End user and stakeholder perspectives on mental health strategies in Roma communities, Seville

Background

Roma populations face mental health inequalities linked to social determinants such as poverty, discrimination and social exclusion. In Spain, these factors are evident in segregated neighbourhoods, where Roma communities have limited access to culturally appropriate mental health services. However, evidence on strategies recommended by Roma communities remains scarce. This study analyses strategies recommended by the community to address mental health issues amongst the Roma population in Polígono Sur, Seville, Spain. This study is part of the MENTBOX project, co-funded by the European Union, which aims to co‑create evidence‑based mental health tools adapted to vulnerable communities.

Methods

We conducted a two‑phase qualitative study following the DIME methodology. Phase one involved Free List interviews to identify relevant problems. Phase two included 16 Key Informant interviews with Roma community members and stakeholders to explore strategies to address these problems. Data were analysed using thematic analysis within a five‑level socioecological framework.

Results

Key Informant interviews focused on four mental health issues identified during the Free List phase: fear and insecurity, interpersonal conflict, isolation, and hopelessness. Participants proposed a range of strategies mainly targeting organisational level, followed by community and public policy levels. Fewer strategies targeted interpersonal and intrapersonal levels.

Conclusions

Recommendations focused primarily on organisational, community and policy levels, with limited emphasis on individual approaches. This reflects a shift beyond individual coping towards structural and collective determinants. The prominence of organisational strategies highlights the key role they play in this context, where trust and antigypsyism emerged as central themes. Findings support the need for multi‑level, community‑centred and intersectoral mental health interventions targeting Roma populations.

Key messages

• Tackling mental health inequities among Roma populations requires culturally responsive, community‑centred and anti‑discriminatory interventions.

• The Roma community in Polígono Sur recommends organisational, community-based and political strategies over individual coping mechanisms when addressing mental health issues.