural barriers such as stigma, acculturation issues, preferences for non-clinical treatments, and lack of trust in formal mental health care. They also indicated significant barriers to access including English language fluency, limited awareness of mental health services, high cost of mental health services, lack of health insurance, and limited access to professional services among U. There have been review studies targeted at a specific immigration group in the U. Some review studies were not established based on theories; hence, some challenges may arise with the interpretation of the results, understanding the relationships of variables, and conceptualizing of the mental help-seeking process \[ 29 — 32 \]. Furthermore, there are unique characteristics in the U. This diverse population offers a suitable context to add evidence on differences and similarities of mental help-seeking process among various cultural groups. Categorizing factors associated with help-seeking process based on the Theory of Planned Behavior TPB may elucidate areas of focus to develop coherent interventions and new standards. In addition, by meticulously looking at the unique cultural values among immigrants, culturally appropriate interventions can be designed and implemented to facilitate this process. Many scholars also have recommended conducting studies on seeking mental health services among U. Therefore, this systematic review study aimed to draw an appropriate framework to explore associated factors with mental help-seeking attitudes, intentions, and behaviors based on TPB constructs among U. Theory of Planned Behavior TPB was used to develop a theoretical foundation for the aims of this systematic review. For example, negative attitudes toward seeking mental services were related to decreased help-seeking behavior \[ 38 — 41 \]. Subjective norms have a significant role due to the higher rate of stigma toward mental issues \[ 43 — 47 \]. Behavioral control is essential since seeking mental care is not totally voluntary and affected by a variety of factors such as language proficiency, time, mental care cost, knowledge about availability, and awareness of the new cultural expectations \[ 26 , 48 — 50 \]. The need of theory-based mental health studies using theoretical frameworks were also recommended by previous researchers \[ 41 , 51 , 52 \]. Theory of planned behavior TPB \[ 37 \]. The Zotero bibliography software was used to collect and manage the references \[ 53 \]. Search terms and identified records are shown in Appendix A. Table 1 indicates the inclusion and exclusion criteria for this systematic review. The quality of cross-sectional, experimental, and qualitative studies was evaluated by the Joanna Briggs Institute JBI \[ 55 — 57 \]. To determine the risk of bias, we evaluated 8 domains for cross-sectional, 13 domains for the Randomized Controlled Trial RCT , 9 domains for the quasi-experimental, and 10 domains for qualitative studies. Of the initial records identified through searching databases, after removing duplicates and screening titles and abstracts, a total of articles were eligible for the full-text review. A total of 19 studies met the eligibility criteria and 85 studies were excluded. Preferred reporting items for systematic review and meta-analyses flow diagram \[ 54 \]. Fourteen studies used quantitative designs, of which 12 were cross-sectional \[ 59 — 70 \] and two were experimental \[ 71 , 72 \]. Three studies used qualitative designs \[ 73 — 75 \] and two studies used a mixed-methods design \[ 76 , 77 \]. Tables 2 and 3 summarize the study characteristics, study instruments, and descriptive results. An adapted conceptual framework of determinants of professional mental help-seeking addressed by included studies based on constructs of the TPB Fig. Regarding sociodemographic characteristics, age, gender, education, and income were factors associated with the mental help-seeking process. Some studies indicated that females were more likely to seek professional mental care compared to males \[ 60 , 71 , 77 \]. However, one study showed that female Chinese Americans were more reluctant to seek mental help from physicians compared to males. They showed that although females are more willing to seek advice for their mental problems, they prefer to seek help from their friends and relatives who speak their language \[ 70 \]. There were also inconsistent findings about the association of age with the help-seeking process. Although there was no significant relationship between age and mental help-seeking attitudes among Chinese Americans \[ 60 \], Bhutanese immigrants 45 years and older reported mental care access challenges more frequently than other age groups among \[ 62 \]. In addition, higher levels of education and income \[ 59 , 62 , 63 , 67 , 70 , 71 \] and having health insurance facilitated seeking mental care \[ 65 , 74 , 76 \]. Table 4 summarizes the facilitators of the mental help-seeking process using TPB constructs. Among subjective norms that are important factors in collectivistic cultures \[ 78 \], a lower level of stigma was a significant facilitator of seeking professional mental care \[ 59 , 60 , 63 , 67 , 75 , 76 \]. To assess the perceived behavioral control, a lower level of mental distress and more access to counselling services facilitated seeking mental care \[ 61 , 62 , 67 , 72 , 73 , 75 \]. Also, immigrants with long working hours, having difficulty involved in taking leave, and unavailable transportation services were less likely to seek treatment due to insufficient time \[ 74 , 75 \]. To assess attitudes toward seeking mental help, favorable beliefs and perceptions about mental health have facilitated seeking professional help \[ 74 , 75 \]. All cross-sectional studies received high scores for clear definition of inclusion criteria and use of valid and reliable measurement tools. However, half of the cross-sectional studies did not identify confounding factors which may affect the relationships of main study outcomes. Among two experimental studies, the RCT study failed to blind participants and assessors \[ 72 \] and the quasi-experimental study failed to consider a control group and multiple measurements of the outcome before and after the intervention \[ 71 \]. Overall, all qualitative studies used appropriate strategies for research methodology and the interpretation of results. One of the mixed-method studies also failed to get a good score due to the inadequate integration of qualitative and quantitative findings as well as insufficient explanations about inconsistencies between qualitative and quantitative results \[ 77 \]. We conducted this systematic review to examine factors related to professional mental help-seeking attitude, intention, and behavior among immigrants, asylum seekers, and refugees living in the U. Our results highlighted the importance of informal help-seeking behaviors across all included studies. Similarly, previous studies also found that the acculturation orientation might considerably affect help-seeking preferences when an immigrant maintains traditional and cultural beliefs \[ 80 — 83 \]. For example, people from Asian cultures preferred to get help from family and friends since seeking professional help is considered shameful and a violation of family coherence \[ 84 \]. Likewise, there was a negative relationship between Asian cultural values and positive mental help-seeking attitudes \[ 85 \]. Conversely, no significant relationship between acculturation levels and professional mental help-seeking attitudes was found among Iranian Americans due to improving knowledge about mental issues, reducing stigma, and more available resources \[ 86 \]. Our findings also emphasized the significance of acculturation levels and traditional values to address the mental help-seeking process and implement interventions due to the complexity of help-seeking behaviors among diverse immigrant groups. Among subjective norms as an essential component of TPB, acculturation levels and cultural beliefs affected the process of mental help-seeking. Our results indicated that factors such as longer years of residence in the U. Furthermore, more acculturated immigrants were more likely to seek professional mental help. Our findings also highlighted the importance of the stigma as a topmost barrier to seeking professional help. Similarly, previous research revealed that the stigma negatively affected help-seeking attitudes and behaviors among western Muslims based on their cultural heritage \[ 87 \]. Vietnamese Americans also showed a higher level of mental illness stigma that resulted in being worried and fearful of break in confidentiality and the feelings of embarrassment and shame, consequently making them less likely to seek professional care \[ 82 , 88 \]. The critical role of stigmatizing attitudes directly or indirectly has been addressed among Asian Americans \[ 26 , 89 \], Muslims \[ 28 , 87 \], Filipino \[ 90 \], and Latin American \[ 91 \]. Another important component of TPB is perceived behavior control \[ 36 \]. According to our findings, more access to mental care services, availability of interpreters, and culturally appropriate services were facilitators of the professional help, especially among refugees and asylum seekers \[ 92 \]. Indeed, if mental health providers establish a trusting relationship without any biased attitudes and negative emotional impacts, immigrants tend to seek mental care \[ 92 , 93 \]. Also, the detrimental impact of cultural incompetence of professional mental help resources was addressed by several studies \[ 92 , 94 \]. Also, access to bilingual mental care providers and interpreter facilities lessen the linguistic mismatch between patients to develop a trusting relationship without judgmental behaviors \[ 10 \]. Despite existing evidence on important advantages of using bilingual mental health workers, their multidimensional roles and contributions remain underrecognized and need future research \[ 92 \]. Not only cultural differences but also institutional and organizational policies in health care facilities limited access to mental care services \[ 32 \]. The attitude toward professional mental help-seeking is considered a key construct of TPB. Our findings showed that favorable attitudes and positive beliefs about professional mental help-seeking and perceptions of mental care helped immigrants to understand the importance of appropriate services. Conversely, financial instability may prevent them from seeking care, as similarly mentioned by previous studies \[ 96 , 97 \]. Also, consistent with our results, studies among Asian Americans revealed important roles of stigmatizing attitudes, previous