The Impact of Depression on the Mental Health of Young Black Women Between 18 to 25 in the Borough of Hackney, UK

ABSTRACT

Depression, especially among black women, is a significant health concern for individuals. Although depression has been experienced by many individuals worldwide, the experiences differ from one group of people to another. Research has shown that even tiny children can manifest some signs of depression, which makes it a serious health concern. Even though considerable research has been done on depression, the experience of black women residing in the UK is primarily unknown.

This dissertation has focused on attaining a deep understanding of depression experiences among young black women above the age of 18 years but below 25 years of age in the Borough of Hackney, UK. A qualitative study method was utilized, describing data and drawing crucial conclusions from the existing literature.

This research found that depression among young black women in the United Kingdom was caused by; cultural factors, identity, the status as a minority, and pressures from the norms of the society. Recommendations to health practitioners have been made to better understand the experiences of depression for each patient at an individual level. The study was limited to black women between 18 to 25 years in the Borough of Hackney, UK.

Keywords: depression, mental health, young black women, health practitioners.

CHAPTER ONE – INTRODUCTION

1.1 Introduction

The data from the mental health bulletin in the United Kingdom shows that for every hundred thousand people who accessed mental health services between the years 2014 and 2015, about five thousand of them were black or black British (Iob et al., 2020). Of these blacks, about 12.7% of them that came into contact with learning disability or mental health services spent at least a night in the hospital, some taking quite a long time there. The percentage of these whites that spent a night in the hospital was less than half of this. The figures of the black men that face risk in mental health are high, but even higher are the statistics of the black women that face a threat. Various circumstances and situations are a potential cause that often arouses depression in people from any background. However, there could be social issues or cultural matters that can bring about a risk of poor mental health to people and especially black women in particular. The case could also be that women struggle with perception daily, which can make the constant fights in their minds appear normal.

Research by the Mental Health Foundation showed that African Caribbean people who live in the United Kingdom have higher chances of being diagnosed with extreme mental illness levels than all other ethnicities in the United Kingdom. Among black people, mental illness is a stigma. Since there is not much participation from the authorities in mental health, experts are in consensus that there is a big gap in statistics for this growing issue. Little is known about the mental health of black women. A research manager from The Mental Health Foundation, Josefien Breedvelt, once argued that these individuals are rarely involved in research. In most studies, the focus has been laid on the minority groups at large, but there has not been a specific focus on the mental health challenges that black women in the United Kingdom face.

This dissertation has focused on the effects of depression among young black women between 18 to 25 years of age in Hackney in the United Kingdom. This research will help to determine what is going on as far as mental health is concerned for this group of people specifically. Data from previous research has also been incorporated to contextualize the impending problem and develop better and more efficient ways to address the effects of depression among young black women in this region. This dissertation has addressed the knowledge gap on mental health among black women that has not been appropriately addressed in the past.

1.2 Background

Black women are experiencing numerous challenges that are unique in mental health care. To understand these disparities, it is vital to appreciate the roles that black women have played in society, even more, the social and racial injustice that these women have faced throughout their history (Wallace et al., 2016). Mental Health Providers claim that young black women are the most disadvantaged in the United Kingdom; many times have had to deal with sexism, racism, and financial inequalities (Molina & James, 2016). Some others believe one of the things that make young black women very resilient people in the Kingdom. In as much as all of these may be true, there is a need to study the mental health of young black women so that treatment outcomes can be optimized.

Simply because the rate at which women experience depression doubles that of men, society can expect the number of white women that receive care to be comparable to that of the black women receiving the same respect. However, to the contrary, there is a significant variation. From history, it has been noted that black women are by far less likely to seek or accept mental health care. A good example is the black woman diagnosed with postpartum depression. They are not expected to take the therapy or the medication that has been recommended (Robotham et al., 2016). For a long time, the lack of participation has been attributed to stigma; however, a recent study has denied this claim. It has been claimed that their previous experience with mental health treatment is the main factor determining how willing they are to accept treatment or therapy again. It is essential to identify what has been barring them from accessing mental health care because depression gets severe when these women do not pursue mental health.

It is expedient for psychiatrists to identify the barriers because once they are singled out, the relationship between the patients (black women) and the doctors will improve, bringing about better mental health care for young black women. Access to a healthcare provider could be one of the significant barriers. The population of black clinicians and psychiatrists in the United Kingdom represents a tiny percentage compared to white. This is also made worse in psychiatry subspecialty programs of training. The whites are less likely to receive diagnoses that have poor long-term effects. The issue of depression for young black women is therefore so important to study as it will solve many mental health concerns for these critical people in society who have suffered quite significantly.

1.3 Statement of the problem

Even though much research has been done on the impact of depression on minority groups, there are few studies on young black women. Mental health practitioners in the USA have attempted to look at the matter and suggested that black women avoid mental health care services depending on their previous experiences with healthcare officers. However, there is still a gap to address the question for young black women, including those who have not visited the doctors even a single time, and the impact depression has on them.

The study has focused on what depression has resulted in the mental health of women below 25 years of age and above 18 years in the Borough of Hackney, United Kingdom.

1.4 Research objectives

The objectives for this dissertation are:

1. To determine what is likely to have been causing depression among young black women in Hackney, United Kingdom.
2. To find out how depression has affected young black women’s mental health in Hackney, in the United Kingdom.
3. To examine the support given to those young black women suffering from depression in Hackney.
4. To make recommendations on what to do to improve mental health support services for young black women in Hackney, UK.

