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Khatib HE, Alyafei A, Shaikh M. Understanding experiences of mental health help-seeking in Arab populations around the world: a systematic review and narrative synthesis. BMC Psychiatry 2023; 23:324. [PMID: 37161342 PMCID: PMC10170733 DOI: 10.1186/s12888-023-04827-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 04/28/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Racial and ethnic disparities in mental health service utilisation and access is well established. Mental illness is common among Arab populations globally, but most individuals display negative attitudes towards mental health and do not seek professional help. The aim of this systematic review was to determine 1) help-seeking behaviours 2) help-seeking attitudes and 3) help-seeking barriers and facilitators, related to mental health services among Arab adults. METHOD A pre-defined search strategy and eligibility criteria allowed for database searching using terms related to: mental health, Arabs, help-seeking, as well as experiences and behaviours. Seventy-four articles were included and analysed through narrative synthesis. Results were reported using the PRISMA guidelines. The review protocol was registered prospectively on PROSPERO (CRD42022319889). RESULTS Arabs across the world have negative attitudes towards formal help-seeking and are reluctant to seek help, despite the presence of psychological distress. There is little information on factors that influence help-seeking behaviours and rates of service use. Preference for informal help sources such as family and friends were expressed and considered more acceptable. Low mental health literacy, stigma, gender, age, education, religion, acculturation, and immigrant status were the most common factors influencing help-seeking attitudes. Barriers to help-seeking included stigma, privacy and confidentiality, trust, mental health literacy, language, logistics, and culture related barriers. Increasing societal and family awareness, external support and encouragement, shared culture between the client and therapist, quality of doctor patient relationship, and feelings of connectedness with the host country among refugees were mentioned facilitators. Mixed findings for the role of religion, and family and community, in relation to facilitating or hindering help-seeking were reported. CONCLUSIONS There is an increased likelihood and preference to seek informal sources of psychological support among Arabs. Contextual and cultural factors impeding help-seeking for Arabs are common across the world. Future research should address actual utilisation rates of services to better understand factors that influence help-seeking behaviours and facilitators to help-seeking. Increasing mental health literacy and developing anti stigma campaigns is necessary. Developing culturally informed interventions should inform future efforts to promote help-seeking among this population.
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Affiliation(s)
- Hania El Khatib
- Division of Psychiatry, University College London, London, UK
| | - Aisha Alyafei
- Division of Psychiatry, University College London, London, UK
| | - Madiha Shaikh
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
- North East London NHS Foundation Trust, London, UK.
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Altwaijri Y, Kazdin AE, Al-Subaie A, Al-Habeeb A, Hyder S, Bilal L, Naseem MT, De Vol E. Lifetime prevalence and treatment of mental disorders in Saudi youth and adolescents. Sci Rep 2023; 13:6186. [PMID: 37061556 PMCID: PMC10105730 DOI: 10.1038/s41598-023-33005-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 04/05/2023] [Indexed: 04/17/2023] Open
Abstract
Previous global and regional studies indicate that adolescents and young adults (i.e., youth) are affected by various mental disorders with lifelong consequences. However, there are no national estimates of mental disorders prevalent among Saudi youth. Using data from the Saudi National Mental Health Survey (SNMHS), we examined the lifetime prevalence, treatment, and socio-demographic correlates of mental disorders among Saudi youth (aged 15-30). A total of 4004 interviews were conducted using the adapted Composite International Diagnostic Interview (CIDI 3.0). Cross tabulations and logistic regression were used to generate estimates for the SNMHS youth sample (n = 1881). The prevalence of a mental disorder among Saudi youth was 40.10%, where anxiety disorders affected 26.84% of the sample, followed by disruptive behavior disorders (15.44%), mood disorders (9.67%), substance use disorders (4%) and eating disorders (7.06%). Sex, education, parental education, income, marital status, region, and family history of disorders were significant correlates of various classes of mental disorders. Only 14.47% of Saudi youth with any mental disorder received treatment for a lifetime disorder. Age, parental education, and family history of disorders emerged as significant correlates of mental health treatment. Lifetime mental disorders are highly prevalent among Saudi youth. There is an unmet need for culturally sensitive and age-appropriate treatment of lifetime mental disorders among youth in Saudi Arabia.
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Affiliation(s)
- Yasmin Altwaijri
- King Salman Center for Disability Research, Riyadh, Saudi Arabia.
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, MBC 03, PO Box 3354, Riyadh, 11211, Saudi Arabia.
