Caught in the middle: reflections on mental health in South Asian women navigating family expectations.

This reflective piece examines under-recognised mental health distress among South Asian women navigating unspoken expectations within extended-family systems. Drawing on clinical experience and a selective review of evidence on stigma, migration-related stress and perinatal disparities, it explores how cultural norms can both protect and constrain emotional well-being. Key insights are that (a) culturally rooted duty and silence mask distress; (b) family networks can be a support and a barrier to help-seeking; and (c) clinicians must balance cultural respect with assessment for individual suffering. Practical recommendations include communication strategies, clinician reflexivity and system-level approaches to reduce ethnic disparities in maternal and mental health.