1.5 Research questions

They include:

1. What have been the leading causes of depression among young women in the United Kingdom?
2. What symptoms are portrayed by the young black women suffering from depression in Hackney, UK?
3. What are the effects of depression on the mental health of young black women in the United Kingdom?
4. What can enhance health care assistance for young black women in the UK?

1.6 Rationale

The apparent signs of depression are less likely to occur in black women, unlike it is among whites. Studies show that depression symptoms can differ from one individual to another. Columbia and New York University did a study that suggested that symptoms of depression among black women can be easily overlooked or go without being treated by doctors. According to them, black women with depression were likely to report only physical symptoms like insomnia, fatigue, irritability, and decreased libido. At the same time, some showed symptoms of self-blame and self-criticism.

It has been known commonly that symptoms of depression can comprise loss of interest in activities, low moods, change in sleeping habits or appetite, and a feeling of worthless or even minor, if any, hope. From research, it could be noted that many studies that relate to the effects or symptoms of depression have been, in most cases, conducted by white people. This suggests that little is known as far as depression is concerned among other minority groups, especially young black women. This study will be so important to show how depression can appear and affect people differently by showing how it affects young black women.

1.7 Dissertation structure

The following are the five chapters in which this dissertation has been structured;

• Chapter one – Introduction. It introduces and context the research gap among young black women aged 18 to 25 in the United Kingdom. Some of the subheadings in the chapter include background, research objectives, research questions, the definition of terms, scope, and delimitations, among others.
• Chapter two – A literature review. A study has been conducted on the previous works from the same field to understand the existing gap in the research and the trends in the area. The theoretical framework is also contained in this chapter.
• Chapter three – Methodology. It explains the research method selected in this dissertation and justifies all the philosophies and methods of data analysis that have been utilized.
• Chapter four – Results and Discussion. A summary of what has been found in the research is presented in this chapter according to the evidence and the sources of data that were used. Some other studies are also brought in to discuss these results.
• Chapter five – Conclusions and recommendations. Conclusions are made here, and recommendations of what can be done to mitigate or control the impact of depression on young black women are also made in this chapter.

1.8 Definition of terms

These are the terms that have been used:

• Depression: mood disorder resulting in loss of interest or persistent sadness. When significant, it affects the victim’s feelings, thoughts, or behavior, leading to various physical or emotional problems.
• Mental health: it comprises of psychological, emotional, and social well-being of an individual, and it affects the thoughts, feelings, and actions of the individual.

1.9 List of abbreviations

The following abbreviations have been utilized in this dissertation:

• UK: United Kingdom
• USA: United States of America.

1.10 Scope and delimitations

This research has been done on the young black women in the Borough of Hackney, UK, who are above 18 but below 25 years of age, and recommendations have been made to help this particular group. However, some parts of the literature review have been obtained outside the United Kingdom, covering more than just the black women of this age bracket. The findings can be applied in other contexts since various people face the same challenges simultaneously.

1.11 Summary of the chapter.

This chapter comprises an introduction, background, research objectives, research questions, and rationale that explains the primary purpose of the chapter. The others included in this chapter are the dissertation structure, definition of terms, and list of abbreviations that tell more about the chapter. This chapter shapes the entire dissertation.

CHAPTER TWO – LITERATURE REVIEW

2.1 Introduction

In this chapter, studies have been done concerning the factor influencing depression among black women and how religion and cultural beliefs related to depression among black women. There has been a thorough examination of previous studies that have dealt with the issue of depression among black women and some other minority groups worldwide.

2.2 Review of literature

2.2.1 Factors that have contributed to depression among blacks in the past.

From a general point of view, mental health conditions occur among blacks at the same frequency or lesser than among white people. From history, it has been noticed that the experience of blacks in America has been characterized by violence and trauma more than it is the case with whites, and it has continued to be so for a long time (Macaskill, 2013). This has tremendously affected the mental and emotional health of the elderly and youth. The dehumanization, oppression, and violence that used to occur against black people have evolved into the racism faced today, whether in an institution, individual or structural racism. This has cultivated a community that cannot be trusted, with many disparities that include and are not limited to access to inadequate care and health care delivery in the health system.

According to research on mental health in the United States of America, the behavior of seeking help is influenced by the mistrust of the system of medication (Assari et al., 2016). Screening data from the Mental Health in the USA has shown that blacks and African Americans who test positive for depression are planning to seek medical help more than the rest of the people in the American population (Bidulescu et al., 2015). Unfortunately, the Africa Americans and blacks in a position to give appropriate medical care to these people are making a tiny percentage of the mental and behavioral healthcare providers’ workforce. Due to these factors, among others, the African American and black people in this region tend to suffer chronic and persistent mental difficulties rather than episodic ones. However, there remains to be hope because this issue has been highlighted, and those who make policies are held to account by the public to devise policies that can correct such a situation.

In as much as there has been progress for some years, racism still has detrimental effects on the mental health of African Americans and black people. The rejection attitudes and negative stereotypes have, in the previous years, been a significant cause of depression among blacks in the USA, but they have decreased. However, they continue to exist with the consequence that can be measured through adverse. Many instances in the past where the negative treatment occurred have also been a significant factor that has caused mistrust of authorities, considering that most of these authorities did not have the best interest of the blacks and the African Americans in their minds. Historical adversities such as sharecropping, slavery, exclusion from health services, education, and economic and social resources based on race have contributed so much to the socioeconomic disparities among blacks. The status of socioeconomic has a relationship with mental health. It is shown from research that individuals who are poor, incarcerated, and homeless or have little substance are more vulnerable to mental health conditions (Coid et al., 2020).

