Understanding the beliefs and attitudes towards mental health problems held by Muslim communities and acceptability of Cognitive Behavioral Therapy as a treatment: systematic review and thematic synthesis.

Background: Muslims experience the lowest recovery rate from mental health difficulties across all religious groups. The aim of this research is to understand the barriers that prevent Muslims from accessing Cognitive Behavioral Therapy (CBT) and the extent to which these may vary across country of residence.

Methods: Systematic review and thematic synthesis for quantitative, qualitative, and mixed methods studies published in English and Arabic informed by the SPIDER search tool. Methodological quality and risk of bias of included papers were critically appraised independently according to the Mixed Methods Appraisal Tool.

Results: A search of seven databases in the Arabic and English language yielded 3836 studies with 210 studies assessed for eligibility. Employing the Mixed Methods Appraisal Tool resulted in 14 studies included in the thematic synthesis. Seven studies adopted a qualitative methodology employing semi-structured interviews and seven were quantitative descriptive studies.

Conclusions: Muslim communities experience barriers accessing Cognitive Behavioral Therapy at the level of the individual, culture, provider and management. The main barriers were experienced at the individual level which was dominated by the influence of Islam regarding the cause of mental health difficulties, which also influenced the way in which difficulties were managed.

Systematic review registration: PROSPERO and registration number: CRD42020192854.