The Development and Implementation of a Custom-Tailored Suicide Response Training for Muslim Communities.

Research indicates that the suicide attempt rate among American Muslims is at least twice the rate of the national US average and follows a different trend of suicide behavior compared to other groups. Religious leaders, such as Imams, are commonly sought out for support, but many lack training in mental health crisis management. The Stanford Muslim Mental Health and Islamic Psychology Lab created the Muslim Community Suicide Response Manual and its accompanying training modules to address this issue. This paper describes the creation, evolution, and future directions of the Suicide Response Training from an Islamic perspective to reduce suicide risk in Muslim communities.

A Brief Overview of the Islamic Ethics of Suicide and Suicide-Related Contemporary Issues from a Sunni Perspective: A Primer for Clinicians and Researchers.

Suicide is a growing global health concern with complex socioeconomic implications. Understanding psychosocial resiliency factors may facilitate suicide prevention. Religious moral objections to suicide, including those inspired by the Islamic faith, appear to promote resilience to suicide. However, few English-language resources provide an overview of Islam's moral and ethical position on suicide, potentially hindering treatment of, and research on, suicide risk among Muslims. In the current paper, Islam's unanimous prohibition of suicide is explored and contextualized within the religion's foundational principles regarding the sanctity of life, the role and necessity of hardships, and one's responsibility to care for their body and to maintain their rights to their community. The role of harsh deterrents to suicide are contrasted with the impetus to show compassion to the deceased and the bereaved. Given the increasing focus on suicide-related topics such as euthanasia/ medical assistance in dying (MAID) and suicide contagion, Islam's ethical and legal position on suicide is discussed in the context of these contemporary moral issues.

An Exploratory Qualitative Analysis of the Stanford-Templeton Convenings on Islam and Suicide.

For over 70 years, studies have reported lower rates of completed suicide in Muslim-majority countries and individuals who identify as Muslim. To this point, the mechanisms underlying the relationship between Islam and lower risk of suicide remain understudied. In an effort to advance our understanding, we convened a bilingual international interdisciplinary panel of experts for a discussion of the current state and future directions of the field. In this paper, we present an exploratory qualitative analysis of the core themes that emerged from the group interviews. We also derive a general theoretical model of the association between Islam and suicide risk.

Developing a Suicide Crisis Response Team in America: An Islamic Perspective.

Suicide is a critical public health issue in the United States, recognized as the tenth leading cause of death across all age groups (Centers for Disease Control and Prevention, 2020). Despite the Islamic prohibition on suicide, suicidal ideation and suicide mortality persist among Muslim populations. Recent data suggest that U.S. Muslim adults are particularly vulnerable, with a higher attempt history compared to respondents from other faith traditions. While the underlying reasons for this vulnerability are unclear, it is evident that culturally and religiously congruent mental health services can be utilized to steer suicide prevention, intervention, and postvention in Muslim communities across the United States. However, the development of Suicide Response toolkits specific to Muslim populations is currently limited. As a result, Muslim communities lack a detailed framework to appropriately respond in the event of a suicide tragedy. This paper aims to fill this gap in the literature by providing structured guidelines for the formation of a Crisis Response Team (CRT) through an Islamic lens. The CRT comprises of a group of individuals who are strategically positioned to respond to a suicide tragedy. Ideally, the team will include religious leaders, mental health professionals, healthcare providers, social workers, and community leaders. The proposed guidelines are designed to be culturally and religiously congruent and take into account the unique cultural and religious factors that influence Muslim communities' responses to suicide. By equipping key personnel in Muslim communities with the resources to intervene in an emergent situation, provide support to those affected, and mobilize community members to assist in prevention efforts, this model can help save lives and prevent future suicide tragedies in Muslim communities across the United States.

The Development of a Novel Suicide Postvention Healing Model for Muslim Communities in the United States of America.

Suicide among American Muslims is understudied, despite recent research  highlighting increased suicide attempts among this population. While suicide is forbidden in Islam, formal guidelines for addressing and responding to suicide within Muslim communities did not exist until recently. The Stanford Muslim Mental Health and Islamic Psychology Lab has responded to a number of suicides in Muslim communities across North America and implemented an original model for suicide response and community healing. This approach incorporates Islamic principles and values to create a culturally and religiously congruent response to suicide that can support loss survivors and steer impacted communities toward healing. The Muslim Postvention Community Healing session described in this paper aims to provide a safe space for individuals impacted by suicide to come together and process their emotions, while also using Islamic teachings to guide the healing process. This unique model has the potential to serve as a valuable resource for Muslim communities across North America, and beyond, in addressing and responding to suicide.

Suicidality in the Arab World: Results from an Online Screener.