There is much interest in the social causes of stress that have been affecting minority groups and how they affect the health of the individual. Generally speaking, anyone experiences stress if they perceive no balance between the demands and the resources available to deal with the stressful situations. There is a perception that some stresses are caused by simply being in a stressful social environment, such as stigma, discrimination, or prejudice, and according to the stress theory, they have the potential to bring psychological and physical consequences and put so many people at risk in terms of their mental health.

2.2.2 Social factors among black women and how they influence depression.

Many studies have focused on how varied social difficulties can be attributed to the cause of depression. Notably, it has been commonly reported among women that they feel overwhelmed or isolated in their social life. Staneva et al. (2015) studied the experience of postnatal depression among black women and those from minority groups. He discovered that most of them had their lives with problems that had been caused by various social factors, including lack of extended family or isolation from their extended families, among others. For the women who were relatively new to living in the UK, their isolation was exacerbated because they were forced to remain with their families doing their normal social activities in further research. Some of the reasons that caused the isolation were just the current circumstances of the women.

A good example is the women who had newborn babies and felt they could not go out much, which led to frustration among them. The feeling of being overwhelmed and isolated is quite common among many new mothers; however, there was a more burden that resulted from their status of immigration, pressures from the culture, and family values, which brought an extra burden to these women (Hackney et al., 2021). This can tell there is a need to research the experience of depression among women of minority groups and black women, particularly to observe the difference and not only the postnatal depression that has been taking place in the United Kingdom, as can be seen from the previous literature.

Loneliness and isolation are not only an issue to the south-Asian mothers alone, but it has been found that African American mothers who undertook an interview having depression could have been caused by diminishing personal strength, which might have resulted from the loneliness. In the same way, there is a lack of strength that can be considered a part of life. In this case, depression was perceived as a normal reaction to the various circumstances of life, which naturally occur mainly for black women and women from other minority groups. The feeling of loneliness and isolation for several studies had resulted from a lack of ability to build social networks, bereavement, or a way of keeping confidentiality and self-protection to the extent of barring oneself from seeking mental health care. Some studies show that the leading cause of depression was poor relationships with other important people, especially those from the family. Some of them discovered that they perceived themselves t lack relationship strength with other people, especially young black women, which promoted a sense of loneliness that caused depression among the victims.

Special attention was paid to what was perceived as violence and the marital challenges’ negative effect on married people. This was also indicating that such a factor causes depression in all women regardless of their backgrounds; however, some of the studies suggested that such issues were more common for black women and other women from minority ethnic groups, and to some of these groups, such a challenge has been accepted and taken as a usual way of life within their communities. There is one of the studies where all women were found to have experienced domestic violence, which was considered the root cause of depression among them. Also, it has led to isolation and loneliness, with most women feeling hopeless (Vrinten et al., 2017). One of the women said it was customary in India for husbands to beat up their women. The thread of abuse was discovered that it was a common one among women from minority ethnic groups and also among African American women, from among which it was noticed that significant traumas like sexual abuse of children by the trusted authorities contributed so much to their depression (Forte et al., 2018). These authorities had made them feel oppressed and disempowered, which has remained unaddressed for a long time. One of the challenges to applying such knowledge is that most of these studies have been conducted only in the United States of America and Canada, with historical contexts in those countries cited. Therefore it poses a question to find out the nature and the degree of abuse, oppression, and depression that occurs among black women and those from other minor ethnic groups in the United Kingdom.

2.2.3 The relationship between culture, religious beliefs, and traditions with black women’s depression.

In most cases, the research that concerns this has been how depression manifests within black women. For this group of people, the meaning of depression has, in a very remarkable manner, been shaped by religious beliefs, culture, and traditions. A thematic analysis was done among African American women who are of age in the USA, where it was found that depression is viewed as a cultural phenomenon. They had come across many deprivations and hardships only found with African American women and only in their country of residence; hence, the ethnic and gender disparities were now considered to have come from cultural history.

Quite some studies have focused on what prayers can do and the benefit that religious healers can bring about something that has been accepted in various cultures as a strategy to cope instead of seeking professional help in mental health (Williams, 2018). Praying to God, among other religious activities, and then believing that there will be a change in things was perceived to prevent or support managing depression for some people. Prayers, in many instances, were considered to be a unique way by which depression can be addressed and also for the women among the other people in the society to get divine wisdom and guidance on what they ought to do. This act was therapy and helped people gain strength and heal from depression. Among African American women, it has also been found from several studies that religion helps them build resilience in life, consistent with broader literature. To turn to this way of managing depression which has been generally accepted among the culture of black women is a good and efficient way to manage stress and depression that occurs on a day to day activities in life. Through this way of managing depression, there is also the lesser urge to get help from others because one understands that one can handle equally complex matters. However, most women continued to experience depression throughout history due to new factors emerging as much as this was a good way of managing depression. Such has posed questions about if such measures indeed deal with depression or if they are only preventing women from getting appropriate support and mental health care that is suitable for them.

Some other studies have discussed faith and religion, where they were viewed as both a protective factor and also one that was capable of increasing risk and causing distress. Scholten et al. (2017) interviewed a woman of south Asian origin in England concerning how the experiences of her postnatal depression with a theoretical kind of approach. It was found that the majority of these women turned to religion. The challenge was that religion did not encourage the women to accept the thoughts across their minds and how they felt something that made them internalize misery. Therefore, they did not tolerate such thoughts and looked ungrateful as religion told them they were experiencing whispers from the devil. This clearly shows that if one reconciles religion with mental health or well-being can be detrimental to one’s health status, the most likely output, especially from black women, would be negative. To manage depression using such approaches as prayer showed that there is a possibility of delaying or preventing those that are seeking treatment from black women concerning their depression and their mental health at large.