experiences of mental health services, and cultural mistrust \[ 98 , 99 \]. Our findings indicated that sociodemographic characteristics are important to study the mental help-seeking process due to their relationships with TPB constructs. Based on our results, women are more proactive to seek professional mental health care services due to their favorable opinions of professional help-seeking \[ 80 , 86 \]. Additionally, traditional gender roles can lead to this difference between men and women in terms of help-seeking behaviors. For example, a sense of being more independent among males may foster a greater perceived risk that results in a low self-esteem and inability to manage their mental issues \[ 99 \]. However, some studies found no relationship between gender and mental help-seeking endorsement \[ 89 , \]. A higher level of education also may facilitate the mental help-seeking process which is consistent with previous studies \[ 86 , \]. In general, U. Although all 19 studies were conducted among U. It is unrealistic to think that immigrants will engage in mental care activities out of their cultural beliefs as the potential impacts of these beliefs were discussed. Therefore, culturally based measures should be taken based on the situation, context, and challenges immigrants face. Also, reducing stigma toward mental illnesses using multidisciplinary community-based approaches highlights the significance of facilitating this process from sociocultural to organizational aspects. This systematic review has led to significant findings. However, some limitations should be noted. The majority of included quantitative studies used convenience sampling to recruit participants which restricts the generalizability of findings \[ \]. Most of the studies also used a cross-sectional design that limits the ability to make a causal inference \[ \]. In addition, self-report data may pose concerns about the social desirability and recall biases \[ \]. Although all studies mentioned the geographic areas for data collection, none of them discussed geographic accessibility as a barrier or facilitator of mental help-seeking. Findings of this review suggest key research gaps that need to be addressed in future research among immigrants. Table 5 indicates implications for research and practice. According to the findings of the systematic review of 19 studies to evaluate factors associated with mental help-seeking among immigrants in the U. The current systematic review shows the importance of understanding socioeconomic features, subjective norms, acculturation, perceived behavioral control, and attitudes that affect seeking mental care services. Also, language barriers, lack of trust for the health providers, limited social support, and length of residence in the U. Bold formatting indicates the final number of identified records when all search terms were included in searching through databases. Duplicates or identical records among databases were highlighted in bold and removed. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript. The authors have no relevant financial or non-financial interests to disclose. The systematic review research did not involve human participants or animal. Obtaining informed consents is not needed for this review study. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. As a library, NLM provides access to scientific literature. J Immigr Minor Health. Find articles by Mona Mohammadifirouzeh. Find articles by Kyeung Mi Oh. Find articles by Iccha Basnyat. Find articles by Gilbert Gimm. Accepted Mar Open in a new tab. C area a population-based telephone survey conducted by researchers at the University of California San Francisco Males The initial mean PHQ—9 score of these 42 enrolled participants when they were previously screened for the depression study was A framework of patient decision-making behavior. Only If family support did not work, they consulted with their relatives and trustworthy community members for further assistance. Psychological factors such as fears of emotions, social norms, beliefs, and self-esteem associated with cultural norms and values influenced seeking mental health support \[ 63 \] Attitudes toward seeking and using formal mental health services Attitudes Toward Seeking Professional Psychological Help Scale Translated Total possible score range: 1. However, some reported feelings of isolation and the desire to be able to carry out postpartum traditions more frequently. Social barriers included inadequate social support, immigration status, and limited English proficiency. Health care delivery barriers included financial and time constraints and lack of childcare and transportation. Facilitators of mental help-seeking attitudes, intentions, and behaviors. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel. Qualitative and quantitative studies examining attitudes, intentions, and behaviors toward seeking help for mental health problems anxiety disorders, depression, post-traumatic stress, schizophrenia, bipolar, phobia, mania, personality disorders, somatic symptom disorder. Literature reviews, systematic reviews, clinical reports, reflective papers, theoretical papers to advance a theory, dissertations, theses, editorials, books, methodological papers, and comments on the literature. The study outcomes did not include attitudes, intentions, and behaviors toward seeking help for mental health problems. The target population that includes immigrants, asylum seekers, and refugees living in the United States. The target population did not include one of these groups, such as migrants, asylum seekers, and refugees. The target population that includes first-generation immigrants living in the United States. Studies which did not report whether migrants were the first generation. Studies that focused exclusively on domestic violence, substance abuse, and suicide because these are not mental health disorders although they may lead to some mental health issues. Texas, New York, and California Chinese community centers, organizations, churches, and schools. Los Angeles, New York City, Austin, Honolulu, and Tampa multiple locations and events such as churches, temples, grocery stores, small group meetings, and cultural events. Western Massachusetts The community members relayed study information in their community through word of mouth, by phone, and at formal and informal gatherings and cultural events. C area a population-based telephone survey conducted by researchers at the University of California San Francisco. Northern California grocery stores, community centers, obstetrician and pediatrician waiting rooms, as well as referrals from community partners and word of mouth. Only 5 participants were at a high risk of developing postpartum depression. Phoenix, Arizona local stores, churches, barbershops, and through word of mouth. New York City organizations with high Jamaican membership such as clubs, churches or those provided services to Jamaican neighborhoods such as barber shops, beauty parlors. New York the waiting room of the practice upon registering for their appointments. California, San Francisco a large multiservice community clinic. The mean CES-D score was 19, suggesting a high level of depressive symptomatology. Social cognitive theory and a model of culture-centric narratives in health promotion. Houston, Texas Chinese community centers such as cultural festivals, employment, and language classes, major Chinese shopping malls, Chinese churches, and temples. Participants were adult patients who previously screened positive for depression but declined to participate in a depression care management study. Total possible score range: 0—; Family members provided the initial frontline support to persons with mental health problems. Psychological factors such as fears of emotions, social norms, beliefs, and self-esteem associated with cultural norms and values influenced seeking mental health support. Attitudes toward seeking and using formal mental health services. Total possible score range: 1. Attitudes towards professional mental health care were assessed by a item scale from the Help Seeking Attitude Scale English. The rate of professional mental health service use was 5. To assess help-seeking preferences for depression, interviewers read a clinical depression vignette. Postpartum traditions played important roles in their well-being and maintaining strong cultural values. Many who had reported sadness said that they would not seek professional help; all had felt that their condition was not severe enough to warrant help-seeking. Participants identified personal barriers including beliefs about emotional health, the perceived stigma of mental illness, hesitancy to seek treatment for symptoms of PPD, and cultural beliefs about motherhood and the role of women. More access to counseling services and interpreter facilities. Positive beliefs about emotional health and the treatment of depression. Future studies on factors related to the mental help-seeking process with an identified mental health problem to describe how a mental disorder affects this process. Future studies with culturally appropriate interventions and long-term follow-ups to evaluate the efficacy and assess different patterns of the help-seeking process. Developing a trusting interaction with immigrants and providing an unbiased environment for them to talk about their mental issues. Future mixed-methods studies to elaborate determinants of professional mental help-seeking behaviors by integrating qualitative and quantitative findings especially in understudied populations. Being aware of cultural sensitivities, values, and norms of diverse cultural groups in addition to being cognizant of their own cultural, racial, and ethnic biases. Future studies on bilingual provider roles and access to interpreter facilities. Providing support resources such as appropriate interpreters, community organizations, family and friends, and religious practices. Future studies on the efficacy of anti-stigma interventions to improve help-seeking attitudes, intentions, and behaviors. Being more flexible about the time and locations of counseling that may encourage clients to seek professional resources and create a sense of comfort which is similar to what they receive from their family and friends. Future studies on first-generation immigrants to find specific cultural aspects related to mental health as well as compare their challenges with the second-generation groups. Providing online mental care services to overcome barriers related to insufficient time, long working hours, and inaccessible transportation.

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