Suicide in the Arab World is grossly understudied. This study sought to understand suicidality among Arabic-speaking individuals visiting an online depression screener. A large sample (N = 23,201) from the Arab World was recruited online. 78.9% (n = 17,042) reported suicidality (thoughts of death or suicide, or a suicide attempt) and 12.4% reported a suicide attempt in the past 2 weeks. Binary logistic regressions indicated that women tended to report more suicidality, and that suicidality tended to decline with age (all ps < 0.001), across all levels of suicidality. Comparing countries with n ≥ 1000 (Algeria, Egypt, Jordan, Morocco, and Saudi Arabia), several 3-way (gender * age * country) and 2-way interactions indicated that some countries departed from the usual pattern of responses. For instance, in Algeria, neither gender nor age differences were observed in reported attempts. Women and younger adults in the Arab World may be at higher risk of suicidality. Differences between and within countries warrant further exploration.

Predictors of depression among Syrian refugee women: A socio-culturally relevant analysis.

OBJECTIVES: Syrian refugee women have faced myriad adversities as they have navigated the realities of war, increasing the risk for mental health concerns such as depressive symptomatology. This study explores the nuances of relevant sociocultural factors that can contribute to depressive symptomatology among widowed Syrian refugee women who live in an institutionalized care setting. We explored the impact of past trauma exposure, perceived independence, and a desire to leave the current place of displacement and the interplay between them. METHODS: The PCRF Traumatic Events Questionnaire and Patient Health Questionnaire (PHQ-9) were administered to 57 Syrian refugee women in Lebanon (Mage = 37; M number of children = 3) to measure levels of trauma exposure and depressive symptoms, respectively. Perceived independence and a desire to leave their current place of residence were measured using 1-item measures. RESULTS: Using hierarchical regression models, past trauma exposure (B = 1.51, p = .002) and perceived independence (B = 0.33, p = .04) significantly predicted depressive symptoms. A desire to travel (B = 0.84, p = .07) marginally predicted depressive symptoms. Past trauma exposure attenuated the impact of perceived independence on depressive symptoms such that at lower levels of past trauma exposure, higher perceptions of independence predicted higher depression (simple slope = 0.29, t = 2.13, p = .05), while at higher levels of past trauma higher perceptions of independence predicted lower depressive symptoms (simple slope = -0.16, t = -2.21, p = .04). Trauma exposure did not moderate the impact of a desire to leave on depression, but age did. CONCLUSION: These findings suggest that sociocultural factors may influence women's experiences with depressive symptoms differently, and this heterogeneity must be accounted for when treatment programs are proposed. Further, Syrian refugee women who have lost primary family members may pose different profiles of depressive symptoms than other groups of women.

Islamic Civilizations and Plagues: The Role of Religion, Faith and Psychology During Pandemics.

The current study seeks to analyze Muslim experiences of communicative diseases with a focus on the psychosocial impacts and public, communal, and personal responses of Muslim populations throughout history. By examining a selection of plague outbreaks between the 8-19th centuries across the lands broadly defined as the Islamic Mediterranean (Varlik, 2017), the guidelines and coping mechanisms that Muslims extracted from their traditional sources are highlighted. This historical perspective contributes to a better understanding of the psychological and social aspects of pandemics for the Muslim community, specifically for the role played by faith and spirituality as determinants of psychological well-being in Muslims' perceptions and responses. We suggest that such an understanding is especially useful for contemporary mental health practitioners working with Muslim patients through the global COVID-19 pandemic.

Addressing Mental Health Through Community Partnerships in a Muslim Community.

The mental health of American Muslims remains significantly understudied and unaddressed, despite known obstacles to Muslims' utilization of mental health services, such as stigma and institutional mistrust. Since the inception of the Stanford Muslim Mental Health and Islamic Psychology Lab in 2014, partnerships across the Bay Area were formed among key Muslim community establishments to address obstacles to good mental health. Through a community-centered approach, diverse stakeholders engaged to identify and address the community's most pressing mental health challenges. Successful outcomes of this approach include facilitated research and mental health initiatives to support the Bay Area Muslim community.

Ethnic Differences in Muslim Women's Mental Health Beliefs, Rejection Attitudes, and Familiarity with Professional Mental Healthcare.

Prior work on Muslims' mental health help-seeking factors has emphasized their rejection attitudes, religious and cultural beliefs, and familiarity with mental health (Aloud & Rathur, 2009; Ali et al., 2021). However, no research has examined differences in these factors across different Muslim ethnic groups, and particularly among Muslim women. 1214 Muslim women living in the USA completed online questionnaires. Data was stratified based on history of mental health visits to control for previous service utilization. MANOVAs assessed ethnic group differences in beliefs, familiarity, and rejection attitudes toward professional mental healthcare. Results revealed significant differences between ethnic groups in all three factors; these differences depended on the women's history of service utilization. Findings suggest that barriers to accessing professional mental healthcare differ among Muslim ethnic groups. Results are discussed in light of clinical implications and other contributing factors to the underutilization of professional mental healthcare among ethnically diverse American Muslim women.

Role of Mosque Communities in Supporting Muslims with Mental Illness: Results of CBPR-oriented Focus Groups in the Bay Area, California.