2.3 Summary

In this chapter, previous research has been evaluated about the causes of depression among women and how it has affected black women at various times in history. How religious tradition and cultural factors affect depression has also been discussed. The research gap could be seen in that little, if not nothing, has been done concerning the impact of depression on the mental health of young black women in the United Kingdom.

CHAPTER THREE-METHODOLOGY

3.1 Introduction

In this chapter, the methodology that was used for the research is described in detail. The philosophical assumptions which guided the researcher throughout the study are explained, and the research design was embraced in this dissertation. In this chapter, the research strategy has been explained, and then it is justified why it was considered most suitable and reliable for this study. The ethical consideration that was taken into account has also been discussed here, with the chapter ending with a summary that contains the critical items from the whole chapter.

3.2 Philosophical assumptions

Research philosophy is a set of assumptions and beliefs concerning knowledge development. It is a very crucial part of the method used in research because it guides the researcher on the most appropriate approach he or she can embrace throughout the research process and the reasons for choosing the approach something that is guided by the research questions to be addressed (Saunders et al., 2015). The research philosophies can be classified into three broad categories; ontology, epistemology, and axiology. They can show how the researcher views the world because the crucial assumptions are contained in them. At every stage of research, there have to be assumptions that are sometimes made with the researchers doing it unconsciously or even consciously. A good research philosophy will comprise consistent and thought-out assumptions. They will guide in choosing the most appropriate methodology, the strategy of research, and the techniques used to collect and analyze the research data. Each research philosophy constitutes different assumptions used to distinguish the research philosophies.

Ontology is the assumptions about reality’s nature that determine how the researcher views their objects of research. Ontology is categorized according to objectivism or subjectivism. Epistemology concerns the assumptions concerning knowledge, what can be accepted, considered legitimate, and valid, and how the knowledge can be conveyed to others. Epistemology is very relevant and so crucial for any research that takes place. There are two aspects of epistemology; the resources researcher, that takes data from the natural world’s perspective, and the feeling researcher, who concerns himself with the altitudes and feelings of workers t their managers.

It can be classified as realism, positivism, and interpretivism. In positivism, the research depends on social entities that can be observed naturally, so research has to be based on data collection and hypothesis. A positivist researcher must follow a structured methodology to achieve his or her hypothesis and work with observations that can be quantified while obtaining statistical analysis. Realism is concerned with scientific inquiries where the disclosing of reality and truth and how objects exist is in the human mind. Interpretivism assesses how human beings differ as social actors in the research (Thanh & Thanh, 2015). It is an approach that is based on social life. Axiology is the role of ethics and values in research (Navalta et al., 2019). It concerns how the researchers deal with their values and those of the others involved in the research. Research has argued that all actions of human beings depend on the values of the individual human. The researcher can display their axiological skills by articulating their values as a basis of how they will judge the research they are undertaking and how they will do it. Even the way a topic is chosen can portray one’s values because it shows that the topic is more important to them than a different topic. This method has a significant impact on the research of social science.

This research has embraced epistemology, specifically interpretivism research philosophy which has largely emphasized qualitative data collection and analysis. This philosophy was selected because this research needs to appreciate that people differ in one way or another, and this is the research philosophy that embraces it. The impact of depression among young black women could be different from the other groups also people and from one young black woman to another. Issues of ethics, and cross-cultural differences, can be adequately studied to a deep level using this type of research philosophy.

3.3 Research design.

This dissertation embraced a descriptive type of research design. This research design help in addressing questions of what, when, who, where, and how that concern the research problem in question. In this study, we cannot make a conclusive decision as to why but information that concerns the current state of various conditions in the situation. The symptoms of depression among young black women were entirely studied in their natural conditions without any changes made to them whatsoever. Data that can be analyzed was obtained without altering the behavior of these women from their natural behavior. Through this kind of research design, I could obtain valuable data to make recommendations for helping the victims of depression in the future from this region and other regions in the United Kingdom. The data was large enough to be used for the analysis of the effects of depression on young black women. The challenge with descriptive methods is that they cannot be replicated as they are more of observation, but the study was conducted from a large sample, so overcome this design challenge.

3.4 Search strategy

A qualitative and quantitative research method was employed where a thorough study was done on the existing bank of knowledge related to the research question. Government reports, online databases, and academic journals made available the data concerning depression among black women between the ages of 18 years to 25 years in the Borough of Hackney, UK. The academic sources used in this study were at most ten years since they were authored before the research was conducted. A qualitative method of analysis was also employed to find out the themes and the patterns of depression among these young black women from this region of the United Kingdom as per the data gathered. The existing knowledge in literature was analyzed in great depth to understand how depression had affected the young black women of this age bracket (18-25). Then recommendations were made on getting mental health care support in Hackney, UK.

3.5 Validity and Reliability

From history, it has been claimed that if it is assumed that the experience of mental health complications like depression is similar to all groups of people, this will fail to appreciate the variability of different people. This means that a quantitative method of research does not capture the complexity and richness of various human experiences exhaustively, and this is what has brought much attention to the qualitative method of research from various researchers on such matters as depression and those other titles that relate to human beings (Potter, 2013). We will not declare the quantitative research method among black women useless when examining the effects of depression because it is still crucial for increasing the knowledge base on matters. However, the main aim of this research was not only to identify factors that may have precipitated depression among black women as quantitative methods can offer but also to get a deep understanding of these factors and the effects on the young women being studied. The quantitative methods of studies have also tried to shed light on patterns for seeking mental health care among black women, but they still fail in that they do not examine the contexts in depth

When a qualitative research method is employed, detailed descriptions of events are obtained together with insights into what these events could imply. This is something that is not available in the available literature. (Potter, 2013) A qualitative research method in the health sector is instrumental in studying an individual’s case and explaining the conditions surrounding this particular individual. It is vital to give attention to the voices that are technically not present in literature but are present in the development of the health sector. This method addressed the challenge of studying depression among young black women in the UK.