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Alan E Kazdin
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Abdullah Al-Subaie
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Edrak Medical Center, Riyadh, Saudi Arabia
| | - Abdulhameed Al-Habeeb
- National Center for Mental Health Promotion, Ministry of Health, Riyadh, Saudi Arabia
| | - Sanaa Hyder
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Health and Meaningful Dialogue (HAMD) Centre, Manchester, UK
| | - Lisa Bilal
- King Salman Center for Disability Research, Riyadh, Saudi Arabia
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, MBC 03, PO Box 3354, Riyadh, 11211, Saudi Arabia
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad Talal Naseem
- King Salman Center for Disability Research, Riyadh, Saudi Arabia
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, MBC 03, PO Box 3354, Riyadh, 11211, Saudi Arabia
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Edward De Vol
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, MBC 03, PO Box 3354, Riyadh, 11211, Saudi Arabia
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The impact of psychiatric education and clinical practice on students' beliefs toward people with mental illnesses. Arch Psychiatr Nurs 2022; 40:56-59. [PMID: 36064246 DOI: 10.1016/j.apnu.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 02/15/2022] [Accepted: 05/02/2022] [Indexed: 11/21/2022]
Abstract
It is common knowledge that people with psychiatric illnesses are stigmatized by a broad spectrum of society. The purpose of this study was to assess the beliefs of undergraduate students toward people with mental illnesses, and determine the impact of psychiatric education and clinical practice on their beliefs. A Quasi-Experimental, single-group pre-test post-test design was used. The study was performed at a private school of health sciences in Saudi Arabia. The study sample consisted of 42 students. For data collection, the Beliefs toward Mental Illness Scale was used. Following the psychiatric education and clinical practice, the total BMIS and subscale scores were significantly lower than the scores obtained before the course. There was a statistically significant difference in the BMIS total scores (t = 2.17, p = 0.001) and subscale scores (Poor social and interpersonal skills: t = 0.78, p = 0.001; Dangerousness: t = 1.17, p = 0.001; Incurability: t = 0.42, p = 0.001) between the pre-test and post-test data. This research indicates that psychiatric educational intervention using face-to-face interaction and clinical practice interaction can positively change stigmatizing beliefs of undergraduate students toward people with mental illnesses.
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Noorwali R, Almotairy S, Akhder R, Mahmoud G, Sharif L, Alasmee N, Mahsoon A, Hafez D. Barriers and Facilitators to Mental Health Help-Seeking among Young Adults in Saudi Arabia: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052848. [PMID: 35270539 PMCID: PMC8909985 DOI: 10.3390/ijerph19052848] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 02/25/2022] [Accepted: 02/28/2022] [Indexed: 02/04/2023]
Abstract
While young Saudi adults are reportedly prone to experiencing a variety of mental health problems, they tend to delay seeking mental health support. Therefore, this study aimed to explore the barriers and facilitators of seeking mental health support among young adults in Saudi Arabia. A qualitative research design was implemented using semi-structured interviews with 12 young adult participants in Saudi Arabia, recruited through social media platforms, and the interviews were then analyzed using thematic analysis. Two major themes emerged: barriers that impede the process of mental health help-seeking and facilitators that assist individuals in seeking mental health support. The barriers included public stigma and lack of awareness, unprofessional mental health practitioners, lack of accessibility to services and information, unsupportive families, intrapersonal dilemmas, and misconceptions based on religious beliefs. Facilitators of help-seeking included increasing societal and family awareness, promoting the accessibility of services, enhancing sources of external support, personal motivation to change, and online therapy. The findings of this study emphasize the importance of promoting mental health literacy among the Saudi public, particularly with regard to young adults and their unique mental health needs. Exploring facilitators and barriers may also assist mental health providers in developing tailored mental health campaigns and interventions directed at young adults.
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Affiliation(s)
- Robena Noorwali
- Faculty of Nursing, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (R.N.); (S.A.); (R.A.); (G.M.)
| | - Sarah Almotairy
- Faculty of Nursing, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (R.N.); (S.A.); (R.A.); (G.M.)
| | - Raneem Akhder
- Faculty of Nursing, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (R.N.); (S.A.); (R.A.); (G.M.)
| | - Ghadi Mahmoud
- Faculty of Nursing, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (R.N.); (S.A.); (R.A.); (G.M.)
| | - Loujain Sharif
- Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah 21551, Saudi Arabia; (N.A.); (A.M.)
