A mix-method approach to the cultural understanding of distress and the non-use of mental health services

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Abstract
Background: The rationale for conducting mixed-method studies is usually based on the desire to combine the complementary strengths of qualitative and quantitative research. Typically, the former provides in-depth descriptions offering strong internal validity while the latter provides strong external validity. The exclusive use of quantitative methods in mental health research presents certain limitations which lie in the subjective nature of mental health problems and related behaviors, and the fact that these are mediated by cultural context. Aims and methods: This paper illustrates, along with the Pathway and Barriers to Mental Health project, the usefulness of using a mixed-method design to study mental health problems and related behaviors in a culturally diverse community. Results: The results show how the various quantitative and qualitative stages of the project were implemented in a Sequential Transformative Design that allows for a better identification and understanding of community mental health problems. This type of mixed design contributed to the development and evaluation of a regional cultural consultation service in mental health. Conclusion: A mixed-methods approach does not simply make positivist science stronger; rather, it contributes to do better research and tailored intervention.