Religiosity and barriers to mental healthcare: a qualitative study among clients seeking community mental health services
Abstract
We explored barriers to seeking mental healthcare, as reported by religious and secular clients in community mental health clinics. We conducted in-depth interviews with 59 clients immediately following their intake session and performed thematic analyses to identify major themes. Respondents across degree of religiosity/faith reported multiple barriers, including client-based and structural barriers. Most commonly, participants reported barriers associated with previous negative experience with mental health services and mental healthcare stigma. Religious clients expressed greater distrust towards healthcare systems and were more concerned about the social stigma associated with seeking treatment. Importantly, different models of treatment and healing emerged among secular and religious participants. Secular clients highlighted the importance of internal processes within the self, while religious clients highlighted the belief in a higher healing entity. Our findings highlight the significance of addressing client expectations in service delivery, attending to referral paths and improving accessibility and availability of affordable services.
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Religious individuals receiving care from an SMHT may have a less positive experience than non-religious individuals.
“Religious individuals receiving care from an SMHT may have a less positive experience than non-religious individuals. 10”
From Religiosity & mental health seeking behaviors among U.S. adults (2024) · cites this paper as [10]
Cites
Basics of Qualitative Research (3rd ed.): Techniques and Procedures for Developing Grounded Theory
Corbin, J., & Strauss, A. (2008) · SAGE · doi:10.4135/9781452230153 · Cited by 12,136 · see citing works
Constructing grounded theory. A practical guide through qualitative analysis
Brink, E., Dellve, L., Hallberg, U. E., Abrahamsson, K. H., Klingberg, G., & Wentz, K. (2006) · International Journal of Qualitative Studies on Health and Well-Being · doi:10.3402/qhw.v1i3.4932 · Cited by 6,909 · see citing works
How stigma interferes with mental health care.
Corrigan, P. (2004) · American Psychologist · doi:10.1037/0003-066x.59.7.614 · Cited by 3,648 · see citing works
Gulliver, A., Griffiths, K. M., & Christensen, H. (2010) · BMC Psychiatry · doi:10.1186/1471-244x-10-113 · Cited by 3,292 · see citing works
Consensual qualitative research: An update.
Hill, C. E., Knox, S., Thompson, B. J., Williams, E. N., Hess, S. A., & Ladany, N. (2005) · Journal of Counseling Psychology · doi:10.1037/0022-0167.52.2.196 · Cited by 2,841 · see citing works
Bulletin of the World Health Organization
Frick, K. D., Lynch, M. C., West, S. K., Muñoz, B., & Mkocha, H. A. (2003) · Bulletin of the World Health Organization · Cited by 2,656 · see citing works
The Psychology of Religion and Coping: Theory, Research, Practice
Favazza, A. (1998) · American Journal of Psychiatry · doi:10.1176/ajp.155.7.988 · Cited by 1,990 · see citing works
Wang, P. S., Aguilar-Gaxiola, S., Alonso, J., Angermeyer, M. C., Borges, G., Bromet, E. J., Bruffaerts, R., de Girolamo, G., de Graaf, R., Gureje, O., et al. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61414-7 · Cited by 1,655 · see citing works
Size and burden of mental disorders in Europe—a critical review and appraisal of 27 studies
Wittchen, H.-U., & Jacobi, F. (2005) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2005.04.012 · Cited by 1,503 · cited 1× · see citing works
“…gap; treatment lag Treatment gap in mental healthcare as measured by the difference between those who need care and those who receive it is prevalent worldwide (Kohn, Saxena, Levav, & Saraceno, 2004; Nakash, Levav, et al., 2014; Wang, Aguilar-Gaxiola, et al., 2007; Wittchen & Jacobi, 2005).”
BackgroundTreatment gap in mental health care.