- Correspondence:
| | - Nofaa Alasmee
- Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah 21551, Saudi Arabia; (N.A.); (A.M.)
| | - Alaa Mahsoon
- Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah 21551, Saudi Arabia; (N.A.); (A.M.)
| | - Duaa Hafez
- Department of Public Health Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah 21551, Saudi Arabia;
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Firdos S, Amanullah M, Mobarki AO. Labeled As Mentally Ill: Community Perspective Toward Mental Illness in Al Ahsa, Saudi Arabia. Cureus 2021; 13:e20127. [PMID: 34984157 PMCID: PMC8720389 DOI: 10.7759/cureus.20127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2021] [Indexed: 11/06/2022] Open
Abstract
Background Communities hold different opinions toward mentally ill people and treat them negatively, irrespective of their behavior. Differences in beliefs can impact not only affected individuals but the entire network and opportunities. This study aimed to examine beliefs about mental illness among different populations of the Saudi community. Methodology This descriptive study was conducted among 840 participants from several groups (different family roles, professions, medical and non-medical students, educated and uneducated, etc.) aged 18-75 years in Al Ahsa, Saudi Arabia. Information regarding participants’ demographics and beliefs toward mental illness was collected through validated measures. Data were analyzed using SPSS version 21 (IBM Corp., Armonk, NY, USA). Results Data analysis showed that individuals over the age of 30 years believed that mental illness is socially dysfunctional, incurable, and a subject of embarrassment. Married couples also considered mental illness to be socially dysfunctional and a subject of embarrassment. Similarly, unemployed participants had more negative views of mental illness than working individuals and students. Furthermore, educators and other professionals believed that mental illness is more socially dysfunctional than healthcare providers. In addition, community groups with a history of mental illness stated that mental illness is incurable. In the family context, grandparents’ beliefs toward mental illness were more negative than other family members’ views. Conclusions This study highlights the diversity in beliefs about mental illness among different groups of Arab society. The influence of poor knowledge, religious beliefs, and subjective attitudes should be explored further, and anti-stigma interventions should be implemented to increase community awareness about mental illness.
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Niska M, Stevanovic M, Weiste E, Ostrovskij T, Valkeapää T, Lindholm C. Self-Disclosure and Non-Communication: Stigma Management in Third-Sector Transitional Employment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211840. [PMID: 34831597 PMCID: PMC8624999 DOI: 10.3390/ijerph182211840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/05/2021] [Accepted: 11/06/2021] [Indexed: 11/16/2022]
Abstract
People who are recovering from a mental illness often have difficulties finding and maintaining employment. One of the main reasons for these difficulties is the negative label, or stigma, attached to mental illnesses. People who possess stigmatizing characteristics may use compensatory stigma management strategies to reduce discrimination. Due to mental illnesses’ invisible characteristics, information control is an important stigma management strategy. People can often choose whether they disclose or non-communicate their illness. Nevertheless, it might be difficult to decide when and to whom to disclose or non-communicate the stigma. Since stigma management is a dilemmatic process, workers in mental health services play an important role in informing their clients of when it is best to disclose or non-communicate their illness. In this article, we adopt the perspective of discursive social psychology to investigate how workers of one mental health service programme evaluate and construct self-disclosure and non-communication as stigma management strategies. We demonstrate how these workers recommend non-communication and formulate strict stipulations for self-disclosure. At the same time, they differentiate non-communication from lying or providing false information. The study contributes to an improved understanding of stigma management in contemporary mental health services.
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Affiliation(s)
- Miira Niska
- Faculty of Social Sciences, University of Helsinki, 00014 Helsinki, Finland; (T.O.); (T.V.)
- Correspondence:
| | - Melisa Stevanovic
- Faculty of Social Sciences, Tampere University, 33100 Tampere, Finland;
| | - Elina Weiste
- Finnish, Finno-Ugrian and Scandinavian Studies, University of Helsinki, 00014 Helsinki, Finland;
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland
| | - Tommi Ostrovskij
- Faculty of Social Sciences, University of Helsinki, 00014 Helsinki, Finland; (T.O.); (T.V.)
| | - Taina Valkeapää
- Faculty of Social Sciences, University of Helsinki, 00014 Helsinki, Finland; (T.O.); (T.V.)
