Explanatory Models of (Mental) Health Among Sub-Saharan African Migrants in Belgium: A Qualitative Study of Healthcare Professionals’ Perceptions and Practices

Culturally differing approaches to the distinction between physical and
mental health contribute to cultural differences in explanatory models of what we
call “mental” health in a Western context. For this reason, we use “(mental) health”
in this study when referring to these models or differences in understanding. This
interpretative, interview-based qualitative study focuses on Belgian mental health
professionals’ perceptions of the (mental) health explanatory models held by their
patients of sub-Saharan African (SSA) descent. The study goals were threefold: first,
to assess professionals’ perceptions of the explanatory models of their patients of
SSA descent; second, to examine how these perceptions influence treatment prac-
tices; and third, to investigate the role of the professionals’ cultural backgrounds,
comparing the results between professionals with and without an SSA background.
Twenty-two in-depth interviews with mental health professionals were thematically analyzed, with ten of the participants of SSA descent. Results show that all pro-
fessionals perceived differences between Western and SSA explanatory models of
(mental) health. Causal beliefs were mentioned as the most important difference,
including their influence on coping strategies and health-seeking behavior among
patients of SSA descent. Professionals’ perceptions and familiarity with SSA
explanatory models of (mental) health affected their treatment practices. Language
and conceptual interpretation difficulties were encountered less frequently by pro-
fessionals of SSA descent. Those with a Western background applied “culturally
sensitive” practices, while professionals of SSA descent implemented an integrated
approach. These results contribute to ongoing discussions about what is considered
“cultural competency.”