Abramowitz, M. Z., Greenberg, D., & Levav, I. (2008) · PubMed · Cited by 1,482 · see citing works
Cross-national prevalence and correlates of adult attention-deficit hyperactivity disorder
Fayyad, J., De Graaf, R., Kessler, R., Alonso, J., Angermeyer, M., Demyttenaere, K., De Girolamo, G., Haro, J. M., Karam, E. G., Lara, C., et al. (2007) · British Journal of Psychiatry · doi:10.1192/bjp.bp.106.034389 · Cited by 1,321 · see citing works
Comprehensive Textbook of Psychiatry
Schwab, J. J. (1968) · Psychosomatics · doi:10.1016/s0033-3182(68)71813-2 · Cited by 1,291 · see citing works
Stigma and Help Seeking for Mental Health Among College Students
Eisenberg, D., Downs, M. F., Golberstein, E., & Zivin, K. (2009) · Medical Care Research and Review · doi:10.1177/1077558709335173 · Cited by 1,193 · see citing works
Measuring the self-stigma associated with seeking psychological help
Vogel, D. L., Wade, N. G., & Haake, S. (2006) · Journal of Counseling Psychology · doi:10.1037/0022-0167.53.3.325 · Cited by 1,190 · see citing works
Mental health: A report of the surgeon general
Marrelli, T. M. (2000) · Home Care Provider · doi:10.1067/mhc.2000.108190 · Cited by 1,025 · see citing works
Religiosity and Mental Health: A Meta–Analysis of Recent Studies
Hackney, C. H., & Sanders, G. S. (2003) · Journal for the Scientific Study of Religion · doi:10.1111/1468-5906.t01-1-00160 · Cited by 911 · see citing works
Alonso, J., Angermeyer, M. C., & Lépine, J. P. (2004) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0047.2004.00325.x · Cited by 758 · see citing works
The Religious Context of Prejudice
Āllport, G. W. (1966) · Journal for the Scientific Study of Religion · doi:10.2307/1384172 · Cited by 590 · see citing works
Dimensions of Religiosity and Their Relationship to Lifetime Psychiatric and Substance Use Disorders
Kendler, K. S., Liu, X.-Q., Gardner, C. O., McCullough, M. E., Larson, D. B., & Prescott, C. A. (2003) · American Journal of Psychiatry · doi:10.1176/appi.ajp.160.3.496 · Cited by 562 · see citing works
Brohan, E., Elgie, R., Sartorius, N., & Thornicroft, G. (2010) · Schizophrenia Research · doi:10.1016/j.schres.2010.02.1065 · Cited by 539 · see citing works
Stigma as Related to Mental Disorders
Hinshaw, S. P., & Stier, A. (2008) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.4.022007.141245 · Cited by 494 · see citing works
Religion as Prosocial: Agent or Double Agent?
Batson, C. D. (1976) · Journal for the Scientific Study of Religion · doi:10.2307/1384312 · Cited by 473 · see citing works
Lasalvia, A., Zoppei, S., Van Bortel, T., Bonetto, C., Cristofalo, D., Wahlbeck, K., Bacle, S. V., Van Audenhove, C., van Weeghel, J., Reneses, B., et al. (2013) · The Lancet · doi:10.1016/s0140-6736(12)61379-8 · Cited by 445 · see citing works
One-Year Prevalence of Psychiatric Disorder in Ontarians 15 to 64 Years of Age
Offord, D. R., Boyle, M. H., Campbell, D., Goering, P. N., Lin, E. H. B., Wong, M. Y.-Y., & Racine, Y. A. (1996) · The Canadian Journal of Psychiatry · doi:10.1177/070674379604100904 · Cited by 336 · see citing works
Gaps in accessing treatment for anxiety and depression: challenges for the delivery of care
Collins, K. A., Westra, H. A., Dozois, D. J. A., & Burns, D. D. (2004) · Clinical Psychology Review · doi:10.1016/j.cpr.2004.06.001 · Cited by 322 · see citing works
Katz, S. J., Kessler, R. C., Frank, R. G., Leaf, P. J., Lin, E. H. B., & Edlund, M. J. (1997) · American Journal of Public Health · doi:10.2105/ajph.87.7.1136 · Cited by 228 · see citing works
Research in Community and Mental Health
Morrissey, J. (1998) · Research in community and mental health · doi:10.1016/s0192-0812(2000)11 · Cited by 193 · see citing works
Help Seeking Behaviour of Psychiatric Patients Before Seeking Care At a Mental Hospital
Chadda, R. K., Agarwal, V., Singh, M. C., & Raheja, D. (2001) · International Journal of Social Psychiatry · doi:10.1177/002076400104700406 · Cited by 181 · see citing works
The Couch and the Cloth: The Need for Linkage
Larson, D. B., Hohmann, A. A., Kessler, L. G., Meador, K. G., Boyd, J. H., & McSherry, E. (1988) · Psychiatric Services · doi:10.1176/ps.39.10.1064 · Cited by 174 · see citing works
Working with Jewish ultra-orthodox patients: Guidelines for a culturally sensitive therapy
Bilu, Y., & Witztum, E. (1993) · Culture Medicine and Psychiatry · doi:10.1007/bf01379326 · Cited by 150 · see citing works
Carone, D. A., & Barone, D. F. (2001) · Clinical Psychology Review · doi:10.1016/s0272-7358(00)00078-7 · Cited by 143 · see citing works
Nakash, O., Levav, I., Aguilar-Gaxiola, S., Alonso, J., Andrade, L. H., Angermeyer, M. C., Bruffaerts, R., Caldas-de-Almeida, J. M., Florescu, S., de Girolamo, G., et al. (2014) · Psycho-Oncology · doi:10.1002/pon.3372 · Cited by 117 · see citing works
Self-citationMayers, C., Leavey, G., Vallianatou, C., & Barker, C. (2007) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.542 · Cited by 107 · see citing works
