Table 4 Key Themes and Sub-themes

Access to information

• Individuals do not know where to obtain information.

• Services not providing readily accessible information.

• Services not aware of up-to-date information and guidance

Cultural and Spiritual barriers

• Religious and cultural practices

• Religious and cultural beliefs

• Intersection of religion and culture

Stigma

• Self-stigma of MH.

• The societal stigma of MH, including that of family members with MH ill-health.

• Institutional stigma, including negative beliefs of reasons why migrants access MH services

Structural barriers

• Service delivery does not consider gender.

• Service delivery not supporting certain types of migrants.

• Lack of interpretation services

• ‘Hostile environment’ policies and practices

Gender-specific issues

• Poor quality of research papers informing service and policy.

• Poor understanding of differences between gender and cultural needs when delivering MH support.

• Prioritisation of male health needs

• Prioritisation of male voices in research

• Intersectionality

Facilitator Themes

Facilitators Sub-themes

Religiosity, Community, and religious leaders

• The willingness of migrant females to discuss mental and spiritual health.

• Spiritual leader awareness of mental health conditions

• Supportive friends and family

Gender-sensitive support

• Availability of culturally and gender-sensitive mental health support.

• Peer support from other migrant females

Education settings as facilitators

• Subjects such as Psychology increased awareness of MH

• Social aspects of educational environments increased chances to access support compared to isolated settings.

Resilience and adaptability

• Resilience as a factor in the increased likelihood of seeking support.

• Adaptability and acculturation to a new environment.