The UK has the largest Bangladeshi population outside Bangladesh and India. According to the 2021 Census, 652 535 Bangladeshis lived in the UK, representing just under 1% of the total population. 1 This community is one of the youngest ethnic groups in the country, with a notably younger age profile than other South Asian communities. 2,Reference Haywood and Mac an Ghaill3 Evidence suggests that British Bangladeshi people experience higher rates of mental ill health than White British individuals, yet report lower rates of diagnosed mental illness than other ethnic groups. 2,Reference Bamford, Klabbers, Curran, Rosato and Leavey4 Although youth-specific prevalence data are limited, adult studies and indicators such as low service uptake and high exposure to psychosocial stressors point to substantial unmet need. 2 Socioeconomic challenges such as low income, unemployment, overcrowded housing and racism further impact British Bangladeshis’ mental health. Reference Bisby, Singam, Beattie, Ekiko and Clilverd5,6
Cultural conflict, identity stress and barriers to service use
Beyond structural inequalities, cultural dissonance between traditional Bangladeshi values at home and broader British society exacerbates these struggles, particularly for younger British Bangladeshis. Reference Bisby, Singam, Beattie, Ekiko and Clilverd5 This is especially critical for young people between the ages of 16 and 24 years, a developmental period characterised by rapid psychological, social and neurological changes, alongside increasing societal expectations around independence, education, employment and relationships. Reference Sabella, Davis, Munson, Curby, Wehby and Lloyd7 This is also the peak period for the onset of emotional and behavioural disorders, and the clash between home and societal norms at this stage can intensify identity conflict and distress, underlining the need for developmentally and culturally responsive mental health support. Reference Blanco, Okuda, Wright, Hasin, Grant and Liu8–Reference Patel, Flisher, Hetrick and McGorry10 Despite these risks, British Bangladeshis have some of the lowest referral rates to talking therapies, 11,12 possibly because of mistrust of services and reliance on informal or community-based support. Barriers include perceived discrimination from healthcare providers, lack of cultural sensitivity, and limited awareness and trust in mental health services. Reference Bisby, Singam, Beattie, Ekiko and Clilverd5 Stigma and distrust in mental health services remain significant barriers to accessing support, particularly for Bangladeshi men aged 22–59 years. Reference Alam13
Community-based support and the need for ethnicity-specific research
Community-based organisations offer an important complement to statutory mental health services. Reference MacDonald, Martin, Clark, Dehn Lunn, Gkiouleka and Harasgama14 For example, the Bangladeshi Mental Health Forum in East London provides Bengali-language workshops, peer support groups, professional training, and partnerships with National Health Service (NHS) Trusts to improve service access and relevance. 15 Camden Council has taken strategic steps to address health inequalities in the Bangladeshi community through awareness and engagement, 16 and Roshni Ghar in West Yorkshire offers culturally sensitive support and safe spaces for South Asian women, including Bangladeshi, Indian and Pakistani communities, experiencing psychological distress. 17 However, they remain limited in scale and are rarely tailored to the specific developmental and cultural needs of younger British Bangladeshis. Although a substantial body of research has explored mental health experiences and service access among South Asian communities in Britain, these studies often conceptualise South Asians as a single, homogeneous group, overlooking the sociocultural and historical differences among Indian, Pakistani, Bangladeshi and other subgroups. There is a need for more granular, ethnicity-specific investigations to better understand the distinctive strengths and challenges of these communities. Reference Poole, Rickford, Martinez, Gill, Frith and Ronaldson18
Current study
Building on this context, this qualitative study investigates the mental health needs of British Bangladeshi youth, focusing on the following research questions:
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(a) How do British Bangladeshi youth (aged 16–24 years) describe and experience mental health challenges in the UK?
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(b) What are the strengths and limitations of mental health support systems and services available for this target group?
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(c) How could mental health support systems and services be developed to better account for the cultural, linguistic, socioeconomic and other factors that are specifically relevant to the lived experiences of young Bangladeshi people in the UK?
