There is a large population of Turkish-speaking migrants living in London, many of whom are refugees (Enneli, Modood, & Bradley, 2005). Primary care and secondary mental health services have consistently reported poor continuity of care among patients from this community. The aim of this study was to explore the possible interconnection of causal attributions and pathways into care among Turkish-speaking, mainly Kurdish, patients with a past history of psychosis. Narratives of illness were elicited from informants. Physical symptomatology was a prominent feature of presentation in this group. These patients did not discuss their health problems conceptualized as uniform ‘models' of illness, but rather in an attributional style that emphasized the experience of traumatic life events, often related to the overarching problem of exile and settlement. Childhood and family issues of poverty and domestic violence were often raised by patients, but tended to be backgrounded as having little contributory significance. These patients sought intervention, serially or in combination, from a diverse range of practitioners, including private healthcare and traditional healers or hocas. Their explanatory models of illness were complex and fragmentary and the relationship between explanations and help seeking is seldom linear. The implications of these findings for health services are discussed. © 2007, Sage Publications. All rights reserved.

Migration Narratives pathways Kurdish Explanatory models Turkish Psychosis help seeking Refugee

personal experience patient care symptomatology immigrant explanatory variable refugee mental health service primary medical care poverty family attitude human Refugees life event psychosis Turkey (republic) Great Britain language religion mental health care Humans Domestic Violence male female Psychotic Disorders clinical article Article help seeking behavior adult migration health care access Turkey United Kingdom Patient Acceptance of Health Care attitude to health