Mental health has recently been receiving increasing attention. Mental health professionals are working to promote awareness and reduce the stigma that has long been associated with mental illness. Within Muslim communities, however, this stigma can be even greater and may take on a spiritual dimension. Some Muslims believe that mental illness is a result of weak faith or a lack of religious commitment. This can make people less likely to talk about their struggles and seek professional help.
According to a study published in JAMA Psychiatry in 2021, “US Muslim adults were 2 times more likely to report a history of suicide attempt compared with respondents from other faith traditions, including atheists and agnostics.” This finding was alarming. In response, many Muslim mental health professionals have been working to increase awareness about mental health while also engaging spiritual leaders and religious scholars in these conversations.
Although the current picture is not always positive, it is fascinating to learn that early Muslim scholars demonstrated a sophisticated understanding of mental illness. This article will shed some light on the bimaristans, hospitals in the Islamic world that included specialized sections for patients experiencing mental illness.
The word bimaristan means “house of the sick” in Persian. One of the earliest known bimaristans was established in Baghdad in the 8th century. Bimaristans were often built within cities and, in some cases, were associated with mosques and educational institutions. They were designed to provide patients with care, support, and a sense of acceptance. The buildings were generally well-lit and ventilated, and patients could have private rooms. Gardens, fountains, and other elements of the natural environment were also incorporated to promote healing. Today, we recognize the potential therapeutic benefits of spending time in nature, including approaches such as forest bathing, which have been explored in relation to stress, depression, and other mental health concerns.
Early Muslim physicians drew upon Greek medical knowledge as one of the foundations of their understanding of mental illness, but they also made significant contributions to the development of medical knowledge and clinical approaches. Their assessments were remarkably comprehensive. Physicians considered patients’ symptoms, their duration, life circumstances, changes in sleep and appetite, and physical health. They also closely observed patients’ behaviour and overall presentation.
Treatment in bimaristans was holistic. Special attention was given to the diet provided to each patient. Music, nasheeds, Qur’an recitation, storytelling, massage, warm baths, and the use of herbs, oils, and fragrances were among the approaches described in historical accounts of care. Financial support was also provided to some patients upon discharge, helping to ease the financial burden of returning home and reintegrating into society.
Muslim physicians and scholars made huge contributions in mental health. For example, Abu Zayd al-Balkhi (9th century) studied psychological distress and proposed cognitive approaches to anxiety and mood disturbances. His description of obsessive-compulsive symptoms is particularly striking and has been noted for its similarities to modern description of obsessive-compulsive disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM), a major reference used by mental health professionals in diagnosing mental disorders.
Avicenna (Ibn Sina) (980–1037 CE) recognized and described the relationship between psychological and physical health and proposed that mental states could influence bodily functions and could be influenced by physical illnesses. He described conditions resembling what we now recognize as depression, mania, and dementia, contributing to the development of medical understanding of mental and psychological disorders.
Al-Ghazālī (1058- 1111 CE) developed a psycho-spiritual framework for understanding human wellbeing. He discussed four dimensions of the inner world: al-Nafs (the self), al-Qalb (the heart), al-Rūḥ (the spirit), and al-ʿAql (the intellect). He explored ways of refining and balancing these dimensions so that a person could become less attached to worldly distractions and more oriented toward the Divine. For al-Ghazālī, this process of inner refinement was an important pathway toward psychological and spiritual wellbeing.
Muslim physicians and scholars were proactive in exploring the relationship between the mind, body, soul, spirit, and environment centuries ago. Learning about this history can help challenge the misconception that seeking help for mental illness is inconsistent with the Muslim faith. Fortunately, Islamic psychology has now developed into a framework that synthesizes the Islamic perspective with modern psychology. It offers a model of wellbeing that takes into account the human being as a whole.
Nouma Hammash, MSW, RSW
Nouma is a registered social worker in Ontario with experience in the nonprofit social and healthcare sectors, where she worked as a Service Navigation Coordinator. She is currently in private practice and is the founder of Serenity Counselling, where she provides virtual counselling and therapy services to individual adults.
Nouma offers therapy in both English and Arabic and tailors her approach to each client’s values and preferences. Her services can be secular- or spiritually-oriented, depending on the client’s own values and preference.
In addition to her clinical work, Nouma is actively involved in research and advocacy initiatives focused on disability rights and inclusion.
www.serenity-counselling.net // info@serenity-counselling.net