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(d) What are the barriers and opportunities for involving community-based organisations and local leaders in mental health support for young people of Bangladeshi origin in the UK?
The study aims to generate in-depth, contextually grounded insights into the lived experiences of British Bangladeshi youth, rather than determine the prevalence or representativeness of mental health problems.
Method
Design and setting
This qualitative study used semi-structured interviews with British Bangladeshi youth, parents and community workers from third-sector organisations. Data were collected between February and August 2024 in London and Leicester, with participants recruited through mental health and youth-focused charities from the Bangladeshi community. Reporting follows the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist to ensure transparency and rigour (see Supplementary File 1). Reference Tong, Sainsbury and Craig19 All procedures comply with the ethical standards of the national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2013, and were approved by the Health Faculties Research Ethics Subcommittee at King’s College London (reference: HR/DP-23/24-40530).
Eligibility
Eligible participants were Bangladeshi young people aged 16–24 years who had experienced stressful events affecting their well-being or had insight into peer’s or family member’s mental health challenges, along with their parents, and Bangladeshi community workers from community and voluntary sector organisations with shared interests in the mental health and well-being of Bangladeshi youth. Given the study’s aim to inform culturally and contextually appropriate early interventions, formal mental health screenings were not conducted. Instead, participants were included based on a perceived need for psychosocial support, regardless of diagnostic criteria. The final sample (N = 26) included 12 young people, seven parents (each corresponding to an index young person) and seven community workers. Young people were purposively and snowball sampled to ensure diversity in age, gender and location (London and Leicester). Parents reflected varied family experiences, whereas community workers were recruited based on their roles supporting British Bangladeshi youth. The sample size was determined by the information power principle Reference Malterud, Siersma and Guassora20 and thematic saturation, Reference Guest, Namey and Chen21 which was achieved after 26 interviews, when no new themes or insights emerged from the data.
Participant recruitment
Recruitment materials, including flyers, participant information sheets and consent forms, were translated into Bangla for parents and community workers who may not be fluent in English. Recruitment was conducted via online and social media platforms (e.g. university portals, WhatsApp groups), and through three collaborating organisations that distributed flyers in community spaces (e.g. libraries, town halls and supermarkets in localities with relatively large Bangladeshi communities). Interested individuals registered their interest via email or a scanned QR code, after which the first author (I.S.) contacted them. All participants received an information sheet and provided written informed consent before participation, and none withdrew. Participants received a £20 voucher and travel reimbursement.
Data collection
Semi-structured interviews drew on a bilingual (English/Bengali) topic guide (see Supplementary File 2), including questions on mental health challenges, support needs and preferences of young Bangladeshi people. Interviews (45–60 min) were conducted online, by telephone or in person at collaborating organisations. I.S., a bilingual researcher, conducted, recorded and transcribed all interviews. Online interviews conducted via Microsoft Teams were auto-transcribed using its built-in feature, and then manually checked and corrected for accuracy. All other interviews were transcribed manually by the first author (I.S.). Bengali transcripts were translated into English by the first author (I.S.).
Data analysis
Interviews were analysed using framework analysis Reference Gale, Heath, Cameron, Rashid and Redwood22 involving transcription, familiarisation, thematic framework development, indexing, charting, and mapping and interpretation. Reference Ritchie and Lewis23 Data were managed and coded using NVivo software, version 14 for macOS (Lumivero, Melbourne, Australia; https://lumivero.com/products/nvivo/). Both inductive and deductive coding were used. Deductive coding was informed by the research questions, topic guide and three theoretical frameworks: Bronfenbrenner’s ecological systems theory, Reference Bronfenbrenner24,Reference Guy-Evans25 Gask et al’s Process Model of Access Reference Gask, Bower, Lamb, Burroughs, Chew-Graham and Edwards26 and the PLACES model. Reference Brown, Lisk, Carter, Stevelink, Van Lieshout and Michelson27 These frameworks supported analysis of environmental influences, help-seeking processes, and culturally accessible service design. Additionally, inductive data-driven coding was applied.
