Groundbreaking study aims to reduce health inequalities

The ROSHNI-2 study is the largest ever research study into postnatal depression in British South Asian mums and was recently published in the medical journal The Lancet. 

It was led by researchers from Lancashire and South Cumbria NHS Foundation Trust (LSCft) in collaboration with NHS and academic partners across the UK and funded by the National Institute for Health and Care Research.

The pioneering study was driven by LSCft Research Operations Manager Farah Lunat’s personal drive to reduce health inequalities within South Asian communities. 

Farah said: “As a British-born Indian Muslim woman and the eldest of five children in a South Asian family, I am intimately familiar with the complexities of navigating identity, faith and culture.

"So, it’s been a passion of mine for years, British South Asian women are the largest ethnic minority group in the UK and are statistically more likely to experience postnatal depression. Yet, they are significantly less likely to access mental health services. 

“The reasons are complex, from language barriers and stigma to a lack of culturally sensitive care. With ROSHNI, together with partner researchers, we set out to change that.

"There was a focus on raising awareness of mental health, reducing ethnic disparities, tackling stigma, and adapting psychological therapies to meet the needs of ethnic minorities.

“As a British-born Indian Muslim woman and the eldest of five children in a South Asian family, I am intimately familiar with the complexities of navigating identity, faith and culture. 

"As a teenager, I watched my own mother navigate pregnancy, postpartum and neonatal loss.

"Though she had lived and worked in the UK since she was 15, she lacked the confidence to advocate for herself.

"As I progressed through my studies and career, I reflected often on the limited or even total lack of support available to her. 

"Even if services had been offered, they would not have reflected what our family needed.

"These experiences cemented my passion for women's health and later shaped my decision to dedicate my career to this field.”

The study is the largest ever study into post natal depression in South Asian mums (Image: LSCft) The study tested a culturally adapted talking therapy called the 'Positive Health Programme' which was designed specifically for British South Asian mums.

Eligible participants were South Asian women with depression, aged 16 and above, who had a baby younger than 12 months old. 

Researchers fluent in common South Asian languages including Urdu, Punjabi, Gujarati, Bengali, and Tamil engaged with faith leaders, who encouraged participation within their sermons. 

Research teams engaged directly with families and were able to be sensitive to cultural family dynamics at home, and attended community centre drop-ins.  

More than 4,000 women took part across the UK, including many Lancashire-based mums.

The results were significant and showed that women who received the tailored support recovered more quickly and sustained their well-being over time, compared to those receiving standard care. 

Farah said: “I reflect on my positionality as a British-born Muslim woman of Indian heritage, a researcher and a practitioner navigating the complex relationships between culture, identity and care.

"This lens has shaped not only the questions I have asked but also the ways in which I have engaged with communities, collaborators and systems. 

"Meaningful engagement requires a cultural shift. ROSHNI is about so much more than clinical outcomes; it’s a story of representation, inclusion and community empowerment. 

"Ethnic minority communities that are so often labelled as ‘hard to reach’ are, in fact, ‘easy to ignore’.

"Our study has proved that a culturally inclusive approach to research does work and has huge potential benefits for improving access to healthcare for underrepresented communities.

“In fact, South Asian Heritage Month’s theme this year is ‘Roots to Routes’ which focuses on exploring the rich journey of growth, and the evolving connections we make through generations. 

"Through its work at the heart of communities, ROSHNI-2 has become part of the journey of many British South Asian families across the UK, demonstrating that the mental health care of the future must be informed by a nuanced understanding of individuals’ ‘roots’ both in the past and present.”

She added: “We have now begun work on the next stage, ROSHNI-3 which will focus on breaking the stigma and addressing postnatal mental health in British South Asian families.

“ROSHNI is an example of what’s possible when we listen, adapt, and include and a reminder that heritage is not only something we celebrate, but something that here at LSCft, we are building upon to improve access to care.”