Mental illness and help-seeking behaviours among Middle Eastern cultures: A systematic review and meta-synthesis of qualitative data

Elshamy, Farah; Hamadeh, Ayah; Billings, Jo; Alyafei, Aisha

doi:10.1371/journal.pone.0293525

Cited by 20 publications

(6 citation statements)

References 77 publications

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“…Indeed a remarkable percentage of the participants in this study either claimed no history of mental illness or did not answer the question, while their children were diagnosed with anxiety disorders using our rating scales ( Figure 2 ). Thus, our result affirms the importance of increasing public mental health awareness and psychoeducation programs in the region, particularly during emergencies ( 58 ).…”

Section: Discussionsupporting

confidence: 81%

Anxiety disorders among children and adolescents during COVID-19 lockdowns and school closures: a cross-sectional study in Kuwait

Alamiri,

Alkhamis,

Naguy

et al. 2024

Front. Psychiatry

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IntroductionInvestigating the epidemiology of mental health disorders resulting from COVID-19 intervention measures, primary school closures, and social isolation in children and adolescents needs to be prioritized over adults at the post-pandemic stage. Most preliminary psychosocial studies conducted during the pandemic have demonstrated that younger age groups are the most vulnerable to such implications. Thus, this study aims to estimate the probable prevalence of specific anxiety disorders in children and quantify their relationships with relevant demographic risk factors.MethodsWe used a cross-sectional study comprising 430 children aged between 8- and 18 years old living in Kuwait during the period of school closures as well as full and partial lockdowns. The survey included questions about participants’ characteristics, children's anxiety using the Screen for Child Anxiety Related Emotional Disorders Questionnaire (SCARED) scale, and children's emotions and behaviours using the Strengths and Difficulties Questionnaire (SDQ). Univariate and multivariate logistic regression analyses were used to summarize the demographic and characteristics of the participants and their association with general, social, and generalized anxieties, as well as behavioural and emotional difficulties. ResultsWe inferred that 24.83% of our participants had at least one anxiety disorder, while 20.19% were classified as abnormal on the SDQ scale. Our multivariate analysis revealed that lockdown duration and sex of the child were consistently significant predictors (p-values < 0.05) of the broad spectrum of selected mental disorders. Additionally, we inferred notable increases in the likelihood of mental disorders associated with the increased duration of lockdowns. ConclusionsOur findings revealed preliminary insights into the vulnerability of young populations to the indirect negative impacts of strict public health measures during pandemic emergencies. Thus, authorities should consider such implications when planning and implementing similar interventions in future pandemics.

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Section: Discussionsupporting

confidence: 81%

Anxiety disorders among children and adolescents during COVID-19 lockdowns and school closures: a cross-sectional study in Kuwait

Alamiri,

Alkhamis,

Naguy

et al. 2024

Front. Psychiatry

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“…Barriers to mental health care seeking among foreign-born MENA individuals in the US may be due to a combination of individual (e.g., attitudes, beliefs) and socio-structural factors (e.g., stigma, access to appropriate care). A review of articles on barriers to mental health care among Middle Eastern cultures noted that economic and structural barriers, as well as a preference for seeking health through alternative sources, healers or other family members may prevent mental health care seeking from a physician or other mental health professional [25]. This is important to consider since our sample includes foreign-born MENA children.…”

Section: Discussionmentioning

confidence: 99%

Mental health and care seeking patterns of Middle Eastern and North African immigrant children in the United States

Kindratt,

Dallo,

Brown

2024

Preprint

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Purpose To determine the prevalence of childhood mental and emotional health concerns and care seeking patterns among foreign-born MENA children compared to US- and foreign-born White children before and after adjusting for covariates. Methods Data from the 2000–2018 National Health Interview Survey (NHIS) were analyzed. Poor toddler mental health in the past two months (2–3 years) and childhood emotional difficulties (4–17 years) in the past six months were measured. Parents also reported whether (yes/no) their child saw a doctor for behavioral or emotional concerns in the past 12 months. Results Parents of foreign-born MENA young children (ages 2–3 years) were less likely to report mental health concerns (44.8%) compared to US-born White counterparts (67.3%; p < .05). Parents of foreign-born MENA children were less likely to report emotional difficulties compared to US- and foreign-born White children (21.9% and 19.3%, respectively; p’s < .05). Foreign-born MENA children with mental or emotional health concerns had lower odds of seeing a doctor in the last 12 months for emotional/behavioral problems (OR = 0.45; 95% CI = 0.24–0.86) or mental health concerns (OR = 0.47; 95% CI = 0.27–0.83) compared to their US-born White counterparts after adjusting for sociodemographic factors. Conclusion Parents of foreign-born MENA children reported fewer mental and emotional health concerns compared to US-born Whites. Those with mental and emotional health concerns were less likely to seek mental health care compared to their US-born White counterparts. Further research is needed to confirm and expand on these findings once a unique racial/ethnic identifier for MENA children is made available for measuring national mental health statistics.