I.S. and H.K.L. independently coded four transcripts. An initial analytical framework was developed collaboratively and refined through discussion with senior co-authors (D.M., P.C.G. and E.C.). I.S. then applied the framework to the full data-set, charting data into a matrix to compare cases and identify patterns. Iterative refinement of codes led to the final themes and subthemes. As an academic psychologist, I.S.’s shared cultural background with participants facilitated rapport and contextual insight. However, differences in migration histories required careful reflexivity to avoid assumptions. Regular discussion with team members from diverse professional and cultural backgrounds ensured analytical rigour and interpretive balance.
Results
Participants
Participant characteristics are summarised in Table 1.
Characteristics of participants (n = 26)
Thematic framework analysis
Thematic analysis identified four key themes: (a) experiences of mental health problems, (b) barriers and facilitators to accessing statutory mental health services; (c) recommendations for statutory service improvements and (d) opportunities and challenges for community-led mental health services (Fig. 1).
Overview of themes and subthemes identified from qualitative interviews.
Theme 1: Experiences of mental health problems
Young people described feeling overwhelmed, agitated, worried, drained and, at times, low, on edge, anxious or depressed. These emotional struggles, often past and present, disrupted their daily routines, relationships and academic performance. Several mentioned feeling tired and expressed distress through culturally shaped experiences like lack of sleep, drowsiness, poor appetite, feeling achy, being lazy and feeling lonely.
‘It literally feels like you cannot get out the bed and anything you do won’t change anything, so you feel powerless…very uncertain of what’s going to happen, and you feel very weak…’ (Young person, male, 21 years old)
Parents echoed these concerns, observing their child’s withdrawal and academic disengagement:
‘It [mental health issue] is significantly affecting [my son’s] life; he can’t focus on anything. He wants to hide from everything; becoming isolated and avoiding social activities or gatherings.’ (Parent, 48 years old)
Mental health challenges were influenced by factors across multiple ecological levels. At the individual level, excessive social media use, gaming and mobile device dependence were reported as contributors to anxiety, depression and social isolation. Parents and community workers viewed these behaviours as detrimental, particularly when they led to unrealistic social comparisons and misinformation.
‘The younger generation spends more time on TikTok, mobile games, or other social media platforms, where much of the content is fake or filled with rumours…This affects us deeply when we mistake it for reality or compare our lives to it.’ (Parent, 46 years old)
Community workers also pointed to broader relational tensions, including conflicts between parents and within extended family networks, as key stressors affecting youth mental health:
‘Family conflict has contributed to their anxiety stage. Sometimes it’s their internal family conflicts, sometimes the extended family conflicts…’ (Community worker, 45 years old)
The school environment posed additional challenges. Four participants described intense competition with peers over academic achievement and career prospects, compounded by fear of failure and high parental expectations. Bullying, sometimes from within the same ethnic community, contributed to anxiety, low self-esteem and educational disengagement.
‘[My daughter] once shared with me that she was bullied in school…When she started university, she saw those same children there, so she didn’t attend university regularly.’ (Parent, 44 years old)
At the macrosystem level, young people described experiences of racism, Islamophobia and cultural misunderstanding in educational and workplace settings.
‘When I was having my mental health struggles and I used to take a lot of time praying and stuff, my head of year actually ended up getting me in trouble…like they thought I was like a terrorist.’ (Young person, female, 20 years old)
Some also described feelings of inadequacy when adjusting to new academic environments:
‘For me, it was exactly like impostor syndrome, where I felt like I didn’t have the skills to be there, like in my seminars. I wasn’t contributing or taking my education seriously. Not because I didn’t want to, but I felt like I couldn’t.’ (Young person, female, 21 years old)
Theme 2: Barriers and facilitators to accessing statutory mental health services
Perceived need for mental health support
Participants described how feelings of shame, fear of judgement, stigma and limited understanding of mental health prevented early help-seeking across generations. Mental health struggles were often hidden or dismissed, with terms like ‘pagol‘ (‘crazy‘) and ‘matha kharap‘ (‘mad‘) used casually, reinforcing shame and misunderstanding:
“They [community members] just call them ‘crazy’… Like, there’s no awareness of what actually mental health is.” (Young person, male, 21 years old)
Young men described pressures to conform to masculine stereotypes and how vulnerability is seen as a weakness.
