Middle Eastern Views of Mental Illness

There are many countries that are considered to be countries of the Middle East. Some of these include Iraq, Iran, Turkey, Yemen, and Isreal, just to name a few. Many of these countries have things in common, such as belief in Islam, use of the Arabic language, connections through the Arab League, historical ties, etc. The different countries form a chain of countries that are linked by culture and religion on the one hand and yet vary greatly in terms of dialect and history on the other. The Arabic language is a large common denominator between these countries; however, dialects can be so different from each other to a point where a person from Syria can hardly communicate with a person from Algeria. (1) Most landscape in the Middle East is either occupied by harsh desert conditions or mountains. This has made its people very tough in terms of living conditions. Lebanon, parts of Syria, Turkey, Iran and Iraq have mountainous areas while most of the other countries are flat and extremely arid. Those living in the desert traditionally used to move around in a perennial search for water, which resulted in unique eating behaviors and homes. A typical Arab house in the desert is built out of mud and has little furniture. The food is basic with little processing. However, in the mountains of Lebanon, Syria or Turkey one will encounter strong homes with heavy stones and arches that can last for generations. In addition, food in these areas is usually produced during summertime and stored in cellars for use when nature does not allow them to go out and work their snow covered fields.(1)
Religions play a big role in the dynamics of the Middle Eastern society. They are considered to be one of the main pillars of the society and individuals are stereotyped based on religion. Islam, Judaism, and Christianity are the main religions practiced in the middle-east and people who practice these faiths only surround themselves with people of the same faith. Daily life is practiced on the basis of ones religion and others are expected to respect that. (1) The present day Middle East is a mixture of very old cultures and very young nations that were organized by European colonial powers after the defeat of the Central Powers which led to the end of World War One and fall of the Ottoman Empire. The culture of the Middle East is thus understood only by learning about the history of the region and the forces that have influenced the growth and demise of controlling powers. Since World War One, colonial countries such as France, Great Britain, and The United States have significantly influenced the Middle East. (1)
Keeping in mind this very generalized description of the Middle Eastern culture we can now begin to look at the beliefs in terms of mental illness. In my research it is safe to say that most all opinions by middle easterners are based off of their religious beliefs. According to the SRA (Stigma Research and Action) people from non-Western cultures tend to attribute the cause of mental illness more frequently to the afflicted individual. It is possible that discrimination against the mentally ill differs in an Islamic culture where mental illnesses and other ailments are, to some extent, considered to be due to the will of God, rather than evil forces, bad behavior, or other personally devaluating factors. According to the holy Koran, people with a mental disorder should be treated with respect, and this might result in a less stigmatizing attitude. Such a perception of causality would also reasonably apply to the individual, and might be a factor that reduces self-blame. One must bear one’s predicament and wait for the mercy of God!
A study was done by SRA researchers and participants were asked a series of open-ended questions. Responses indicated feelings of alienation, sharing stereotypes about the mentally ill, experiences of discrimination, social withdrawal, and resistance to being stigmatized and discriminated against. For example, responses included: Yes, they discriminate against us; They don’t count on us; Our society has no capacity for us; I mean there is no cultural understanding in our society; They ridicule, insult and harm us; I wish they could understand that psychiatric patients are like other patients, like patients with cancer or cardiac disease and that they can live their lives. A recurring theme was the idea of the mentally ill as dangerous and aggressive: They all believe a mentally ill patient is a natural born killer and that’s why I try to keep myself to myself and not even claim what I’m entitled to; When the police came they were acting as if I was a criminal, but they ought to know that I’m a patient, not a criminal. (2)
The International Journal of Mental health Systems has thoroughly researched the country of Iraq in terms of their views on Mental illness. According to their research public attitudes towards mental illness in Iraq has shown that community opinion about the aetiology of mental illness is broadly compatible with scientific evidence, but understanding of the nature of mental illness, its implications for social participation and management remains negative in general. (3)
As nurses we have to remain unbiased, and educational towards our patients and their families. When faced with a patient with a mental illness whom is Middle eastern we need to stay mindful of the fact that they probably believe that they were afflicted by their God in some way, or in some way they deserved to be born with this illness. We need to simply educate them on the importance of medication Therapy and safety. We should treat all of our patients the same no matter what their cultural beliefs are and we should always treat each patient with respect. Active listening is an important skill to master as a nurse with all patients but with Middle Eastern patients especially it is a sign of respect to listen to them first, and allow them to finish completely prior to speaking. Giving this level of respect to all patients all the time will ensure that as nurses we never offend, and that we give the best quality care.