3.6 Data Collection and analysis

The data used in this research was mainly obtained from existing literature concerning depression among young black women, health records, and a database from the government. This data from the existing literature was carefully and thoroughly examined to align with the research questions being studied. The data was then analyzed by a descriptive method of analysis which suits the qualitative research technique so well. Essential themes that come out and are in line with the research objectives and questions were gathered and analyzed.

3.7 Ethics and Bias

Ethical considerations are the principles that are set out to guide research design and research practices. Those who venture into research should adhere to some guiding code of conduct when collecting data from people or other observable sources (Harriss et al., 2019). The ethical considerations are important because they protect the rights of all those participating in the research in one way or another, enhance the validity of the data and the research results, and help maintain the integrity of academics or science. If the ethical considerations are violated, the credibility of the research goes very low if anything remains because there will be no one to trust the research if the methods utilized have moral questions.

Everything sourced from previous work was cited adequately in this work, and the authors were also acknowledged in the in-text citations.

3.8 Summary

The methodology and steps used in this research have been described. The subheading discussed in this chapter includes; philosophical assumptions, research design, search strategy, validity and reliability, data collection and analysis, and ethics and bias. All these subsections have been used to clarify the processes used in this research.

CHAPTER FOUR-RESULTS AND DISCUSSION

4.1 Introduction

In this chapter, the effect of depression among young black women that have been caused by discrimination and racism, hostility, and social roles and expectations have been discussed. The factors contributing to this group of people not being willing to seek mental health care have also been captured here. A thorough examination of the existing literature has been looked into to respond to the research questions. Some of the matters that could be studied further in the future have also been pointed out, and the chapter ends with a summary to usher in the next chapter.

4.2 Findings

4.2.1 Impact of depression caused by discrimination and hostility due to racism.

A particular emphasis was laid on the issue of racism, discrimination, and exclusion throughout the research. What was perceived as discrimination and racism and the stress associated with it was believed to be a factor that contributed to depression by the young women examined. This experience of racism and a perception of unfair treatment was found to cause depression and gave these young women a sense of powerlessness. Such experiences were discovered to have been occurring at the places of work, discrimination while attempting to access healthcare services and other services where a few of them claimed that there is a hundred percent discrimination. Racism and oppression also were found to have contributed so much to the depression among these young women in the Borough of Hackney (Mouzon & McLean, 2017). Some literature pointed out that racism was a normal day-to-day thing that was persistent in that region of the United Kingdom. It was amazing to find out that sexism was also termed to have been closely related to racism by some, which made these women feel like they were under a double kind of depression. Because of this, the young black women felt it was like they were going through a unique kind of depression from the one the white women go through. Throughout the entire study, it was pretty clear that racism has become a norm in the United Kingdom, and it has often been occurring in their daily endeavors. From this study, it can also be seen that mistrust in society can be linked with discrimination or racism and the imbalance of power at various levels in this region.

There are other researches from which the discrimination and racism among young black women appeared to be very cunning and embedded in various social contexts (Mansfield et al., 2021). Historical circumstances forced some aspects of life, such as jobs and choice of life partners, to be controlled by gender and race. These experiences made people think about a specific race like the blacks created some languages around their race. They experienced depression and suffering closely related to personal experiences, representing an extensive group of women. This shows that it was more about socialization and that the changes that might happen were determined by the generation from which they hail. This issue of the present context is very crucial as far as racism and discrimination experiences are concerned and how they relate to depression. This is because the social context keeps changing, and it is also different depending on the ethnic group of people and the country that people live in, our case being the United Kingdom. It is, therefore, essential to understand that the experience of depression could differ significantly for people who live in different generations. Also, those who live in the United Kingdom could differ from the depression of those who live in other countries.

An excellent example of this is (Smith et al., 2013), who found out that the African American women who used to wear hijab faced or perceived themselves to be facing a greater level of discrimination and racism after the terrorist attacks that happened in the United States of America around that time. This kind of social context will harm the people who have been affected negatively and result in a tremendous burden on their emotional life. This is eye-opening because we realize that, despite the black women facing similar challenges, the social context could cause the experience to differ from the young women that had existed in a different social context. The experience of social factors of this nature could be different for the young black women who have grown from a different historical and cultural context like these in the Borough of Hackney, UK.

4.2.2 Effects of depression caused by expectations and social roles

Expectations and social roles were also found to have often caused depression among young black women in the United Kingdom. Some black women from many studies shared how their expectations had become a source of depression. What was perceived to be a lack of support and multiple roles are also risk factor that contributes to depression among young black, where some of the roles were perceived to belong to the female gender and were deemed to be appropriate to the women according to society. A good example is caregiving jobs or jobs that make the women be domesticated in their homes, which has triggered depression at various times among these women (Bower et al., 2013). Issues concerning different social norms and the expectation of a woman and the adverse effects that they cause to people do not happen only to black women. However, it was discovered that some particular types of oppression, some based on race and gender, added to the impact of depression among these women. There is a possibility that the issue is not only about what a woman is expected to do in society but also about trying to get a place in society or even a family unit. Some women claimed their husbands were not helping them, and they had to work double shifts to fulfill their domestic needs and go out to work for their families, which contributed to depression. Throughout the literature, negative emotions came from these expectations and experiences, some of which included feeling worried, sad, overwhelmed, and some felt that they had been taken for granted, which seemed to be causing depression to the women. As observed in some literature, normative social roles have often caused much pressure on various people (Ronaldson et al., 2020). However, Schmied et al. (2017) suggested that the status of ethnicity can amplify such effects.

