Between culture and religion: explanatory models of mental health conditions amongst Muslims in Cape Town, South Africa.

INTRODUCTION

Mental health remains highly stigmatized across many cultural and religious contexts, including Muslim communities in South Africa (SA), where Muslim mental health is under-researched. With Islam being one of the fastest-growing religions globally, alongside increasing global stressors affecting Muslim populations, there has been a rise in demand for mental healthcare. Recent literature highlights the importance of culturally relevant care, particularly through understanding Muslims' explanatory models of mental health conditions to ensure responsive and appropriate services. However, existing studies in SA remain limited and dated.

METHODS

This study explored the explanatory models of mental health conditions among Muslim psychological service users and members of the general Muslim public. Semi-structured individual interviews were conducted with service users, and focus group discussions were held with public participants. A total of 39 participants (21 service users and 18 public members) were recruited through purposive and snowball sampling. Data were analyzed inductively using reflexive thematic analysis.

RESULTS

Findings highlight diverse explanatory models encompassing beliefs, attitudes, causal explanations, perceptions of severity, and treatment preferences. Mental health was understood through an integrated framework of Islamic teachings, cultural norms, and societal expectations. Faith-based coping strategies, such as prayer, trust in Allah, and religious practices, were widely endorsed. However, stigma remained prominent, with mental health struggles often described as "not spoken about." This silence was linked to fear of social judgement, misconceptions, and limited mental health literacy.

DISCUSSION: Findings demonstrated the multifactorial, complex nature of explanatory models and the influence of broader contextual factors on them. These models are continually negotiated in experiences of psychological distress. Experiences of isolation and delayed help-seeking were emphasised in the community, demonstrating that explanatory models influences help-seeking behavior.