Having the confidence to seek therapy when you have a mental health condition is one of the most difficult situations one has to face throughout their life. According to a 2016 survey by the NHS, “approximately 1 in 4 people will experience a mental health problem each year.” With this statistic it is obvious that treating mental health is not uncommon, but being treated by a counsellor that does not have the same cultural background as the client, unfortunately is.

 

Nafsiyat is a psychotherapy centre that has been providing therapy in 24 different languages to the multicultural backgrounds of North London for decades. Founded in 1983, by psychotherapist Jafar Kareem, he was one of only three psychotherapists working in the NHS from a non-white background. In the Eighties, he found that the need for non-Westerners benefitting from psychotherapy and other talking therapies was not being fulfilled. It was on this foundation that Nafsiyat was created.

 

The centre provides intercultural therapy to families, couples, adolescents and children, and refugees; as well as training to their staff. There is finally a place where minorities can speak to therapists from their culture, rather than communicating through interpreters. “The main languages are Turkish, Bengali, Arabic, Farsi and Somali...we have two Turkish speaking therapists who have worked here for over 20 years, so we are well known in that community” says Adam Weatherhead, Managing Director of Nafsiyat. As some languages do not have words that translate directly into English, a lot can be lost through translation, which affects consultations and the patient finding comfort in confiding in a therapist.

 

The mental health charity, Mind, states that although “the overall number of people with mental health problems has not changed in recent years, worries about things like money, jobs and benefits can make it harder for people to cope.” While patients from different cultural backgrounds are not excluded to these worries, there are also “external realities” Weatherhead says. The psychotherapy that Nafsiyat provides “allows in poverty, racism, isolation, immigration and housing issues. It accepts that these factors could have an impact on the clients’ mental health.”

 

According to the Mental Health Foundation, “African-American people are three to five times more likely to be diagnosed and admitted to hospital for schizophrenia.” as they are reluctant to seek services, and they find some treatments coercive. With Chinese people, the close family structure of the Chinese community is supportive, but “it may generate feelings of guilt and shame, resulting in people feeling stigmatised and unable to seek help.” Some cultures also physically portray their mental health condition in a way that is invisible to the majority. Weatherhead said “Turkish people can present themselves in the form of physical symptoms. These are known as medically unexplained symptoms, like back pain when doctors can’t find any reason why, are a big issue for the NHS. The back pain might be due to a grief issue, such as not being around during a parent’s death.”

 

The domination of white clinicians in the industry makes room for unconscious biases, miseducation and cultural encapsulation, which affects their view of the patient being treated, resulting in patient dissatisfaction. “We find that people from certain countries have a distrust of large government institutions, so they favour a community approach,” Weatherhead says. “Hospitals and buildings with NHS or mental health signage might be intimidating or put people off due to stigma surrounding mental health issues, which is greater in certain ethnic communities. This relates to cultural accessibility.”

 

Rather than using current conventional methods of therapy, all therapists need to take into account the whole and inner being of a patient. One’s health cannot be generalised in the same way that symptoms of mental health are. Intercultural therapy is already being provided in some other community organisations and private practices, but being able to offer services in many languages is more expensive than just the one. Weatherhead said “Due to widespread funding cuts across councils and the NHS, psychotherapy like CBT is used as it it cheaper and easier to evidence results...so being able to offer intercultural therapy to marginalised communities is probably not a high priority for them, sadly.”

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