This paper presents the first systematic review and narrative synthesis that focuses on mental health help-seeking among Arabs living in different countries around the globe. This included behaviours and attitudes towards mental health help-seeking, as well as barriers and facilitators to seeking psychological support in this population. We conducted this review in aim of understanding what factors may influence Arab's help-seeking and use of psychological services. We also aimed to provide a comprehensive overview on whether this may differ across Arab immigrants/refugees and Arabs residing in Arab countries. The results of this study provide an insight into help-seeking attitudes and behaviours among Arabs in different geographical contexts, and particularly what challenges they are facing. The review identifies support needed that could increase service use and awareness of available mental health support among Arabs. We hope that this paper will have a significant impact on shaping the support and services offered to ethnic minority Arab populations to encourage help-seeking.

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Psychosis is one of the most disabling psychiatric disorders. Paediatric traumatic brain injury (pTBI) has been cited as a developmental risk factor for psychosis, however this association has never been assessed meta-analytically. A systematic review and meta-analysis of the association between pTBI and subsequent psychotic disorders/symptoms was performed. The study was pre-registered (CRD42022360772), adopting random-effects model to estimate meta-analytic odds ratio (OR) and 95% confidence interval (CI) using the Sidik-Jonkman method. Subgroup (study location, study design, outcome type, assessment type, and adult verses adolescent onset) and meta-regression (quality of evidence) analyses were also performed. The robustness of findings was assessed through sensitivity analyses. The meta-analysis is available online as a computational notebook with an open dataset. We identified 10 relevant studies and eight were included in the meta-analysis. Based on a pooled sample size of 479,686, it was found that the pooled OR for the association between pTBI and psychosis outcomes was 1.88 (95% CI [1.07, 3.30]). There were no subgroup effects and no outliers identified. The association remained robust after removal of studies with low quality of evidence, however the OR reduced to 1.45 (95% CI [1.02, 2.07]). A leave-one-out sensitivity analysis showed the pooled association changed from marginally significant to marginally non-significant after removal of any one of three studies. In conclusion, we report cautious meta-analytic evidence for a positive association between pTBI and future psychosis. New evidence will be key in determining long-term reliability of this finding.

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