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Good practice guidance – cultural humility and professional curiosity

Masira Hans thinks that all practitioners can practice with ‘cultural humility'
Asma: Is the ability to engage with Muslim people in that really informed and sensitive way that you’ve described in your case studies, like how you worked with people, do you think that only a Muslim practitioner could do that? I don’t think so. I think it’s about practitioners having the confidence and the cultural humility for me. Why don’t we ask people what it is that they want? I mean, I’ve worked with clients that are Christian, for example. I’m not Christian. I’ve worked with people that are pagan, for example, I’m not pagan. But I still try to work within that Christian faith, within that pagan faith if they wanted to.
So clearly, and if that’s worked, then clearly You don’t have to be of the same religion. You just have to want to know more. You have to want to understand more. And you can’t be afraid to ask the questions, actually, do you know about this? Will this help? And for me, all religions speak about humility. Well, humanity speaks about humility, speaks about kindness and empathy. I think they’re the tools that are the most important ones. And obviously awareness around what is within that religion. Simple things for me, like, for example, fasting in, in, in Ramadan.
I mean, I don’t know about you, but I’m, in the mornings if I am fasting, I’m not the best at 9 o’clock in the morning. In Ramadan, if I don’t want an appointment at that time, it’s not because I’m not engaging, it’s because I genuinely just can’t get up! [laughs]
Asma: You’re talking to a coffee addict here! Ramadan mornings are hell for me. And even like you know another simple example is I used to work, I was working with a woman that had just had a baby so she was in the perinatal period. Now, I know there is something in the religion but I know some cultures take it a little bit more seriously, for 40 days, for example, you can’t leave the house and you can’t attend any kind of appointments. I know some of it is culture, but generally. So there was this one person that I was working with, and she had an appointment with a more mainstream kind of service.
And it was given to her within them 40 days. She was obviously not attending or she’d say like, you know, I can’t attend. And they had offered her two appointments within that same 40 day period. And she had obviously said no and she was down as not engaging. And I was like, when I got to her I was like well actually it’s not because she’s not engaging because she doesn’t want the support or she’s not,
what’s the word? She’s not… she’s disinhibited and she’s not realising that she’s got mental health concerns. She just can’t come in those 40 days that you’ve offered. If you had just asked her, why are you not engaging, wouldn’t it would have just been so much easier? To me, it’s almost quite simple. And just something like that or even another example that I’ve got of a person whose wife passed away so he’d want to visit his wife’s grave every Friday, it brought him peace and she had just passed away, it wasn’t like it was five years ago.
It was literally like a month or two ago that she just passed away, and if he was going back to the grave every Friday
that wasn’t religious specifically, but it was still attached to religion for him because he’d go there and he’d pray and he’d kind of almost have mercy on her in some kind of respect. But that was, again, down as like OCD symptoms or things like that. And I was like, what if it’s not, why don’t you just ask him, what does he get out of that? That woman, why can she not attend in the days and work around that? Yeah. So but to go back to your answer, I don’t think it’s only a Muslim therapist that can work with a Muslim.
I think it’s more about having cultural humility and having the desire to want to help people and want to learn about other cultures. But then not overstepping that because sometimes I mean, I’ve been there in therapy where you spend like, you’re spending like £45 for a session, for example, and you’re spending half an hour just explaining a cultural kind of background. And I’m like, I just spent like £20 talking to you about what, I had to explain my own self to you, which is a bit annoying at times, but you know, it’s a side note [laughs]. So I think it’s important to realise that, you know,
you need to try and look into who you’re working with in the wider perspective. Look into certain religions, look into certain practices to an extent, to try and help people. I think for me that’s what if you’re a therapist, if you’re a counsellor, that’s what you’re there for, to help people. So it’s more than just a one hour session or supervision that you have to do. It’s more about techniques that will help you to be a bit better at your job. I think the most important thing that I’d like to get across is when working with people from a Muslim background, incorporate that for them and with them. Don’t be afraid.
And what we need to do is incorporate spirituality as part of tools to help people with their care plan. That’s my biggest message I can say

In this video, Masira Hans, Severe Mental Illness Programme Manager at Mind in Bradford, responds to a question from Asma. Asma asks whether it is only Muslim practitioners who can work with Muslim people with mental health problems in a way that is informed about, and sensitive to, their religion and spirituality.

Masira thinks that all practitioners can practice with ‘cultural humility’ (not presuming that your culture should be the norm for all people, and the desire to learn about other cultures) as an approach that all practitioners can use to ask people about their experiences. Cultural humility is explained in more detail in the next step. She emphasises that humility, kindness, and empathy are essential tools when providing mental health support. A basic level of awareness of religious practices and beliefs, such as fasting during Ramadan, can also be helpful.

Masira gives an example of working with a Muslim woman who held a belief that she should not leave her home for forty days after giving birth. This belief is common in South Asian cultures and is related to post-natal bleeding as ritual impurity. Other agencies were concerned that this woman was not engaging with support for her mental health problems because she did not attend appointments. Masira felt that it was a simple matter of asking the woman why she had not attended appointments, which Masira did, and she was subsequently able to explain to others why this woman could not engage with support services during that period.

Masira recommends that practitioners should work with service-users to incorporate spirituality into mental health care plans for Muslims, in ways that work for them.

Over to you

Think of a question that you might ask a Muslim about a religious belief or practice that would help you to understand how it might impact on their mental health. Consider carefully how you would ask this question in a way that is sensitive and displays cultural humility. Share your question below, see if you can answer the questions put by other learners, or suggest improvements to any questions.

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Understanding Mental Health in Muslim Communities

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