‘There is that sort of stigma still around Bangladeshi boys…as a man, you kind of proceed as needing to be tough.’ (Young person, male, 19 years old)
All participant groups highlighted a profound lack of mental health knowledge, leading to problems being overlooked or misinterpreted.
‘…They [parents] don’t understand much. They think, “Oh, you’re upset, everyone gets upset once in a while. It’s nothing out of the ordinary.’ (Young person, female, 18 years old)
Although younger generations have begun to develop a language around mental health, confusion persists about differentiating normal stress from clinical conditions. A community worker noted that terms like anxiety, depression and feeling low are commonly used by young people to describe their challenges.
Navigating service access
For families who recognised a young person’s mental health needs, navigating support was often filled with barriers. One key challenge was caregivers’ limited English proficiency, which restricted their ability to advocate for their children, communicate with providers and access information. One parent explained that they heavily relied on their children to navigate systems at their NHS general practice, but the children’s reluctance to help made accessing care even more difficult. Also, discomfort and feelings of personal shame further hindered the youth’s ability to engage with the statutory mental health system.
‘People [Bangladeshi] are hesitant to seek support from the NHS…taboo, feeling of shame, ‘I can deal with myself’, ‘what’s the benefit of talking to people about it’.’ (Community worker, 39 years old)
A lack of awareness about available mental health services also created difficulties, leaving individuals unsure of how or where to seek support.
First impressions and cultural disconnect
Initial encounters with mental health professionals played a crucial role in shaping attitudes toward continued engagement. Many participants felt that therapists lacked cultural competence, leading to discomfort during sessions.
‘My sister took therapy from an English lady and my sister was not happy as the therapist didn’t understand our cultural things.’ (Community worker, 41 years old)
Furthermore, community workers mentioned that a lack of mental health professionals with Bangladeshi heritage in boroughs such as Southwark, Camden and Islington further contributed to dissatisfaction, as people struggle to find culturally or religiously aligned therapists.
Categorisation by services
Participants expressed dissatisfaction with general practitioners (GPs) misattributing emotional distress to physical problems or offering general advice, such as recommending rest or exercise, without addressing mental health issues. One young person explained,
‘With my GP I had issues because when I initially told them how I’m feeling, they were like, “Oh, maybe you’re anaemic.” Then they sent me for a blood test. But I wasn’t anaemic at all.’ (Young person, female, 24 years old)
Similarly, several young people felt therapists unfamiliar with Bangladeshi culture misunderstood or pathologised their family dynamics.
‘I felt like I had to explain myself a lot…like…my family’s not bad…like, I think a White British person might say, “Oh, is that not a bit abusive?” So, I have to tiptoe around issues and not explain them to the full extent because I’m worried about them thinking badly of my family.’ (Young person, female, 20 years old)
Service offer and availability
Community workers pointed to budget cuts, staff shortages and limited service provision as barriers to effective long-term mental health support. Short-term therapy was also seen by one young person as insufficient for addressing complex mental health concerns.
‘I ended up having one session. Although [the therapist was] very nice, it felt like they don’t really know how to provide proper counselling—because they give you five sessions and then you’re on your way…they sort of messed up!’ (Young person, female, 20 years old)
Long waiting lists further discouraged help-seeking.
‘Sometimes [the GP] refers to a psychiatrist or psychologist, but there’s a long queue. And there’s a saying, “by the time I get my appointment, my mental health will have already improved!”’ (Community worker, 45 years old)
Receipt or rejection of services
Participants mentioned that families often seek religious or supernatural remedies over medical treatment for their mental health problems and prefer Muslim therapists to ensure their faith and world view were understood and respected.
