Reviewgold2023

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

Farah El-Shamy · Ayah Hamadeh · Jo Billings · Aisha Alyafei

114 citations0/0 files storedPLoS ONE

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Mental Health Treatment and Access Cultural Competency in Health Care Gender Roles and Identity Studies

Abstract

BACKGROUND: Western literature has long explored help-seeking behaviours related to mental health issues. However, this has been relatively neglected in the Middle East despite an increase in mental health needs in the region. The purpose of this review was to conduct a systematic review and qualitative meta-synthesis exploring help-seeking behaviours related to mental health issues in the Middle East. METHODS: We conducted a systematic review and meta-synthesis to gain a comprehensive overview of what is known about mental health and help-seeking behaviours in the Middle East from published qualitative research in the Middle Eastern region. A search of electronic databases (MEDLINE, Embase, CINAHL, PsycINFO and QScience) was carried out from inception to July 2022. The quality of the included studies was assessed using the Critical Appraisal Skills Programme tool, and the review protocol was pre-registered with PROSPERO (Ref: CRD42022311494). RESULTS: We identified 16 qualitative studies exploring mental health-seeking behaviours in Middle East countries. Facilitators and barriers to help-seeking were captured under six overarching themes. Across all studies, we identified negative attitudes towards seeking help for mental health issues, economic and structural barriers to accessing mental healthcare, and misconceptions surrounding religious beliefs, all of which had a critical role in impacting decisions to seek mental healthcare services. Many sought help from alternative sources, such as traditional healers or family members before consulting a healthcare professional. The role of the family and cultural norms was also identified as key contributors to people's help-seeking behaviours. CONCLUSIONS: This meta-synthesis indicates the existence of many challenges surrounding mental health-seeking in the Middle East, including public and internalizing stigmas. This suggests an urgent need for an increase in psychoeducation and mental health awareness in the region.

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References

2014Standards for Reporting Qualitative Research 2009The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration 2001Conceptualizing Stigma 2002Rethinking individualism and collectivism: Evaluation of theoretical assumptions and meta-analyses.2008Treatment gap in mental health care.2004The treatment gap in mental health care.2020Optimising the value of the critical appraisal skills programme (CASP) tool for quality appraisal in qualitative evidence synthesis 1997Qualitative metasynthesis: Issues and techniques

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2026A culturally embedded digital–community paradigm for mental health in the Middle East: A conceptual letter toward system-level transformation 2025Understanding the Differences Between Online and Offline Mental Health Help Seekers: Cross-Sectional Comparative Study

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