Another interesting theme in many studies was put across, and it concerned being strong according to the culture. A study showed that some young black women who were having issues of depression were interviewed, and they were saying they felt a need to be women who are more potent than white women, and this is a matter that needs to be studied further in the future (Khan et al., 2008). Show this strength seemed to be acceptable by these women as a way of managing stress than dwelling on the stress. Depression appeared to be a weakness among most of the women in this study, and they needed to get past that lest they get to suffer. This is a challenge because as women try to show this strength, they might prevent mental health professionals from giving them the support they need.

4.2.3 Barriers to seeking help for depression

Research has shown very many barriers that are perceived to hinder young black women from seeking treatment. Research showed that black women who have depression have several barriers to seeking healthcare assistance at individual levels, community levels, or healthcare provider levels. This could be seen in various ways ranging from; when they think about the symptoms they have, seeking advice, or even refusing the formal type of healthcare and then resolving to use self-care. Avoiding the issue was discovered to be the option that most women choose (Leamon et al., 2014). Some were willing to seek health care help. However, unfortunately, there were barriers to seeking care and altitude, which hindered them from accessing the appropriate mental health care services. Some of these barriers are; fear of being perceived as crazy, terrible experiences with the mental service health care providers where some of the doctors or those who offer the services seemed not to care, and cost issues, especially for those without insurance covers to cater for their medical expenses, issues of transport, language difficulties, and ignorance about the healthcare services (Logie et al., 2013). A number of these issues may have resulted from their low-income status in as much as it is an issue with the ethnic background of these women. This raised the question of whether there are such issues in countries that provide free healthcare, unlike the case in the United Kingdom. Looking at a study that was conducted on women from a mixture of ethnic backgrounds in the West Indian Canadians and another in the United States of America, the findings were found to be consistent. This is because, in both of these studies, stigma served as a barrier to seeking medical healthcare or even for the women to talk about depression reason being the women who could be found with diseases that cannot be cured thought they would be considered to be crazy (Overstreet et al., 2013). The women, therefore, resolved to embrace self-care practices like socializing, volunteering, and working instead of seeking mental health care assistance. It is a significant finding because much effort has been made to change how black women perceive mental health care, but now it has been discovered that they have altitudes towards these treatments, and some believe that the treatments do not work for them. This kind of data is essential to understand the impact of the social processes accepted and attitudes toward seeking mental health among young black women in the United Kingdom.

Another piece of literature (Memon et al., 2016) brought up the concern of the perception of the professional of health. The women from the Southern part of Asia who participated in the interviews felt that the general psychologists were not there to advise on psychological matters but instead to give advice related to medication. This is why they did not approach them to discuss depression, for they were afraid to be viewed as moaning, and they perceived that there might be no cure for their prevailing situations. Just as it is expected, the vast majority of them did not go to get help for their depression from the available mental health care facilities, something which s similar to some other findings (Matthews et al., 2021). In some literature, black women felt that the health professionals to whom they were explaining their issues to did not understand something that made them uncomfortable. They ceased seeking mental health support from them. It was also discovered that religious and cultural sensitivity for the health service providers is significant for black women seeking mental health support. Some women were found to believe that healing is finally dependent on God or religion and that any treatment to work is not really about the doctors but about God. That is why they did not have much confidence in the healthcare support providers. It is, therefore, of great importance for those who offer these services to be aware of the influence religion has on the success of treatment and other interventions from psychology. Some studies have suggested that it would be more beneficial if mental health care services were based on the needs of the individuals seeking the services (Joffres et al., 2013). When interviewed by this researcher, some women said they would be more comfortable with a healthcare supporter of their race if they could get one to address their matters. According to them, some of the professionals who were there to help them were unwilling to help, while others were incapable of helping. From this paper, it would be a good thing if black people could get a good representation among the mental health care officers in the United Kingdom because this has prevented many people from seeking medical assistance.

4.3 Discussion

This review has examined qualitative data, which has significantly contributed to understanding how depression affects young black women, and inferences have been made on what is known and what is yet to be known. The literature covered in this dissertation has brought some important conclusions that can be put in themes such as; depression is affected by culture, traditional beliefs, religion, social factors, discrimination and racism, and barriers to seeking help. Depression was viewed as a social and cultural construction influenced by the context in which young black women are currently. Something familiar throughout the research is that poor quality relationships and isolation from loved ones and the family were discovered to be a source of depression and also strains and stresses the young black women in the United Kingdom. In as much as a large number of people experienced these strains, the research found that the cultural factors and the ethnic background of black women, in general, had a significant impact on the levels of depression. Other psychosocial factors that contributed to depression from various literature materials were linking social roles, expectations, and depression. These social roles and expectations indeed cause depression to many individuals, but when it comes to these young black women in the United Kingdom, the expectations and roles had a firm foundation on issues related to practices specified by culture and extra burdens. Discrimination and racism were viewed to be contributing to depression and causing stress among black women, and it caused further isolation (Veling, 2013). Among other antecedents, these were noted to have been influencing the behavior of seeking mental health care assistance, which made the young black women prefer self-help practices to seek mental health care support available in the region.