‘…you know, when you have those [mental health] problems, they [traditional Bengalis] say things like Jinn [evil spirit] or like, “oh, she’s possessed…she needs Ruqyah [Islamic healing method]”, things like that, like exorcisms.’ (Young person, female, 20 years old)
There was also fear and mistrust of conventional treatments, with young people noting that many in the community were wary of therapy and antidepressants, fearing dependency on medication.
Despite challenges, participants acknowledged some strengths within the statutory mental health system:
Bilingual support and self-referral pathways
NHS providers, particularly GPs, were praised for providing multilingual information and interpreter access, facilitating clearer communication. In addition, the NHS Talking Therapies self-referral system was appreciated for its simplicity and prompt response, allowing individuals to initiate help-seeking without a GP referral.
‘The government, local authorities, voluntary sectors, and the NHS have many centres and services available in multiple languages like English, Bengali, Hindi and Somali.’ (Community worker, 52 years old)
Theme 3: Recommendations for statutory service improvements
Improving mental health understanding and reducing stigma
Participants emphasised the need for educational programmes to improve community understanding of mental health issues, reduce stigma, and normalise open conversations:
‘…you need to create awareness among the people so that they can understand what is happening in their family, what a mental health issue is, and what the symptoms of mental health issues are.’ (Community worker, 45 years old)
To improve awareness, participants recommended culturally relevant outreach strategies, such as using ethnic media, mosques and community centres, as well as incorporating storytelling, art therapy and role-play at fairs and cultural events.
‘People watch ethnic channels like Channel S, NTV [UK-based Bangla language TV channels]. So media can be a powerful tool…Some people like to read newspapers. So we can use both print and electronic media, mosque, leafletting, and word of mouth.’ (Community worker, 45 years old)
Participants also suggested integrating mental health education into school curricula, focusing on resilience, emotional regulation and coping strategies. One community worker highlighted that many young people struggle with understanding their emotions and forming a sense of identity, underlining the need for such support.
Increasing acceptability of mental health services
Participants stressed the need for culturally sensitive language, relatable examples and bilingual or multilingual support groups to enhance accessibility.
‘It’s easier to talk to someone who is from the same background. You might even speak the same language.’ (Young person, female, 21 years old)
Young people strongly preferred therapists who share or deeply understand their cultural background and gender, as they perceived it could help with communication and building trust.
‘I would go to a Muslim female professional, maybe South Asian or another ethnic minority, because they have that ingrained knowledge of where I’m coming from.’ (Young person, female, 21 years old)
Community workers advocated for a multidimensional approach, incorporating self-referral pathways with support from a trusted contact person.
‘I don’t think young people will come to the community centre and say, “I don’t feel right…I feel anxious.” It’s when they go to a service or youth club, where they have a point of contact, that they might open up and share. Then, a professional or contact person can pick it up or take the next steps and approach services gradually.’ (Community worker, 41 years old)
Participants also highlighted the importance of flexible therapy options, including both online and in-person sessions, and adjusting session frequency or length to suit individual preferences. Another key concern was the need for early intervention and quick access to support, avoiding long waiting periods.
‘It is better to recognise this as quickly as possible, if somebody’s suffering from mental problems, they need support without wasting time because earlier intervention can help them to get better.’ (Community worker, 63 years old)
Finally, nine participants emphasised the importance of placing services in accessible and familiar locations, such as schools and universities:
‘…like you’re in a hostile environment at home, and when you go to school, it’s a safe environment where you can possibly share. Having that place is very important.’ (Young person, male, 19 years old)
Theme 4: Opportunities and challenges for community-led mental health services
Community-led mental health initiatives
Participants strongly advocated for family-focused mental health initiatives, emphasising the need to educate parents and older generations about conditions such as anxiety and depression. They believed that increasing parental awareness and motivation was critical for ensuring that children receive appropriate support at home. Parents also expressed a willingness to engage in mental health programmes, especially if they perceived these as being tailored for their children’s benefit. Young people highlighted the importance of structured community spaces to promote open discussions and a sense of belonging.
