Beliefs as states to consider in the care of Muslim patients with mental disorders

Abstract

The article addresses the cultural dimension in mental health care for Muslim patients, underlining the need for professionals to have training and tools for an effective approach and to avoid diagnostic errors, especially in emergency and primary care. The early Arab-Islamic tradition of care for mental illness (bimaristans, psychotherapy or al-‘ilaj al-nafs) is reviewed and two beliefs that can generate confusion between “belief” and “pathology” are described: the râged or “sleeping child” and possession by the jnûn (genies), as an explanatory framework for physical and psychosomatic conditions. Drawing on a study of a psychiatric prison centre that showed a higher proportion of “unspecified psychotic disorder” in the immigrant population, the incorporation of the “Cultural Formulation” into the DSM-IV and its limitations are discussed. Finally, three keys for practice are recommended: considering the power of the family and the community, recognizing the existence of other care agents (such as the fquih) and taking into account the patient’s passive position towards treatment.