The interplay of stigma and faith in affecting mental health outcomes among Pakistani Christian individuals and communities

Religious minorities frequently experience long-term social marginalization, which can adversely affect their mental health. Christians are a historically marginalized group in Pakistan who face identity-based stigma, social stereotyping, and economic hardship. Despite the Minority Stress Model’s proposition that stigma contributes to psychological distress, limited empirical research has examined how religious coping and perceived stigma interact to influence psychological stress among Pakistani Christians. This study examined the relationship between perceived stigma and psychological stress and investigated whether positive and negative religious coping were associated with stress and moderated the stigma–stress relationship. It also explored participants’ lived experiences of stigma, stress, and faith-based coping. A mixed-methods design combined a cross-sectional survey with qualitative semi-structured interviews. A total of 312 Christian adults aged 18–55 years from Lahore, Karachi, and Faisalabad participated in the quantitative phase through community-based stratified sampling. Participants completed the Perceiveda Stigma Scale (PSS), DASS-21 Stress subscale, and Brief Religious Coping Scale (Brief RCOPE). Twenty participants were purposively selected from the survey sample for semi-structured interviews. All measures demonstrated strong internal consistency (α = 0.86–0.88). Quantitative data were analyzed using Pearson correlations and hierarchical multiple regression with moderation analysis, while interview data were analyzed thematically. Participants reported moderate-to-elevated psychological stress (item means ≈ 1.76–2.14) and moderate perceived stigma (M ≈ 3.09–3.55/5). Perceived stigma was positively associated with stress ( r ≈ .42, p < .001), while positive religious coping was negatively associated with stress ( r ≈ − .28, p < .001) and negative religious coping was positively associated with stress ( r ≈ .34, p < .001). Hierarchical regression showed that perceived stigma significantly predicted stress (β ≈ 0.40, p < .001), with religious coping explaining additional variance (ΔR² ≈ 0.11, p < .001). Findings from the 20 interviews complemented the quantitative results, highlighting chronic stress, identity-based exclusion, economic pressures, and social marginalization. Participants described prayer, faith, and religious community as important sources of emotional support and resilience, while some also reported periods of spiritual uncertainty and struggle. Perceived stigma represents an important contributor to psychological stress among Pakistani Christians, while religious coping has both protective and vulnerability-enhancing dimensions. Integrating quantitative and qualitative evidence highlights the importance of culturally and religiously sensitive mental health interventions that address minority stress while recognizing the complex role of faith in coping and psychological well-being.