Mental health issues and seeking of formal mental health services among Muslims in the Southeastern U.S.: preliminary investigation of a contextual theoretical framework based on the theory of planned behavior/theory of reasoned action and the social ecological model

The Muslim community in the Southeastern U.S., being a small part of the larger Muslim population in the U.S., faces many psychosocial issues and underutilizes mental health services. Muslims’ underutilization of mental health services to address their psychosocial issues affect both Muslims and non-Muslims alike. Given today’s highly interconnected world, the issues of one individual or community often impact others in ways not experienced at other times in history. However, there is lack of research on Muslims and especially for those in the Southeastern U.S. regarding their approach toward mental health issues and seeking formal mental health services. Researchers stress the necessity to understand Muslims’ approach toward mental health issues and seeking the services by utilizing well-grounded theories to create and/or shape contextual theoretical frameworks (models). However, few researchers have utilized clear theoretical frameworks to ground their studies, which creates an unsystematic approach to research and clinical practice for this vulnerable population. In their study with 88 counselors in the U.S. Cashwell et al. (2013) found that although the participants rated the integration of religious/spiritual aspects into counseling as very important, they integrated these aspects less frequently into their counseling practice than how ratings of importance would suggest. Young and Cashwell (2011) stressed attending to client’s spiritual/religious perspective by stating, “meeting the client where [they] are, without judgment and with compassion, is the foundational building block” (p. 22) to address issues in counseling. The purpose of this study was to understand how Muslims in the Southeastern U.S. approach mental health issues and seeking formal mental health services. A second purpose was to partially test (examine) the proposed contextual theoretical framework based on Theory of Planned Behavior/Theory of Reasoned Action (TPB/TRA) and Brofenbrenner’s Social Ecological Model (SEM) to answer the eight research questions. In total 209 participants’ responses were used for statistical analyses. The results indicated that the participants had slightly higher than the moderate/favorable level on the five constructs: cultural beliefs about mental health issues/problems and their causes and treatments (CBMHP-cultural beliefs), knowledge about formal mental health services (KFMHS-knowledge), and perceived behavioral control toward seeking formal mental health services (PBC) constructs; and a moderately favorable level on attitudes toward seeking formal mental health services (ATFMHS-attitudes) construct; and slightly under the moderate level (meaning participants had a little stronger stigma than moderate level) for perceived social stigma toward seeking formal mental health services (PSTSFMHS-stigma) construct. Meaning that, the participants did not strongly favor or disfavor the five constructs. In addition, the participants strongly aligned with a medical/scientific explanation of mental health issues and their causes and treatments based on responses to the measure of CBMHP-cultural beliefs. The paths (relationships/analyses) among the five main constructs were positively or negatively significant except for one. In an open ended question, the largest group of the participants defined mental health providers from a medical/psychopathology perspective while the others fell under three other categories. In addition, majority of the participants did not feel safe and attributed it to the current climate of exosystem and macrosystem systems they live in. In sum, nearly all researchers in the Muslim mental health literature have stressed the importance of understanding contextual factors for more culturally, spiritually, and structurally appropriate interventions and services. Therefore, it was first necessary to assess and understand how Muslims in the Southeastern U.S. approach to mental health issues and seeking formal mental health services through a well-grounded theoretical framework. In this way, mental health providers and researchers will be able to understand Muslims within a more culturally and structurally contextual perspective and address the mental health issues of this population more effectively by utilizing the results of this study