There were some strengths and weaknesses that were realized during the research. One of the strengths is that in this research, the population of young black women with the age bracket of 18-25 years old was reached, and it had been quite challenging to reach such a population traditionally; hence very little has been known concerning them as far as depression is concerned. Some literature made it possible to compare cultural groups as women from other minority groups worldwide were also studied. The methodology employed in this research was purely qualitative, making it possible to get the subjective nature of the depression experience (Lazris et al., 2021). Such a qualitative study can function as the first step in understanding various populations of people and getting to know the mysteries that have been unknown in the literature. To be able to provide a critical context to understand experiences such as the behavior of seeking help is a strength of the qualitative method of study. One weakness that is almost obvious for many studies is that with qualitative methods, it is never easy to see the impact depending on the approaches used. This might not have been the case in this research; however, it is still considered a potential weakness.

4.4 Summary

This chapter’s main question was findings to respond to the research questions. A thorough examination and discussion have been done to answer the questions about the effects depression have had on young women’s mental health in the Borough of Hackney in the United Kingdom. Some of the recommendations that have been made for practice are; health practitioners familiarize themselves with how depression affects young black women and understand varied individual experiences of depression among these women. In the following chapter, conclusions, and recommendations for future studies have been made.

CHAPTER FIVE-CONCLUSIONS

5.1 Introduction

This chapter contains the general conclusions from the dissertation work undertaken, practice recommendations, limitations, and recommendations for further research.

5.2 General conclusions

The purpose of this research was to get a deep understanding of the experience of depression among black women between 18 to 25 in the Borough of Hackney in the United Kingdom using a qualitative study method. The main finding was that depression among young black women in the United Kingdom was caused by; cultural factors, identity, the status as a minority, and pressures from the norms of the society. Together with this, some of the themes that came up include; expectations from culture and depression. It is good to remember that the literature reviewed in this study may not capture all the young black women in the United Kingdom. However, it gives much insight into the experiences of depression among these women. It gives a basis through which we can make general claims concerning the depression experienced by young black women in the United Kingdom.

5.3 Recommendations

The findings obtained from this research can be helpful in the provision of service and practice. Some of the recommendations that will aid in achieving this from the above research include;

1. Health practitioners are supposed to familiarize themselves with the variable experiences of depression among young black women because there are many impacts on the ethnic identity of the individual.
2. Health practitioners should seek an understanding of depression experiences per individual and use it in a productive way to create trust, which is vital for treatment and mental health care support.
3. It would be good to utilize health promotion campaigns and health services to help enhance literacy on health matters among young black women experiencing depression so that they can understand the benefits and disadvantages of using medication and get equipped for their personal needs related to their health.

4. A better understanding must be pursued to fathom how mental health and identity relate to enhancing target health promotion, utilizing person-centered interventions, and effectively managing depression.

5.4 Limitations

1. The research was done among black women between the ages of 18 to 25 years in the Borough of Hackney, UK.
2. The qualitative research method faces some criticism, such as it could have been affected by the researcher bias, among others, and yet it is the method that was solely used in this study.

5.5. Recommendations for further study

1. Research should be conducted, allowing those affected by depression to talk for themselves and reflect on what the experiences of depression mean to their personal lives.
2. Another research should be done to examine how effective primary healthcare could be in managing depression and whether it can handle depression cases.

