Mental Health Challenges of Muslim Populations Exposed to War and Discrimination

Bilal Irfan, MS; Aayesha Soni, MD; Mohammed Al-Hasan, MBBS; Belal Aldabbour, MD

Since Palestinians began broadcasting the live devastation of Gaza in October 2023, many Muslim individuals have found themselves living 2 simultaneous realities. In one, they have witnessed flattened neighborhoods, mass casualties, starvation, and pleas for help; in the other, they have walked through streets where keffiyehs, hijabs, or pro-ceasefire slogans could trigger suspicion, verbal abuse, or tar- geted violence. Watching ongoing death and destruction abroad while being subjected to racism at home is exerting an under- recognized mental health challenge on a population already bur- dened by decades of surveillance and stigma since the September 11 attacks and underlying trauma from previous crises, such as the wars in Iraq, Syria, Lebanon, and Yemen.

Unlike single-event disasters, the Gaza war confronts Muslim individuals across the world, particularly in minoritized contexts, with multiple, reinforcing stressors. These include the influence of so- cial media, which delivers continuous exposure to graphic conflict- related imagery. Habituation to graphic content may lead to emo- tional numbing in some contexts while exacerbating anxiety and distress in others, contributing to emotional dysregulation and the potential development of mood and anxiety disorders.¹ Studies in populations in Muslim-majority countries show that hours of such viewing predict heightened stress levels and depressive symptoms.² This observation echoes findings from other traumatizing events. For example, a study on those directly affected by the September 11 attacks (eg, someone they knew died in the events) found that those who repeatedly viewed television images of the attacks dem- onstrated significantly higher odds of posttraumatic stress disor- der (PTSD) and depression.³ Muslim communities are heteroge- neous in ethnicity, migration history, and socioeconomic status, and their mental health profiles vary accordingly. As such, these mental health challenges are likely graded: direct bereavement or familial ties may exaggerate risk, whereas purely vicarious exposure could produce subsyndromal distress rather than syndromal psychiatric conditions.

In addition, there has been a marked global increase of Islamo- phobia, with historically high reporting levels. In the US, the Coun- cil on American-Islamic Relations logged a record 8658 bias com- plaints in 2024, a 7.4% increase from the previous year and the highest reported since data collection began in 1996, largely attrib- uted to Gaza-related backlash.⁴ Furthermore, the suppression of civil liberties and academic freedom on topics related to the Gaza war is enabling a widespread concern and self-censorship within af- fected communities in many regions of the world, in particular the US and several European countries.⁵

Exposure to the ongoing devastation in Gaza, coupled with a rise in Islamophobia, represents an increased risk of broader mental health distress. While data on formal psychiatric diagnoses directly

attributable to the post–October 2023 period in Muslim communi- ties are still emerging, the existing literature provides compelling evi- dence for substantial mental health challenges in this population. After the September 11 attacks, there was an unprecedented rise in Islamophobia, and several studies examined the US Muslim com- munity’s mental health assessments and needs, increased preva- lence of anxiety and depression, and an overall deterioration in Mus- lim individuals’ mental health.⁶ This phenomenon can be understood through the lens of minority stress, which posits that the excess stress experienced by individuals from stigmatized groups due to chronic exposure to prejudice, discrimination, and social stigma adversely impacts mental health.

Research has shown that experiences of Islamophobia and dis- crimination are associated with poorer mental health outcomes and diagnosable psychiatric conditions, including elevated rates of psy- chological distress, anxiety, depression, and PTSD in Muslim populations.^6,7 A comprehensive systematic review on this topic that included studies across 3 continents found that discrimination due to Muslim identity was associated with a greater number of depressive symptoms and higher qualitative levels of anxiety, distress, and paranoia.⁶ In 1 study, religious discrimination against Muslim women was even concluded to influence self-harm.⁶ The intersection be- tween chronic exposure to prejudice and the mechanisms of minor- ity stress extends beyond general stress, increasing the vulnerability of Muslim populations to mental health challenges. Furthermore, populations exposed to conflict and trauma, including vicarious ex- posure and community-level trauma, have increased prevalence of psychiatric conditions.⁸ Collectively, these factors suggest a pro- nounced risk of mental health challenges within Muslim communi- ties, especially in the wake of events, such as the Gaza war.

Such findings call for targeted strategies to combat the sub- stantial mental health effects of the rise in anti-Muslim racism stemming from the Gaza war. To translate these threats into action- able care, mental health services can prioritize several steps. Thefirst is to move systematic screening for war-related distress upstream. Brief tools, such as the 4-item Primary Care PTSD Screen, may help identify Muslim individuals experiencing intrusive imagery and fa- cilitate earlier referrals and diagnosis when embedded in routine re- views. This intervention could also benefit from the development and application of discrimination measures that are validated for use in Muslim populations.⁶ The second step is to build first-line capac- ity in the spaces that Muslim individuals already trust. Academic- faith partnerships that train community leaders and organizers to deliver psychological first aid can help in providing war and disaster- response related knowledge and self-efficacy and have been ad- opted by multiple US health departments.⁹ Third, if clinicians iden- tify in conversation with patients that the causes of some of the downstream health concerns stem from legal-related issues (eg, fear of deportation or repercussions from an employer for speaking out about the Gaza war), they may have an opportunity to provide re- ferral to legal services. For example, medicolegal partnerships that connect patients to immigration services may aid in reducing de- portation-related anxiety and improve adherence to treatment by resolving some of the threats that sustain hyperarousal.¹⁰ Further- more, the social prescribing system within the UK shares guidance on a holistic approach to managing wider determinants of health care for migrants, including the use of link workers for comprehensive assessments and subsequent referrals to services, such as immigra- tion legal aid. Every country and setting may be unique in terms of the feasibility, accessibility, and risk associated with pursuing such pathways, and clinicians should thus exercise caution and rigor- ously consult patient preferences.

Representative data remain scarce, yet the warning signs are clear. A failure to address the mental health burden the Gaza war has placed on Arab, Jewish, Muslim, Palestinian, and student commu- nities may result in entrenching mental health comorbidities in these populations. It can also serve to erode trust in mental health ser- vices that are already viewed with skepticism by communities sub- ject to profiling. While the center of attention is rightfully on Pales- tinians in Gaza, the mental health toll that the war has extracted transcends borders.

ARTICLE INFORMATION

Author Affiliations: Center for Bioethics, Harvard Medical School, Boston, Massachusetts (Irfan); Center for Surgery and Public Health, Brigham & Women’s Hospital, Boston, Massachusetts (Irfan); Department of Neurology, University of Michigan Medical School, Ann Arbor (Irfan); Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor (Irfan); Epilepsy Program, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada (Soni); Division of Neurology, Department of Medicine, University of Cape Town, Cape Town, South Africa (Soni); Princess Alexandra Hospital NHS Trust, Harlow, United Kingdom (Al-Hasan); Barts and the London Medical School, London, United Kingdom

(Al-Hasan); Faculty of Medicine, Islamic University of Gaza, Gaza, State of Palestine (Aldabbour).

Corresponding Author: Bilal Irfan, MS, Center for Bioethics, Harvard Medical School, 641 Huntington Ave, Boston, MA 02115 (birfan@umich.edu).

Published Online: October 1, 2025. doi:10.1001/jamapsychiatry.2025.2686

Conflict of Interest Disclosures: None reported.

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