| Summary: | Background: Ethnic minorities, particularly the South Asian community, have a high prevalence of depression within the United Kingdom (UK). They suffer from poor health, social isolation and tend to not access available health services and treatment. Culturally appropriate psychosocial interventions are effective for depression. However, in the UK, very limited research evidence is available to date. The research study focuses on the processes involved with the aim of developing and evaluating the acceptability, adherence and effectiveness of a culturally appropriate psychosocial intervention for the South Asians in the UK.Methods: A phased programme of research was planned to achieve the aims. In the first phase, a systematic review was conducted. The aim was to identify and synthesize the literature on effective psychosocial interventions for common mental disorders, particularly for ethnic minorities in developed countries. In the second phase, four focus groups from which three with ethnic minority service users and one with the health professionals were conducted. The purpose was to collect and understand the views of South Asian service users and providers in order to culturally adapt an intervention as part of the AMP programme. In the final phase of the study, seventeen qualitative interviews were conducted with the psychosocial intervention trial participants and the intervention provider team. The case studies were analysed to evaluate the delivery, acceptability, adherence and cultural appropriateness of the psychosocial intervention. Findings: The systematic review provides reasonable evidence from trials and subgroup analyses from trials that ethnic minority patients could benefit from modified psychological treatments. However, there is no systematic documentation of cultural adaptations available. The participants of the focus groups and evaluation interviews identified cultural specific and universal barriers and highlighted cultural sensitive modifications for interventions which the health care providers need to respond in order to make mental health care accessible for the ethnic minorities. The qualitative studies show evidence that cultural adaptations improve acceptability and adherence in interventions. The findings highlighted empathy as the significant need of the participants of the well-being intervention. People make choices depending on the intensity of their need, the nature of the problem and the options available to them. The participants suggested that fulfilment of needs is vital rather than assuming that cultural matching is always necessary. Conclusion: Culturally modified interventions for specific populations can improve acceptability and accessibility. Better engagement and adherence to psychosocial interventions can be achieved by overcoming culturally specific and universal barriers and by providing treatment choices to patients according to the nature and urgency of their specific need. Further research is required for developing an evidence base in respect of designing effective mental health treatments for minority patients. A systematic way of documenting all these adaptations is essential. It would enable progress by improving comparability and replication of modifications across studies.
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