ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Social Psychiatry and Psychiatric Rehabilitation
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1560460
Cultural Narratives, Social Norms, and Psychological Stigma: A Study of Mental Health Help-Seeking Behavior in Peshawar, Pakistan
Provisionally accepted
- 1University of Malakand, Chakdara, Khyber Pakhtunkhwa, Pakistan
- 2Faculty of Economics and Management, Czech University of Life Sciences Prague, Prague, Prague, Czechia
- 3Kohat University of Science and Technology, Kohat, Pakistan
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Mental health stigma remains a critical barrier to accessing psychiatric care worldwide, particularly in culturally traditional societies like Peshawar, Pakistan. This study explores how cultural narratives, social norms, and stigma interact to influence mental health help-seeking behavior within the sociocultural context of Pashtunwali-the traditional honor-based code of conduct followed by the Pashtun people, which shapes social behavior and attitudes in the region. A cross-sectional survey was conducted with a stratified random sample of 400 adults aged 19 years and above, using culturally validated tools including the Mental Illness Stigma Scale (MISS) and a Social Norms Scale. Bivariate analyses included simple linear regression and binary logistic regression to explore individual relationships between variables. Multivariate analyses involved multiple linear regression and Structural Equation Modeling to assess the combined and mediating effects of variables. Results indicated that cultural narratives positively influenced help-seeking behavior, accounting for 42% of its variance. Stigma had a significant negative effect, reducing help-seeking likelihood by 26% for each unit increase. Social norms were positively associated with help-seeking behavior and indirectly reduced stigma. Combined, these variables explained 68% of the variance in help-seeking behavior. Findings suggest that addressing stigma and leveraging culturally resonant narratives and supportive social norms rooted in Pashtunwali are essential for improving mental health service utilization in Peshawar and similar sociocultural environments.
Keywords: cultural narratives, social norms, mental health stigma, psychiatric help, structural equation modeling ( SEM)
Received: 14 Jan 2025; Accepted: 30 Jul 2025.
Copyright: © 2025 Daraz, Bojnec, Khan and Hussain. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Younas Khan, Kohat University of Science and Technology, Kohat, Pakistan
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