Germany: Muslims with psychological problems face additional difficulties

Islam in Europe - 16 August 2009

Psychological illness among Muslims is regarded as a special problem. Many doctors do not know how to deal with the situation, while treatment concepts and patient-focused services are lacking in Germany. By Cigdem Akyol

Yilmaz A. is 60 years old and came with his wife to the Ruhr region of Germany from eastern Turkey some 36 years ago. Mr A., who's Kurdish, worked as a welder. The couple had three daughters, and lived quietly in the middle of the Ruhr – his only link to his home country being a satellite dish so that he could watch Turkish television.

His family isn't particularly religious. Neither his wife not his daughters wears a headscarf. Mr A. never goes to the mosque, preferring instead the tearoom. Ten years ago, he lost his job and did not look for a new one. He began to lose himself in thought and his psychological state became unbalanced.

Mr A. says that, for a long time, he didn't know what was wrong with him. Neither did his doctors. Only later did a psychiatrist recognize his symptoms as being those of clinical depression and, since then, he has been taking the anti-depressant drug Fluoxetin.

Lack of interest in the needs of the Muslims

Mr A. is just one of 15 million migrants living in Germany. Among them are some 3.5 million persons of Muslim faith, who have turned Islam into Germany's second largest religious community. For far too long, the majority society has not interested itself in the life led by "the foreigners" apart from their work in the coal mines and on the construction sites.

Talk has always been in terms of "us" and "them," while reservation and mistrust have characterized both sides. Yet, the migrants are also a part of this society, with all their strengths and also with their troubles and difficulties. It is only natural that mental illness afflicts members of this group as it does others.

Psychotherapy for Muslims, however, remains a side issue in the West. There are statistics for almost every detail of Muslim life, such as education levels and even Internet behaviour, but hardly anyone has shown concern for their mental well-being.

There are no statistical surveys on mentally ill Muslims. When German Health Minister Ulla Schmidt recently presented a report on mental illness in the country, Muslims were not mentioned. "This disregard also contributes to the rise in the number of clinically depressed Muslims," says Meryam Schouler-Ocak, director of the psychiatric outpatient clinic at the University Psychiatric Clinic of the Charité Hospital and head of the Berlin Alliance against Depression.

Problems of comprehension

There are studies showing that individuals with an immigrant background are rarely recommended psychotherapeutic treatment. Many attempt to deal with their suffering within the family for fear of not being properly understood. "This is why we have to make a greater effort with these patients," says Schouler-Ocak.

The Rüsselsheim-based therapist team, Ibrahim Rüschoff and Malika Laabdallaoui, have written a book called "Guide for Muslims," offering both specialists and patients information on dealing with such difficult situations. Some patients travel all the way to Rüsselsheim from other German states or even from abroad out of a sense of shame, reports Rüschoff, who works as Assistant Medical Director for Neurology, Psychiatry, and Psychotherapy and also runs a private practice together with his wife, who's a qualified psychologist,.

Cultural differences

In a cultural environment that stresses saving face and in which the concept of honour holds a high place, those suffering from psychological difficulties are willing to travel a long way in order not to encounter anyone they know.

The reasons for this secrecy lie not only with the culture, but also with the religion. The private sphere in Islam is greatly valued. Intimate details and family life are not topics of discussion with outsiders. Practicing Muslims fear that their problems are not taken seriously enough and that they therefore can't expect any help, explains Rüschoff.

This could simply be seen as a reflex to avoid therapy, but Rüschoff believes that the mistrust is not entirely groundless. "Therapists are themselves mirrors of society and also hold many prejudices against Islam," he says. Some doctors might regard the wearing of the headscarf as unnecessary or not take seriously other religious practices. The consequences are dire. "Patients fear that one of the aims of therapy is to eliminate their faith, and they therefore avoid treatment," states Rüschoff.


Source: Qantara (English)