‘Maybe creating a community hub having a drop-in or like a space where young people can come in and get the right support.’ (Young person, female, 22 years old)
Peer support was seen as valuable. Youth and community workers highlighted the potential peer-led initiatives to create relatable, safe spaces for mental health conversation:
‘Peers will be the best way. Young people will be trained and then deliver it, and they will feel so relatable.’ (Community worker, 48 years old)
Participants identified trusted community figures, such as leaders, role models and religious authorities, as crucial in bridging the gap between statutory services and the community, reducing stigma and promoting openness.
‘It might be good to have a Bengali speaker just showing how they’ve gone through, like being not so well mentally and then reaching out to support, and how it’s improved them…’ (Young person, male, 19 years old)
Participants also called for better coordination between GPs, hospitals and community organisations to provide integrated and holistic care. Bilingual and culturally competent professionals, especially those with a Bangladeshi background, were seen as vital for delivering services in ways that resonate with community needs.
Challenges to community engagement
A key barrier to community-based support was fear of stigma and concerns about confidentiality. Participants described hesitancy to seek help from within their own community, worried that personal information might be shared or misused.
‘…if you want support from the community, the barrier will be finding the right person. In my experience in the Bengali community, people like to talk about other people… if I share something, will she keep it a secret, or will she tell others, and then people might make fun of me?’ (Young person, female, 24 years old)
Additionally, insufficient funding, resources and staffing can create significant obstacles for community organisations.
‘We can train organisational staff or members of the community to deliver these services. But the main issue would be the funding to deliver these kinds of services.’ (Community worker, 52 years old)
Discussion
The study investigated experiences of mental health problems and priorities and preferences for mental health support among British Bangladeshi youth through interviews with young people, parents and community workers. Using thematic analysis informed by key theoretical models, four themes were identified regarding mental health issues, barriers and facilitators to accessing services, recommendations for service improvement and opportunities for strengthening community-led support.
The mental health challenges reported by our participants build on prior research indicating that internalising problems are evident among Bangladeshi and other ethnic minority youth in the UK. Reference Bains and Gutman28 Participants also described culturally specific expressions of distress, including supernatural explanations like Jinn possession Reference Alam13,Reference Dein, Alexander and Napier29 and the tendency to somatise symptoms, particularly where open discussions of mental health are discouraged. Reference Bhui and Bhugra30 In many contexts, emotional distress is seen as situational rather than medical, which can delay diagnosis and treatment. Reference Rodie, Park and Chowdhury31,Reference Karasz32 These cultural frameworks significantly influence how mental health is experienced and when support is sought.
British Bangladeshi youth identified family conflict as a key contributor to mental distress. Intergenerational tensions and differing cultural expectations between parents and children often led to isolation and emotional strain, consistent with acculturation theory and associated stress. Reference Bhui, Stansfeld, Head, Haines, Hillier and Taylor33,Reference Berry34 Research shows that such conflicts hinder communication and support within Bangladeshi families. Reference Alam13,Reference Kapasi35 Although British Bangladeshis navigate both heritage and Western cultural norms, Reference Helman36 traditional values often persist, shaping mental health perceptions and influencing help-seeking behaviours. Reference Sheikh and Furnham37 Young people also stressed social media overuse, bullying and discrimination (e.g. racism, Islamophobia) as major stressors, reflecting a broader tendency within Bangladeshi communities to view mental distress as socially rooted rather than biologically based. 2,Reference Rodie, Park and Chowdhury31,Reference Karasz32 This situational framing is common across South Asian cultures. Reference Desjarlais, Eisenberg, Good and Kleinman38 Consistent with minority stress theory, Reference Meyer39 participants linked discrimination in schools and communities to psychological distress and imposter syndrome. Structural racism has similarly been shown to exacerbate mental health issues among ethnic minorities. Reference Bisby, Singam, Beattie, Ekiko and Clilverd5,Reference Nazroo40
