Mental‐Health Help‐Seeking Among Muslims in the Liverpool City Region: A System‐Informed Qualitative Study of Knowledge, Attitudes, Practices

BACKGROUND: Muslims in United Kingdom (UK) minority contexts remain underrepresented in mental health research, despite evidence of unequal access and experience. In deprived and superdiverse settings such as the Liverpool City Region (LCR), culturally unsafe encounters, low service literacy and stigma may combine to delay help-seeking and widen inequities. AIM: To explore knowledge, attitudes and practices (KAP) related to mental health among Muslims in the LCR, and to identify actionable system leverage points to improve access, engagement and culturally responsive care. METHODS: A qualitative study informed by social constructivism. Purposive sampling recruited Muslim adults (n = 11; age 18-59; 6 women/5 men) from diverse backgrounds (Yemeni, Somali, Egyptian, Algerian, Pakistani, Bangladeshi). Recruitment was community-enabled through mosques and community networks. Semi-structured interviews (in person or MS Teams) were audio-recorded, transcribed, anonymised and analysed using Reflexive Thematic Analysis with an audit trail, reflexive memoing and team debriefs. RESULTS: Three interlinked themes were generated: (1) Barriers to access and engagement: stigma and reputational risk, communication difficulties, confidentiality concerns and perceived stereotyping reduced disclosure and trust; (2) Cultural and religious context in mental health: participants endorsed integrating faith-based coping and clinical care, with mosques and imams functioning as trusted entry points but with variable mental health capability; (3) System and service provision challenges: limited knowledge of access routes, crisis visibility of services, perceived Islamophobia, and resource/leadership gaps reinforced late presentation. Findings suggested an accumulating pathway from stigma and low trust to delayed access and crisis-driven contact. CONCLUSIONS: Inequities reflected system design and relational safety as much as individual knowledge. Co-designed, community-enabled pathways, faith-literate practice, safeguarded referral interfaces with faith leaders, and routine equity monitoring are key mechanisms for improving engagement and outcomes in the LCR and similar UK city regions.