Identifying mental health problems and pathways for intervention in the Roma community of Polígono Sur, Spain: a qualitative socio‑ecological study

Roma communities in Spain experience disproportionate exposure to adverse social determinants of health, contributing to increased vulnerability to mental health problems. Despite these factors, scientific data on the mental health of the Roma population in Spain remains scarce. This study aimed to identify key mental health problems among Roma individuals of Polígono Sur , a highly disadvantaged neighbourhood in Seville, Spain; examine their perceived causes, consequences, and response strategies; and assess implications for developing culturally appropriate and community‑responsive mental health programmes. We conducted a two‑phase qualitative study following the Programme Design, Implementation, Monitoring, and Evaluation (DIME) protocol. In phase one, Free List (FL) interviews with 34 participants identified locally relevant problems. In phase two, 16 Key Informant (KI) interviews provided detailed descriptions of these problems, explored perceived causes and effects, and identified strategies considered useful to address them. Data were analysed using thematic analysis and organised within a five‑level socioecological framework (intrapersonal, interpersonal, organisational, community, and public policy). Across FL interviews, we identified 74 problems affecting the Roma population in Polígono Sur and we explored the following problems in the KI: fear and insecurity, interpersonal conflict, isolation, and hopelessness. Perceived determinants and consequences emerged across all socioecological levels, underscoring the interplay among individual vulnerabilities, community dynamics, and structural disadvantage. Although several initiatives existed—primarily at the organisational level—substantial mental health needs remained unmet, particularly those related to community conditions, structural barriers, and policy gaps. Findings highlight the need for mental health strategies within the Roma community that integrate individual‑level support with broader community‑centred and structural interventions. Based on our findings, we recommend adopting intercultural, preventive, and rights‑based approaches, complemented by culturally adapted self‑help materials and guided self‑help tools to strengthen coping skills, resilience, and stress management. Embedding these personal‑level supports within coordinated community and policy actions may provide a more comprehensive and sustainable response to the multi‑level mental health needs identified in this highly vulnerable population.