Objective The purpose of this study was to explore perspectives of Muslims residing in the Bay Area, California on the role of the mosque community in supporting community members' mental health needs and barriers to mental health care for members who experience mental health challenges. Methods This study employed a CBPR-focused qualitative approach in the form of content analysis of three focus group discussions organized and conducted with the help of a Community Advisory Board made up of members of the Muslim Community Association. Results Two major themes were identified upon examination of the data: services needed in the mosque community and barriers to addressing mental health issues in the mosque community. Specifically, participants reported wanting support groups within the mosque space, mosque-based activities, virtual support, community social workers, and family-oriented services. Barriers reported included community stigma, lack of cultural awareness of race-ethnic minorities within the community, attribution of mental illness to lack of faith or supernatural causes, and specific barriers unique to vulnerable/special subgroups within the community. Conclusion These findings highlight the need for developing mental health-related services and social support initiatives within the mosque space, specifically for those Muslim Americans living in the Bay Area in California. Furthermore, special attention needs to be placed on the barriers to accessing these services as identified by the community members.

Predicting rejection attitudes toward utilizing formal mental health services in Muslim women in the US: Results from the Muslims' perceptions and attitudes to mental health study.

BACKGROUND: The underutilization of mental health services is a recognized problem for the growing number of Muslims living in the West. Despite their unique mental health risk factors and the pivotal role they play in determining mental health discourse in their families and in society, Muslim women in particular have not received sufficient study. AIM: To help remedy this research gap, we examined factors that may impact the rejection attitudes of Muslim women toward professional mental health care using the first psychometrically validated scale of its kind; the M-PAMH (Muslims' Perceptions and Attitudes to Mental Health). METHODS: A total of 1,222 Muslim women responded to questions about their cultural and religious beliefs about mental health, stigma associated with mental health, and familiarity with formal mental health services in an anonymous online survey. RESULTS: Hierarchical multiple regression analysis revealed that higher religious and cultural beliefs, higher societal stigma, and lower familiarity with professional mental health services were associated with greater rejection attitudes toward professional mental healthcare. The final model was statistically significant, F (5, 1,216) = 73.778; p < .001, and explained 23% of the variance in rejection attitudes with stigma accounting for the most (12.3%) variance, followed by cultural and religious mental health beliefs (6%), and familiarity with mental health services (2.7%). CONCLUSIONS: Findings suggest that although the examined factors contributed significantly to the model, they may not be sufficient in the explanation of Muslim women's rejection attitudes toward mental health services. Future research may explore additional variables, as well as predictive profiles for Muslim women's perceptions and attitudes of mental health based on a combination of these factors.

Improving Recruitment for Mental Health Research in Muslim American Women : Research Recruitment in Muslim American Women.

This study determines the methods for improving recruitment of Muslim American women in mental health research. Studying this minority population in more depth will reduce their suffering from mental illness. A 40-item survey, along with cover letter, was hosted on the Stanford University website and sent via email to organizations known to have large Muslim American women populations. Although approximately 200-300 responses were hoped for, an unexpected total of 1279 women completed the survey within days. The effectiveness of this survey was attributed to multiple factors: ease of an online survey, privacy afforded through an anonymous survey, trust in the PI, the survey being hosted by a reputable university and understanding the importance of mental health research. It is important to continue improving methods to recruit the minority Muslim American women population for studies.

Common and Country-Specific Characteristics Associated With Suicidality in the Arab Region.

OBJECTIVE: To explore the prevalence of recent (previous 2 weeks) suicide attempts and estimates of likelihood of future suicide attempts as well as demographic characteristics associated with such attempts among residents of the Arab region looking for depression information online. METHODS: Google Ads were used to recruit 1,003 Arabic-speaking adults mostly from February 2014 to June 2014 to take part in a depression and suicidality screening study using a self-report questionnaire based on DSM-IV diagnostic criteria. RESULTS: Of the eligible participants (N = 900), 10.6% reported a suicide attempt in the previous 2 weeks, and 16.1% indicated a likelihood of making a suicide attempt in the following month. Men, those declining to state their sexual orientation, those from lower subjective social status (SSS), and unemployed individuals had higher odds of reporting a past suicide attempt (P = .001, P = .002, P < .001, P = .023, respectively). Younger individuals, those less religious, those with past suicide attempt, and those with lower SSS had higher odds of a likelihood of a future suicide attempt (P = .03, P = .02, P < .001, P = .001, respectively). Comparing the 4 countries with highest number of participants (Algeria, n = 148, Egypt, n = 260, Morocco, n = 118, and Saudi Arabia, n = 99), lower SSS was associated with higher odds of an attempt for Algeria, Morocco, and Saudi Arabia, but not for Egypt (P = .002). Lower religiosity was related to higher odds of estimates of future suicide for Algeria, Egypt, and Saudi Arabia, but not for Morocco (P = .014). CONCLUSIONS: Suicidality among residents of Arab-speaking countries warrants further exploration. Common predictors of risk may be less relevant for some populations.​.