Stigma, shame and fear of judgement were key barriers to help-seeking in the Bangladeshi community, echoing findings that internalised stigma and cultural taboos, driven by fears of gossip and social exclusion, discourage early intervention. Reference Bisby, Singam, Beattie, Ekiko and Clilverd5,Reference Rodie, Park and Chowdhury31 Community and family judgement, often branding individuals as ‘crazy’ or ‘weak’, intensifies this reluctance. Reference Alam13 Cultural ideals of masculinity, which prize endurance and self-reliance, further prevent men from seeking support. Reference Alam13,Reference Clement, Schauman, Graham, Maggioni, Evans-Lacko and Bezborodovs41 Although young people in the Bangladeshi community are increasingly informed about mental health through school lessons, social media and peer conversations, their understanding may be limited. For example, research suggests young people in the UK have difficulty distinguishing between everyday stress and clinical conditions. Reference Foulkes42 Foulkes Reference Foulkes42 argues that although increasing awareness about mental health has many benefits, it may result in young people mislabelling normal developmental struggles (like sadness or stress) as mental health disorders, particularly when appropriate support systems are lacking. Language barriers meant that parents in this study struggled to access mental health services on behalf of their children and found it difficult to communicate with providers, relying on assistance from English-speaking family members. Reference Bisby, Singam, Beattie, Ekiko and Clilverd5,Reference Rodie, Park and Chowdhury31 A lack of awareness about services further limited access. Reference Haywood and Mac an Ghaill3
Cultural and systemic barriers within statutory mental health services, such as child and adolescent mental health services and GP practices, shaped participants’ experiences with services, echoing prior findings. Reference Alam13,Reference Nazroo40 A lack of cultural competence and underrepresentation of diverse therapists led to feelings of misunderstanding and detachment, especially among Sylheti speakers (a dialect of Bangla), who often view mental health through non-Western lenses. Reference Bisby, Singam, Beattie, Ekiko and Clilverd5 Additionally, GPs frequently misattributed mental health issues to physical symptoms, delaying diagnosis and eroding trust, reflecting known patterns of somatisation in the Bangladeshi community. Reference Bisby, Singam, Beattie, Ekiko and Clilverd5,Reference Bhui and Bhugra43
Systemic issues like staff shortages, funding cuts, and long waiting lists continue to limit access to timely, effective care, reinforcing previous findings on how under-resourced services discourage early help-seeking and exacerbate mental health crises. Reference Haywood and Mac an Ghaill3,Reference Bisby, Singam, Beattie, Ekiko and Clilverd5,Reference Bhui and Bhugra43 Traditional beliefs and negative perceptions about pharmacological treatments, particularly among older Bangladeshis, often frame mental illness as spiritual (e.g., Jinn possession), leading individuals to seek help from Imams rather than professionals, limiting service uptake and reinforcing stigma. 2,Reference Bisby, Singam, Beattie, Ekiko and Clilverd5,Reference Alam13
Despite barriers, participants acknowledged strengths in current statutory services, such as bilingual support, access to interpreters, culturally diverse professionals in certain boroughs and the user-friendly NHS Talking Therapies referral system. Although cultural competence is crucial for effective care, Reference Bhui, Warfa, Edonya, McKenzie and Bhugra44 these provisions may be limited to areas with large Bangladeshi populations, raising concerns about unequal access elsewhere.
The study identified culturally sensitive strategies to improve access, including mosque-based outreach, Bengali media campaigns and creative methods like art therapy to reduce stigma and promote early engagement. Key recommendations from participants included expanding bilingual, culturally aligned services and flexible therapy options (online and in-person) to address wait times, language barriers, and service acceptability, echoing earlier findings. Reference Bisby, Singam, Beattie, Ekiko and Clilverd5,Reference Rodie, Park and Chowdhury31 The findings also highlighted that community-led initiatives have the potential to address generational gaps in awareness. Educating parents can enhance their capacity to better understand and respond to their children’s mental health needs. Community spaces like peer groups and drop-in centres may additionally provide culturally safe avenues for dialogue and connection. Involving young leaders, community workers and religious figures, such as Imams, can also reduce stigma and promote help-seeking, especially when mental health is framed in ways that align with cultural and religious values. Reference Bisby, Singam, Beattie, Ekiko and Clilverd5,Reference Alam13,Reference Rodie, Park and Chowdhury31
However, a key challenge is the fear of judgement and breaches of confidentiality when disclosing mental health concerns within close social networks, discouraging individuals from seeking informal or community-based support. Past findings also emphasise the need for neutral, external spaces to ensure privacy. Reference Bhui, Warfa, Edonya, McKenzie and Bhugra44 Limited funding and resources also constrain community organisations’ capacity to provide scalable services, reflecting inequalities in resource allocation. These findings indicate the need for community-based, culturally sensitive mental health support tailored to Bangladeshi communities, helping to improve engagement, accessibility and mental health outcomes. Representatives from these communities should be actively involved in the development of future programmes and policies, ensuring that support is both relevant and sustainable.
