As a young girl, I struggled with my mental health. Coming from a Muslim-Pakistani household as the eldest daughter, mental health was not something that was discussed. I wouldn’t say that there was a particular stigma against it, but just that it wasn’t perceived as even existing.
So, fast-forward to age 13 when I had my first panic attack, I had no idea what was going on. To me, it was unreconcilable that I could feel that bad and frightened when there was nothing bad going on in my life. At the time, my understanding was that if you experienced loss, if your parents were getting divorced, if you were heartbroken, then you could feel like this. It didn’t make sense to be feeling low every day with snippets of these weird attacks every so often.
Four years later, when I finally received help, I started to realise what was going on – I was experiencing anxiety. But then came the second bump in the road: the therapy that I had received from the NHS three times over the space of two or three years was not helping. If what works for everyone else isn’t working for me, there clearly isn’t anything wrong with me, I must be pretending… is what I thought.
Until I started to develop more awareness. I started to open up to others and share my experience and what I started to realise was that this was a commonality between myself and some of my Muslim friends. One friend told me that her therapist had told her that she needed to stop repeating the Shahada (declaration of faith central to Islam) when she felt anxious because it was a manifestation of OCD (Obsessive Compulsive Disorder). It wasn’t, it just bought her peace.
And that’s when the penny dropped for me. Some of my difficulties were related to my religion, and so the strength and coping strategies that I needed would have to draw upon my religion. However, that was not something that was ever understood, utilised or even explored in therapy – hindering any progress that could be made. So, I wondered, is this the same experience for all Muslims? Because surely, the experiences of a few cannot be generalised to an entire population.
So I conducted my dissertation looking at the mental health outcomes for Muslims and found that following therapy Muslims were less likely to recover and improve across almost all outcomes. This is consistent with other research conducted on data that is available. For example, when accessing NHS Talking Therapies (until recently called IAPT services), Muslims experience a lower recovery rate (40.3%) compared with Christians (54.5%) and Jews (49.5%). This would indicate that this is not an issue pertaining to religion in general but to Muslims specifically. Furthermore, of the 45,999 Muslims referred to NHS Talking Therapies in England during 2021-2022, only 2.6% finished their course treatment, compared to 18.4% of Christian patients and 38.9% of those reporting no religion (NHS Digital, 2022). This would indicate that there is something about therapy for Muslims which is hindering their engagement, desire to continue and, as a result, their outcomes.
Lantern Initiative’s findings go some way to explain this, highlighting that whilst respondents felt mainstream counselling did help to some degree, one in five people felt judged or dismissed as a Muslim by structured, formal counselling, and 84% of respondents expressed a desire for faith-informed counselling services (Lantern Initiative, 2021). Based on the data available, the needs of Muslims are not being adequately met in mainstream services.
The extent to which the problem exists cannot be tackled until a clearer picture is observed. A survey carried out by the Muslim Youth Helpline found that of over 1,000 British Muslims aged 16-30, only 13% of respondents with mental health needs saw a counsellor (Hekmoun, 2019). This highlights that only a small proportion of Muslims who need help are accessing care.
Before tackling the problem and understanding why it exists, it’s essential to understand the extent of the problem. At present, the poor availability of data and lack of routine collection means that the problem cannot be fully understood. To establish a full picture of the outcomes and experiences of Muslims accessing mental health support, sufficient data has to be collected. Routine collection of data on religion needs to be mandated for researchers and commissioners to fully understand the extent of the problem.
Some NHS Talking Therapy services are taking steps to modify and improve services to better serve the needs of minority groups. Work has involved employing practitioners who speak different languages, adapting therapies to local population needs, staff training and community engagement and collaboration. These are the changes that need to be made to improve services not only for Muslims but other communities who may have similar experiences.
We need to see investment in faith-informed, culturally competent mental health services so that Muslims everywhere can access support that meets their needs and acknowledges their cultural and religious context. Local commissioners and NHS services should work in partnership with Muslim-led organisations which are often more trusted and already providing effective faith-informed support.
With a clearer picture of the situation, and a recognition of the inequalities facing the community, Muslims across the country can get the mental health support they need – but commitment to the cause must start now.
For more information about Muslim communities’ mental health determinants, access and outcomes, check out our fact sheet.