An Exploration of the Experience and Sense-Making of Psychosis in a South Asian Population: An Interpretative Phenomenological Analysis

There is strong evidence of inequalities in mental healthcare access, experiences and outcomes for service users belonging to Black and Asian Minority Ethnic groups experiencing psychosis. Clinicians and academics have speculated that culture-specific conceptualisations of psychosis, alongside inequitable service provision may explain disparities. There is, however, a dearth in literature exploring this in a South Asian population, despite this ethnic group being the second largest in the UK. The present study aimed to explore how people from this minority group have experienced and made sense of First Episode Psychosis (FEP). A qualitative approach was used to explore the lived experience and sense-making of British South Asians experiencing FEP and accessing early intervention services. Eight people were interviewed using a semi-structured format. The data were analysed using Interpretative Phenomenological Analysis. Three superordinate themes were identified in the group analysis: 1) Disconnection from self and others 2) Doubt and dispute 3) Power and shame. Participants characterised psychosis as a terrifying and uninvited intrusion and a fundamental shift in sense of self. Distinctive ethnic, cultural and systemic influence was strongly evident in how people conceptualised their experiences, how they managed their sense-making and where they sought support. Experiences were discussed in the context of power and shame, and this research proposes that socio-cultural/political context and racialised discourses have an impact on self-concept, the experiences of help-seeking (formal and informal), and fundamentally how services help them. Implications of this study for practice, policy and research are discussed.