REFERENCES

• Assari, S., Lankarani, M. M., & Burgard, S. (2016). Black–white difference in the long-term predictive power of self-rated health on all-cause mortality in the United States. Annals of epidemiology, 26(2), 106-114.
• Bower, P., Kontopantelis, E., Sutton, A., Kendrick, T., Richards, D. A., Gilbody, S., … & Liu, E. T. H. (2013). Influence of initial severity of depression on effectiveness of low-intensity interventions: a meta-analysis of individual patient data. Bmj, 346.
• Bidulescu, A., Francis, D. K., Ferguson, T. S., Bennett, N. R., Hennis, A. J., Wilks, R., … & Sullivan, L. W. (2015). Disparities in hypertension among black Caribbean populations: a scoping review by the US Caribbean Alliance for Health Disparities Research Group (USCAHDR). International journal for equity in health, 14(1), 1–11.
• Coid, J., Rodriguez, R. G., Kallis, C., Zhang, Y., Bhui, K., De Stavola, B., … & Ullrich, S. (2020). Ethnic disparities in psychotic experiences explained by area-level syndemic effects. The British Journal of Psychiatry, 217(4), 555-561.
• Forte, A., Trobia, F., Gualtieri, F., Lamis, D. A., Cardamone, G., Giallonardo, V., … & Pompili, M. (2018). Suicide risk among immigrants and ethnic minorities: a literature overview. International journal of environmental research and public health, 15(7), 1438.
• Hackney, K. J., Daniels, S. R., Paustian-Underdahl, S. C., Perrewé, P. L., Mandeville, A., & Eaton, A. A. (2021). Examining the effects of perceived pregnancy discrimination on mother and baby health. Journal of Applied Psychology, 106(5), 774.
• Harriss, D. J., MacSween, A., & Atkinson, G. (2019). Ethical standards in sport and exercise science research: 2020 update. International journal of sports medicine, 40(13), 813–817.
• Iob, E., Frank, P., Steptoe, A., & Fancourt, D. (2020). Levels of the severity of depressive symptoms among at-risk groups in the UK during the COVID-19 pandemic. JAMA network open, 3(10), e2026064-e2026064.
• Joffres, M., Jaramillo, A., Dickinson, J., Lewin, G., Pottie, K., Shaw, E., … & Canadian Task Force on Preventive Health Care. (2013). Recommendations on screening for depression in adults. Cmaj, 185(9), 775-782.
• Khan, U., Crossley, C., Kalra, L., Rudd, A., Wolfe, C. D., Collinson, P., & Markus, H. S. (2008). Homocysteine and its relationship to stroke subtypes in a UK black population: the south London ethnicity and stroke study. Stroke, 39(11), 2943–2949.
• Lazarus, D., Perkins, M. M., Bay, A. A., & Hackney, M. E. (2021). Qualitative evaluation informs understanding of motor cognition and therapies in older adults with mild cognitive impairment. Journal of Alzheimer’s Disease, 84(2), 691–703.
• Leamon, S., Hayden, C., Lee, H., Trudinger, D., Appelbee, E., Hurrell, D. L., & Richardson, I. (2014). Improving access to optometry services for people at risk of preventable sight loss: a qualitative study in five UK locations. Journal of Public Health, 36(4), 667–673.
• Logie, C., James, L., Tharao, W., & Loutfy, M. (2013). Associations between HIV-related stigma, racial discrimination, gender discrimination, and depression among HIV-positive African, Caribbean, and Black women in Ontario, Canada. AIDS patient care and STDs, 27(2), 114–122.
• Macaskill, A. (2013). The mental health of university students in the United Kingdom. British Journal of Guidance & Counselling, 41(4), 426–441.
• Mansfield, K. E., Mathur, R., Tazare, J., Henderson, A. D., Mulick, A. R., Carreira, H., … & Langan, S. M. (2021). Indirect acute effects of the COVID-19 pandemic on physical and mental health in the UK: a population-based study. The Lancet Digital Health, 3(4), e217-e230.
• Matthews, E. B., Savoy, M., Paranjape, A., Washington, D., Hackney, T., Galis, D., & Zisman-Ilani, Y. (2021). Shared decision making in primary care based depression treatment: communication and decision-making preferences among an underserved patient population. Frontiers in Psychiatry, p. 12, 681165.
• Memon, A., Taylor, K., Mohebati, L. M., Sundin, J., Cooper, M., Scanlon, T., & De Visser, R. (2016). Perceived barriers to accessing mental health services among black and minority ethnic (BME) communities: a qualitative study in Southeast England. BMJ open, 6(11), e012337.
• Molina, K. M., & James, D. (2016). Discrimination, internalized racism, and depression: A comparative study of African American and Afro-Caribbean adults in the US. Group Processes & Intergroup Relations, 19(4), 439-461.
• Mouzon, D. M., & McLean, J. S. (2017). Internalized racism and mental health among African-Americans, US-born Caribbean Blacks, and foreign-born Caribbean Blacks. Ethnicity & Health, 22(1), 36-48.
• Navalta, J. W., Stone, W. J., & Lyons, S. (2019). Ethical issues relating to scientific discovery in exercise science. International journal of exercise science, 12(1), 1.
• Overstreet, N. M., Earnshaw, V. A., Kalichman, S. C., & Quinn, D. M. (2013). Internalized stigma and HIV status disclosure among HIV-positive black men who have sex with men. AIDS care, 25(4), 466–471.
• Potter, W. J. (2013). An analysis of thinking and research about qualitative methods. Routledge.
• Robotham, D., Satkunanathan, S., Doughty, L., & Wykes, T. (2016). Do we still have a digital divide in mental health? A five-year survey follow-up. Journal of medical Internet research, 18(11), e309.
• Ronaldson, A., Chandakas, E., Kang, Q., Brennan, K., Akande, A., Ebyarimpa, I., … & Bhui, K. (2020). Cohort profile: Cohort profile: the East London Health and Care Partnership Data Repository: using novel integrated data to support commissioning and research. BMJ Open, 10(9).
• Saunders, M. N., Lewis, P., Thornhill, A., & Bristow, A. (2015). Understanding research philosophy and approaches to theory development.
• Schmied, V., Black, E., Naidoo, N., Dahlen, H. G., & Liamputtong, P. (2017). Migrant women’s experiences, meanings, and ways of dealing with postnatal depression: A meta-ethnographic study. PloS one, 12(3), e0172385.
• Scholten, S., Velten, J., Bieda, A., Zhang, X. C., & Margraf, J. (2017). Testing measurement invariance of the Depression, Anxiety, and Stress Scales (DASS-21) across four countries. Psychological assessment, 29(11), 1376.
• Smith, D. J., Nicholl, B. I., Cullen, B., Martin, D., Ul-Haq, Z., Evans, J., … & Pell, J. P. (2013). Prevalence and characteristics of probable major depression and bipolar disorder within UK biobank: a cross-sectional study of 172,751 participants. PloS one, 8(11), e75362.
• Staneva, A., Bogossian, F., Pritchard, M., & Wittkowski, A. (2015). The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth: A systematic review. Women and birth, 28(3), 179–193.
• Thanh, N. C., & Thanh, T. T. (2015). The interconnection between interpretivism paradigm and qualitative methods in education. American journal of educational science, 1(2), 24-27.
• Wallace, S., Nazroo, J., & Bécares, L. (2016). The cumulative effect of racial discrimination on the mental health of ethnic minorities in the United Kingdom. American journal of public health, 106(7), 1294-1300.
• Williams, D. R. (2018). Stress and the mental health of populations of color: Advancing our understanding of race-related stressors. Journal of health and social behavior, 59(4), 466–485.
• Veling, W. (2013). Ethnic minority position and risk for psychotic disorders. Current opinion in psychiatry, 26(2), 166–171.
• Vrinten, C., McGregor, L. M., Heinrich, M., von Wagner, C., Waller, J., Wardle, J., & Black, G. B. (2017). What do people fear about cancer? A systematic review and meta‐synthesis of cancer fears in the general population. Psycho‐oncology, 26(8), 1070–1079.