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“…Stigma as a result of cultural and gender norms were key factors influencing the acceptability of MHPSS programmes. The stigma associated with needing and receiving help for mental health issues is evidenced across cultures and intersects with gender (Elshamy et al, 2023 ; Khatib et al, 2023 ). This review concurs with existing evidence to suggest that both ‘self-stigma’ (e.g., internalised sense of shame or feeling devalued due to mental health issues) and ‘societal stigma’ (e.g., whereby communities may stigmatise individuals with mental health issues) can impede the uptake of services (Bawadi et al, 2022 ; Abo-Rass et al, 2023 ).…”

Section: Discussionmentioning

confidence: 99%

“…While mental health issues affect both men and women, traditional gender roles may prevent men from seeking help or discussing their emotional struggles as openly as women due to the stigma attached with doing so (Khatib et al, 2023 ). Cultural and gendered beliefs among displaced communities may stigmatise mental health issues, viewing them as personal failures or signs of weakness (Elshamy et al, 2023 ). Gender-specific barriers were observed in responses to certain programme components.…”

Section: Discussionmentioning

confidence: 99%

Mental health and psychosocial support programmes for displaced populations in low- and middle-income countries (LMICs): A systematic review of process, perspectives and experiences

Dickson,

Ko,

Nguyen

et al. 2024

Camb. prisms Glob. ment. health

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Displacement exerts an ongoing negative impact on people's mental health. The majority of displaced populations are hosted in the global south, yet there is a paucity of evidence synthesis on the implementation of mental health and psychosocial support (MHPSS) programmes in those contexts. We undertook a systematic review of factors influencing the delivery and receipt of MHPSS programmes for displaced populations in low-and middle-income countries to address this gap. A comprehensive search of 12 bibliographic databases, 25 websites and citation checking were undertaken. Studies published in English from 2013 onwards were included if they contained evidence on the perspectives of adults or children who had engaged in, or programmes providers involved in delivering, MHPSS programmes. Fifteen studies were critically appraised and synthesised. Studies considered programme safety as a proxy for acceptability. Other acceptability themes included stigma, culture and gender. Barriers to the accessibility of MHPSS programmes included language, lack of literacy of programme recipients and location of services. To enhance success, future delivery of MHPSS programmes should address gender and cultural norms to limit mental health stigma. Attention should also be given to designing flexible programmes that take into consideration location and language barriers to ensure they maximise accessibility. Impact statementAs the global population continues to experience displacement due to conflict, disasters and other crises, addressing the mental health and psychosocial well-being of displaced communities in low-and middle-income countries (LMICs) remains a critical and ongoing concern. This review has identified 15 high-quality studies on the key factors impacting the acceptability and accessibility of mental health and psychosocial programmes targeting displaced populations in LMICs, such as stigma, gender, language, literacy and the locational reach of services. The stigma surrounding mental health remains pervasive in many societies, impeding help-seeking behaviours and reinforcing a culture of shame around psychological health. Addressing stigma requires psychoeducative approaches that respect cultural beliefs and promote mental health awareness and acceptance. Similarly, acceptability of programme components can differ by gender; thus, an assessment of gender and other sociocultural factors could be assessed during feasibility phases of programme trials to inform whether any adjustments need to be made to ensure greater equity in participation. Consideration of language and literacy barriers is also crucial for ensuring access to all programme components and optimising engagement in MHPSS services. Furthermore, the physical location of the displaced populations can hinder programme accessibility. In remote or conflict-affected regions, access to mental health and psychosocial support services may be limited, and timing and competing demands may necessitate taking a pragmatic approach to programming. Overall, understanding w...

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Mental illness and help-seeking behaviours among Middle Eastern cultures: A systematic review and meta-synthesis of qualitative data

Cited by 20 publications

References 77 publications

Anxiety disorders among children and adolescents during COVID-19 lockdowns and school closures: a cross-sectional study in Kuwait

Anxiety disorders among children and adolescents during COVID-19 lockdowns and school closures: a cross-sectional study in Kuwait

Mental health and care seeking patterns of Middle Eastern and North African immigrant children in the United States

Mental health and psychosocial support programmes for displaced populations in low- and middle-income countries (LMICs): A systematic review of process, perspectives and experiences

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