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Knowledge and Attitude of Pharmacy Students toward People with Mental Illnesses and Help-Seeking: A Cross-Sectional Study from Saudi Arabia. PHARMACY 2021; 9:pharmacy9020082. [PMID: 33923438 PMCID: PMC8167626 DOI: 10.3390/pharmacy9020082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/13/2021] [Accepted: 04/15/2021] [Indexed: 11/23/2022] Open
Abstract
People with mental illnesses (MIs) face several challenges in addition to their disease. People’s negative views of those with MIs impact patients’ decisions to seek professional help. The aims of this study were to assess pharmacy students’ attitudes toward people with MIs and seeking help for mental health, as well as their knowledge about the causes of MIs. A cross-sectional survey was conducted on pharmacy students at Unaizah College of Pharmacy, Qassim University, Saudi Arabia. Out of the 460 distributed questionnaires, 330 complete questionnaires were received, giving a response rate of 71.7%. Overall, the mean total score for attitude towards people with MIs was 60.16 ± 10.48 (maximum attainable score: 105). In this study, 51.12% believed that people with MIs are more likely to harm others than a person without MIs and 66.9% mentioned that they did not trust the work of a mentally ill person as part of their work team. However, only 35.45% believed that it is difficult for mentally ill individuals to follow social rules. In terms of attitudes toward help-seeking, the mean total score of was 12.83 ± 3.16 out of the maximum score of 25. In addition, the mean total score for knowledge about causes of mental illness was 2.92 ± 1.76 out of the maximum score of 8. The participants reported that MIs could be due to genetic inheritance (56%), substance abuse (54.5%), or brain disease (66.1%). The findings showed that there are some negative attitudes toward people with MIs and negative attitudes towards seeking help for mental health. In addition, some misconceptions about the causes of MIs are prevalent. Consequently, the incorporation of more topics concerning mental health in pharmacy curricula could help improve the awareness of and knowledge about mental health.
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Lin CY, Tsang HWH. Stigma, Health and Well-Being. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7615. [PMID: 33086659 PMCID: PMC7589594 DOI: 10.3390/ijerph17207615] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 10/15/2020] [Indexed: 02/05/2023]
Abstract
In order to understand the phenomenon of stigma in different populations (e.g., different ethnicities, different diseases, and different conditions), this Special Issue collects papers from around the world to illustrate the stigma phenomenon. After a rigorous process of peer review, a total of 24 papers were published and included in the Special Issue. These papers were contributed from different continents and countries, including the Americas (e.g., United States), Europe (e.g., Finland), and Asia (e.g., Saudi Arabia). Therefore, the diversity of ethnicity was ensured in the Special Issue. Moreover, these papers address different stigmatized populations/conditions (e.g., mental illness, obesity, public housing, homosexuality, and transgender). The most discussed populations were those with mental illness and those with obesity/overweight. However, additional evidence on the stigma topic is still needed. Specifically, future studies could consider the following directions to explore in depth the issues of stigma in different populations: (1) using longitudinal designs to understand the temporal or causal relationship between stigma and other related psychosocial factors; (2) designing treatment programs to fight stigma-this could be carried out in healthcare providers, healthcare trainees, the public, caregivers, and the stigmatized populations.
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Affiliation(s)
- Chung-Ying Lin
- Institute of Allied Health Sciences, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Hector W. H. Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China;
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Tensions and Paradoxes of Stigma: Discussing Stigma in Mental Health Rehabilitation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165943. [PMID: 32824309 PMCID: PMC7459444 DOI: 10.3390/ijerph17165943] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/13/2020] [Accepted: 08/14/2020] [Indexed: 02/02/2023]
Abstract
Mental illness remains as one of the most stigmatizing conditions in contemporary western societies. This study sheds light on how mental health professionals and rehabilitants perceive stigmatization. The qualitative study is based on stimulated focus group interviews conducted in five Finnish mental health rehabilitation centers that follow the Clubhouse model. The findings were analyzed through inductive content analysis. Both the mental health rehabilitants and the professionals perceived stigmatization as a phenomenon that concerns the majority of rehabilitants. However, whereas the professionals viewed stigma as something that is inflicted upon the mentally ill from the outside, the rehabilitants perceived stigma as something that the mentally ill themselves can influence by advancing their own confidence, shame management, and recovery. Improvements in treatment, along with media coverage, were seen as the factors that reduce stigmatization, but the same conceptualization did not hold for serious mental illnesses. As the average Clubhouse client was thought to be a person with serious mental illness, the rehabilitation context designed to normalize attitudes toward mental health problems was paradoxically perceived to enforce the concept of inevitable stigma. Therefore, it is important for professionals in rehabilitation communities to be reflexively aware of these tensions when supporting the rehabilitants.
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