Crossing boundaries: identifying and meeting the mental health needs of gypsies and travellers

Background: Although little is known about the mental health of Gypsies and Travellers, their life expectancy is lower than the general population, perinatal death rates are higher, and non-UK studies of the mental health of Roma people suggest higher rates of mental disorders and suicide. Aim: To explore the mental health needs of Gypsies and Travellers in Sheffield, the extent to which services are meeting these needs and ways in which services might be improved. Method and Results: This mixed method study included: (1) A health status survey which revealed higher levels of anxiety and depression and lower social functioning than a comparison group in a local deprived area, (2) Semi-structured interviews with Gypsies and Travellers to elicit their views about mental health problems and services. Most interviewees talked about “feeling low” or “stressed” due to social and economic factors. They were unclear about the role of psychiatric services, and (3) Focus groups with service providers to explore their experiences and views about providing services for Gypsies and Travellers. They found it difficult to address the high levels of deprivation and complexity of need presented by this community partly because of limited and inaccurate information. Conclusions: The study concurs with recent calls for “joined-up” working: services need to work across boundaries to address social and economic factors underlying distress and to ensure consistency and communication between primary and secondary care. Family and community-based models of care may improve acceptability and effectiveness of services. Education, information and training are required to reduce discrimination and increase existing support to meet the mental health needs of Gypsies and Travellers.