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Diverse mental health beliefs among Muslims

Dr Yusuf makes direct connections between factors of diversity among Muslims and their mental health experiences
Let’s take a look at some of these features. So what types of factors of variance or diversity exist in the Muslim community? So some of them relate to culture. Some of them relate to socioeconomic status or class. Some of them relate to the degree of integration. Some of them relate to language. At the same time, what you will find with Muslim service users and patients is that there are a number of unifying factors.
The metaphysics that we spoke about earlier, the general understanding of the human in relation to God, the belief systems that are in place, for example, about the belief in the hereafter, and life after death, The centrality of faith based thinking to how one understands what one is experiencing. The degree of religious practice, whether that is occasional religious practice, when a person has passed away, for example, or much more daily or routine religious practice. And then there is a fourth element that one needs to be aware of, which one often finds, which is about what you might call pathological spirituality. That is to say, how one’s spiritual beliefs or religious ideas may negatively impact on a person’s mental health.
Now, this may relate to a number of factors. One of them is the idea of the mental health or the mental illness coming as a punishment from God. The other is about the influence of malign spiritual factors. If a Muslim patient gets comfortable with you, you might hear them talking about black magic. You might hear them talking about evil spirits. These are things that you will find often, particularly in what’s called folk spirituality or folk psychology, a lot of mental health conditions tend to be attributed to these sorts of malign influences, and we’ll take a look at them as we go forward. Let’s take a deeper look at some of the key factors of diversity.
Let’s start with ethnicity and culture. Muslims come from a very wide range of cultures. In fact, they are represented in virtually all cultures and ethnicities on the globe. Because of this, what you will find are differing subsidiary beliefs with relation to their mental health. People from a particular culture might be much more, might foreground the effect of things like black magic, evil spirits like the jinn, concepts like envy or the evil eye in terms of understanding their mental health. Those from other cultures, you might find that those are more in the background. This also impacts on the degree of integration versus what you might call ghettoization.
How integrated with the mainstream community do they see themselves versus how separate from it? There are parts of the UK with very high Muslim densities of population where you might find people are more insular. There are other places where you might find there is much more integration. And then, of course, where ethnicity and culture are concerned, there are the effect of wider family and community views on a person’s mental health that may very well influence them. You then have the question of their socioeconomic level. Now, this may not be as variable in regards to beliefs about mental health problems as you might expect.
Don’t think, for example, that because somebody is a middle class professional, they won’t hold, inverted commas, ‘traditional’ views about mental health. You might encounter a situation where a very traditional person experiencing a depression and anxiety will tell you straight to your face that this is a problem with my brain. Whereas a middle class professional might tell you no, I’m convinced that this is in relation, this is a negative spiritual impact because of black magic for example. Nonetheless, however, one’s socioeconomic level will sometimes be determinant of the degree of integration into the mainstream. Therefore, the degree of access to services that that person feels comfortable with and can utilize, their degree of comfort with health care professionals and so forth.
And of course, the next point, which is their language, language is a huge factor. It is a major issue in terms of the diversity of Muslim experience of mental health.
Language is a core factor of the human being in some senses in fact, the human being is the speaking animal. The only animal that has a grammatical system that applies to their grammar. It is a huge factor in terms of self-expression, but even in terms of the way in which we perceive emotions that we are affected by, and conditions that we have. What does depression actually mean? What does schizophrenia actually mean? is what we mean by depression in a modern Western English perspective, the same thing as what a traditional middle aged lady from the subcontinent means when she talks about gabraath in Urdu? Is schizophrenia the same thing as what a person from the Middle East might talk about Junoon?
There are well-defined concepts of distress that exist in different cultures, and it is a mistake to assume that they automatically map onto certain concepts within the Western mental health framework. Hence, again, professional curiosity, exploring what that person means when they talk about a concept like this, becomes extremely important. Language can also serve as a real barrier to accessing talking therapies. In the NHS, talking therapies are more and more coming to prominence as the primary means of dealing with a mental health condition.
When a person is, has to speak about their deepest feelings and emotions in a second, sometimes third language, it can be really difficult. I sometimes ask patients, what language do you dream in? That’s your mother tongue. And I’ve seen patients when they become extremely distressed who speak English, but they become extremely distressed, slip back into their vernacular or their mother tongue in order to really get out how they feel. Because of this, and because most talking therapies are only really available in English, language is something that we need to be very, very conscious of.
Hence, you will find that people from Muslim backgrounds particularly certain cultures, tend to be more reliant on medication rather than talking therapies in order to try to find some to find some relief and this means that they’re missing out on a lot of the mental health service provision that is freely available in this country.

In this step, Dr Yusuf makes direct connections between factors of diversity among Muslims and their mental health experiences.

Throughout this video, Dr Yusuf demonstrates how an understanding of the diversity within Muslim communities can improve mental health support. He makes practical recommendations throughout, and advocates for the use of ‘professional curiosity.’ Dr Yusuf also outlines factors of diversity and unity among Muslims.

Factors of diversity include (ethnic) culture; socio-economic circumstances; degree of integration; language.

Unifying factors include metaphysics and belief; centrality of faith (the Muslim worldview); religious practice; pathological spirituality (when religious beliefs negatively impact mental health, e.g., mental health problems as a punishment from God).

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Understanding Muslim Mental Health

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