Addressing religion and spirituality in psychotherapy: clients’ perspectives
Knox, S., Catlin, L. A., Casper, M., & Schlosser, L. Z. (2005) · Psychotherapy Research · doi:10.1080/10503300500090894 · Cited by 98 · see citing works
Coping and help‐seeking in the UK adult population
Barker, C., Pistrang, N., Shapiro, D. A., & Shaw, I. (1990) · British Journal of Clinical Psychology · doi:10.1111/j.2044-8260.1990.tb00885.x · Cited by 82 · see citing works
Alegria, M. M., Nakash, O., & NeMoyer, A. (2018) · World Psychiatry · doi:10.1002/wps.20486 · Cited by 65 · see citing works
Self-citationParikh, S. V., Lin, E. H. B., & LESAGE, A. D. (1997) · The Canadian Journal of Psychiatry · doi:10.1177/070674379704200903 · Cited by 64 · see citing works
Disparities in Psychiatric Care. Clinical and Cross-Cultural Perspectives
(2010) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e3181da4f57 · Cited by 55 · see citing works
The Global Fight against the Stigma of Schizophrenia
Kadri, N., & Sartorius, N. (2005) · PLoS Medicine · doi:10.1371/journal.pmed.0020136 · Cited by 54 · see citing works
Clinical Use of the DSM Categorical Diagnostic System During the Mental Health Intake Session
Nakash, O., Nagar, M., & Kanat‐Maymon, Y. (2015) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.14m09214 · Cited by 47 · see citing works
Self-citationReligious commitment and the construal of sources of help for emotional problems
Mitchell, J. R., & Baker, M. C. (2000) · British Journal of Medical Psychology · doi:10.1348/000711200160471 · Cited by 36 · see citing works
Nakash, O., Nagar, M., & Levav, I. (2014) · Psychotherapy Research · doi:10.1080/10503307.2014.885147 · Cited by 34 · see citing works
Self-citationNakash, O., & Saguy, T. (2015) · Social Psychological and Personality Science · doi:10.1177/1948550615576003 · Cited by 29 · see citing works
Self-citationNakash, O., Nagar, M., Danilovich, E., Bentov-Gofrit, D., Lurie, I., Steiner, E., Sadeh‐Sharvit, S., Szor, H., & Levav, I. (2013) · International Journal of Social Psychiatry · doi:10.1177/0020764013504562 · Cited by 29 · see citing works
Self-citationInterpersonal complementarity in the mental health intake: A mixed-methods study.
Rosen, D. C., Miller, A. B., Nakash, O., Halperin, L., & Alegria, M. M. (2012) · Journal of Counseling Psychology · doi:10.1037/a0027045 · Cited by 27 · see citing works
Self-citationNakash, O., Nagar, M., & Kanat‐Maymon, Y. (2015) · Journal of Counseling Psychology · doi:10.1037/cou0000074 · Cited by 25 · see citing works
Self-citationA Matter of Faith: Religion and Mental Health
Friedli, L. (2000) · Journal of Public Mental Health · doi:10.1108/17465729200000010 · Cited by 12 · see citing works
Band, M., Dein, S. L., & Loewenthal, K. M. (2011) · Mental Health Religion & Culture · doi:10.1080/13674676.2010.548059 · Cited by 11 · see citing works
Mental health and mental health care for Jews in the Diaspora, with particular reference to the U.K.
Loewenthal, K. M. (2012) · PubMed · Cited by 7 · see citing works
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Serfaty, D. R., Cherniak, A. D., & Strous, R. D. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.113349 · Cited by 24 · see citing works
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Boateng, A. C. O., Sebu, J., Lekwauwa, R., Britt, K. C., Oh, H., & Doolittle, B. (2024) · The International Journal of Psychiatry in Medicine · doi:10.1177/00912174231187841 · Cited by 15 · see citing works
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Lefevor, G. T., Paiz, J. Y., Milburn, H. E., Sheffield, P. E., & Tamez Guerrero, N. A. (2022) · Counselling Psychology Quarterly · doi:10.1080/09515070.2021.1874297 · Cited by 15 · see citing works
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Moreno, A. N., Bartkowski, J. P., & Xu, X. (2022) · Religions · doi:10.3390/rel13050415 · Cited by 12 · see citing works
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- Authors
- Nakash, O., Lambez, T., Cohen, M., & Nagar, M.
- Affiliations
- Reichman University (IL)
- Corresponding author
- Nakash, Ora
- Venue
- Mental Health, Religion & Culture
- Publisher
- Informa UK Limited
- Published
- 2019-05-28
- Volume
- 22
- Issue
- 5
- Pages
- 437-452
- ISSN
- 1367-4676 (ISSN-L)
- 1469-9737
- OpenAlex
- W2971530711
- Cited by
- 26
- References
- 50
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 8 · 2023: 4 · 2022: 5 · 2021: 4 · 2020: 1
- FWCI
- 2.44
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Mental Health Religion & Culture (publishedVersion)
- Topics
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Sociology and Political Science › Cultural Competency in Health Care
- Keywords
- religiosity, barriers to mental health care, mental health stigma, community mental health services, religious clients, trust in healthcare system, customer expectations, access to mental health care, referral pathways
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