Mental health problems in Moroccan-Dutch people: a mixed-methods study into social determinants, experiences and explanations

We have performed a mixed-methods study into mental health problems in Moroccan-Dutch people. The aim of the study is to increase the insight in how social and cultural determinants are related to: a) the development of mental health problems, b) the way mental health problems are experienced and explained and c) the conversation about mental health problems and help-seeking for them. The first aim has been studied with a cross-sectional survey, for which people were recruited in the online environment of the website Marokko.nl. This study showed an association between social exclusion and depressive and psychotic symptoms. Subsequently, a qualitative analysis of online forum discussions (also at Marokko.nl) was performed. Forum contributors experienced many negative social determinants, which were associated with mental health problems. Explanations for mental health problems were an important topic in the discussions. We identified medical and religious explanations, with matching remedies. Some contributors used dichotomous explanations (either religious or medical), while others combined medical and religious explanations. In the follow-up qualitative interview study, the experienced taboo on mental health problems was the most important finding. This taboo could be unravelled into aspects of child-raising, difficult life circumstances, religion and the Moroccan-Dutch culture. The taboo was a barrier towards finding professional help for mental health problems. Throughout the different components in the thesis, it was clear that religion is important for Moroccan-Dutch people. We therefore included an essay on the role of the Islam in mental health problems.