Strengths and limitations
This study included diverse perspectives from young people, parents and community workers, providing a more nuanced understanding of mental health needs across generations. This triangulation of views revealed important areas of convergence, such as shared concerns about stigma and access barriers, as well as divergence, particularly in how young people and parents conceptualised mental health and their preferred support mechanisms. Collaboration with community organisations, bilingual materials and interviews in participants’ preferred languages ensured inclusivity. The study captured perspectives from both London and Leicester, although samples were not systematically compared with each other because of differences in size and context.
However, the study has some limitations. Despite efforts to include a wide variety of participants, time constraints and limited staff capacity meant that only three out of 14 organisations agreed to collaborate, limiting the diversity of organisational insights. Although formal screening was not conducted (as described in the Method), this approach may have led to the inclusion of participants whose mental health conditions did not meet diagnostic criteria, which could affect the specificity of the findings. Furthermore, the study did not conduct member checking to validate participants’ accounts, which may have affected the credibility of the findings. Relying solely on interviews is another limitation; incorporating additional qualitative methods such as focus groups or ethnographic research could have helped triangulate and strengthen the results.
In conclusion, this study highlights how cultural stigma, intergenerational tensions and systemic barriers within statutory services shape British Bangladeshi youths’ experiences of mental health. Sustainable improvement requires enhancing cultural competence, reducing access inequalities and strengthening trusted, community-based and bilingual support. Embedding community partnerships and youth participation within service design can ensure that mental health support is inclusive, contextually relevant and effective.
Supplementary material
The supplementary material is available online at https://doi.org/10.1192/bjo.2026.10999
Data availability
The data that support the findings of this study are available from the corresponding author, I.S., upon reasonable request.
Acknowledgements
The authors would like to express their gratitude to volunteer organisations – the Wapping Bangladesh Association (WBA), the Bangladesh Youth Movement (BYM), and the Bangladesh Youth and Cultural Shomiti (BYCS) – for their assistance in participant recruitment. We also extend our heartfelt thanks to all the participants who took part in the interviews.
Author contributions
I.S. contributed to study conceptualisation, data curation, formal analysis, investigation, methodology, project administration and validation, and wrote the original draft of the manuscript. H.K.L. conducted the formal analysis and reviewed the manuscript. K.R.-C. contributed to study conceptualisation, methodology and supervision, and reviewing and editing the manuscript. D.M. and P.C.G. contributed to study conceptualisation, methodology, supervision and validation, and reviewing and editing the manuscript. E.C. supervised the study, and contributed to validation and reviewing and editing the manuscript.
Funding
I.S. was funded by the Commonwealth Scholarship Commission (BDCS-2022-51). K.R.-C. is funded by a UKRI Future Leaders Fellowship (MR/W00285X/1). D.M. received support from the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London (IS-BRC-1215-20018). P.C.G. was supported by the UK Medical Research Council (UKRI) in relation the Indigo Partnership (MR/R023697/1) award. The views expressed are those of the authors and not necessarily those of the NIHR, the Department of Health and Social Care or UKRI. For the purpose of Open Access, the authors have applied a Creative Commons Attribution (CC-BY) licence to any Author Accepted Manuscript version arising.
Declaration of interest
None.
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