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Religion and mental health are very sensitive issues in the Arab world and Islam today. Many Muslims feel targeted by others, which no doubt has consequences on their mental health and well-being. At every point in this book we seek to objectively and even-handedly present and discuss these sensitive topics which psychiatrists, therapists, and pastoral counsellors need to know about when treating Muslims. We believe that religious beliefs and practices can bring tremendous solace and hope, but the misunderstanding of or distortion of those beliefs can also lead to much pain and distress.
Despite the potential buffering effects of devout religious faith, mental health problems are not uncommon among Muslims. Rates of significant depressive symptoms in American Muslims range from 27.9% to 61.9% depending on method of assessment and population studies (Hodge et al., 2015; Amer & Hovey, 2012; Abu-Ras & Abu-Bader, 2009). Similarly, significant anxiety symptoms are present in 24.9% to 65.4% of American Muslims (Amer & Hovey, 2012; Abu-Ras & Abu-Bader, 2009). Emotional disorders are also prevalent in Muslims outside the United States (U.S.), although there is little research examining mental disorders specifically in Muslims. In one of the few such studies, the rate of mood disorders diagnosed using the WHO CIDI in 366 adult Muslims in southern Ethiopia was 15.3% (Awas et al., 1999), compared to 9.6% in the general population of the U.S. (Demyttenaere et al., 2004). Of course, this comparison is between Ethiopia and the U.S., and does not account the socioeconomic and environment differences between the U.S. and this poverty-stricken African country.
Rates of mental disorder in Muslim-majority countries (rather than in Muslims specifically) are more readily available. For example, the rates of depression and anxiety disorders in 766 adults living in rural Bangladesh (a country which is over 80% Muslims) was 8.0% and 5.0%, respectively, based on examination by a psychiatrist using DSM-IV diagnostic criteria (Hosain et al., 2007). In a study of 1,475 adults attending Primary Health Care Centres in Qatar (nearly 70% Muslim), rates of psychiatric disorder identified using the WHO CIDI diagnostic interview were 18.3% for major depression, 17.3% for any anxiety disorder, 14.1% for personality disorder, 6.6% for psychosis, and 0.8-1.4% for substance use disorder (Bener et al., 2015).
Finally, using DSM-IV-R and ICD-10 criteria, the 2010 Global Burden of Disease (GBD) Study found that major depressive disorder contributed only a small percentage (2.6-4.0%) to overall disability-adjusted life-years (DALYs) among adults in 22 Arab countries (Algeria, Egypt, Bahrain, Comoros, Djibouti, Iraq, Jordan, Saudi Arabia, Kuwait, Lebanon, Libya, Mauritania, Morocco, Oman, Palestinian territory, Qatar, Yemen, Somalia, Sudan, Syria, Tunisia, United Arab Emirates) (Mokdad et al., 2014). On the other hand, the GBD Study also found that DALYs from mental disorders overall were higher in North Africa and the Middle East than in other regions in the world (Whiteford et al., 2015). The prevalence of mental disorders among children and adolescents has been estimated to be 12.8% in the Middle East compared to 12.0% in Europe and 19.9% in North America (Polanczyk et al., 2015).
Conclusions
Mental disorders and emotional problems are common among Muslims living in and outside the U.S. The reasons for this are numerous. Many Muslims outside of the U.S. live in poverty and in socioeconomically deprived areas of the world affected by war and terrorism. Those living in the U.S. or other western countries are in a different cultural environment where there is often internal conflict between their Islamic values and the surrounding community (especially among young Muslims). In addition, Muslims are likely to experience discrimination in western countries, where they may have difficulty finding employment, be excluded from social or community groups, or even fearful of their safety (targeted for their religious beliefs or dress)
Thus, mental health professionals are likely to encounter Muslim clients in their practices and therefore need to know something about how Islam developed historically, what Muslim believe and practice today, and how these beliefs and practices are related to mental health.