Mental and Spiritual Illnesses in Yemen: Balancing Reality and Skepticism

Haneen Al-Wahsh – Sawt Al-Amal (Voice of Hope)

The concept of mental illness and its classification varies from person to person. Despite the symptoms and suffering people experience as a result, many still lack awareness of the importance of mental health and its scientific treatment. Fear of societal judgment and the stigma associated with mental illness leads some to seek spiritual treatment (healing through the Quran and Islamic supplication) as an alternative to psychological therapy, believing it to be the only solution to their problems.

Mental health in Yemen has gone through different stages, starting with neglect and ignorance and progressing towards development and attention. Yemen saw its first mental hospital in 1966 in Aden, opened by the British at the time. It relied on one doctor and was more like a prison cell. The situation in Hodeidah is not much different, with the Salam Mental Hospital opening about ten years later and offering no treatment to patients.

Mental health in Yemen took steps forward, witnessing a significant shift with the establishment of a mental health department at the Republican Hospital in Sana’a in 1978. Four years later, the World Health Organization released a study to assess the reality of mental health in Yemen, confirming the urgent need to develop services.

Despite the existence of these mental health centers and services, societal culture has played a significant role in limiting the concept of psychological treatment to mental health centers only, leading to those seeking treatment being labeled “crazy.” Fear of negative societal judgment has deterred many patients from seeking treatment, leading to the worsening of their conditions. There is still a belief in society that spiritual treatment is an effective cure for some symptoms of mental illnesses that come with different names.

Between Two Concepts

Mental health, as defined by the World Health Organization in 1946, is “a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.” Recently, spiritual well-being has been added to the definition, which clarifies that mental well-being is the first component and the main pillar of general health, according to Dr. Ashgan Al-Fadhli, a professor of sociology and a specialist in psychological support and family counseling.

Mental illnesses in Yemen still face many challenges, the biggest one being misconceptions. Many patients and those around them suffer from wrong ideas about the nature, causes, and treatment of mental illnesses. There are also misconceptions about the treatment and causes of mental illnesses, with people believing in possession by jinn (spirits), the evil eye, or magic, which leads them to seek spiritual solutions instead of mental health treatment.

Al-Fadhli points out that the treatment of mental patients can only be done by specialized doctors, as with any other physical illness, because mental illnesses have biological, chemical, and social causes and are not a result of possession or magic. She insists that depriving a patient of medical treatments that have been proven effective in controlling mental illnesses is unacceptable religiously, legally, and scientifically.

Regarding societal acceptance, Al-Fadhli says, “Society is becoming more aware and accepting of the idea of mental illness and the importance of its treatment. Some of the things I recommend to individuals and communities are giving themselves enough time for sleep and rest, expressing their thoughts and feelings through various means, like writing down whatever bothers them or talking to a close friend or a specialist, and making ‘stress-relieving breathing’ part of their daily routine to help get rid of some negative beliefs about themselves and their abilities.”

She continues: “Modern medicine has not been able to deal with beliefs related to magic, meaning there is no definitive answer to this issue. We don’t deny the existence of jinn or the evil eye, as it is mentioned in the Quran, but perhaps these are defensive psychological tactics that individuals use to express themselves in a way that guarantees freedom of expression.”

Dr. Samiha Ghanim believes that “psychiatry does not deal with spiritual beliefs and does not interfere with them as they are part of cultures. However, a psychiatrist can correct misconceptions about magic, especially if the patient has sought spiritual treatment before seeking medical help.”

Common Symptoms

Many people in Yemen resort to “Al-Ruqya Al-Shar’iya” as a means to treat some mental illnesses, believing in its ability to expel jinn and magic. Al-Ruqya Al-Shar’iya means reciting verses from the Quran and supplications, while blowing on the patient, with the goal of healing physical and mental ailments. Many Yemenis believe in the effectiveness of Al-Ruqya Al-Shar’iya in treating mental illnesses, especially those that have no medical explanation.

Shaikh Wahib Abdul-Jalil mentions some psychological symptoms that vary from person to person, and some may see manifestations in behavior and the body that cannot be explained medically. Spiritual doctors assess these symptoms carefully to provide appropriate assistance. Some of these symptoms include: feeling an unexplained heaviness, general pain in the body, disturbing and recurring dreams that include frightening or strange things, sudden panic or fear without a clear reason, and sudden changes in mood and behavior that can reach aggression. In light of these symptoms, Al-Ruqya Al-Shar’iya is considered a way to provide psychological and spiritual comfort.

Many Yemenis mix up mental illnesses with witchcraft and sorcery, leading to delays in seeking appropriate treatment. To understand the differences between mental illness and spiritual illness, Wahib explains, “Mental illness is linked to the individual’s mental and emotional state, and its symptoms include mood swings, emotional outbursts, anxiety, depression, insomnia, and thinking disorders. It is treated through medical and psychological methods, as well as behavioral therapies, and is understood as a neurological or behavioral disorder.”

He adds: “Spiritual illness, on the other hand, is linked to religious and spiritual beliefs, and its symptoms include feeling spiritually drained, depression, anxiety, loss of concentration, and nightmares. Magic and sorcery are treated through legitimate Islamic healing practices and spiritual healing practices, and it may be viewed as a test of faith.” However, Wahib stresses the importance of looking at these illnesses from a scientific and more comprehensive perspective in modern times.

How to Achieve Mental Health

Mental health is one of the most important aspects of overall health and has a significant impact on the individual’s life and society. Dr. Al-Fadhli defines mental health as “a person’s view of themselves and how they react to a particular situation and is linked to the person’s environment in terms of customs, traditions, values, norms, and upbringing, in addition to the fact that mental health is a state of balance between feelings, thoughts, and behavior.”

The meaning of mental health and mental disorders can be understood by understanding and evaluating thoughts, feelings, and behavior; Al-Fadhli points out some signs of good mental health in an individual, such as the ability to cope with stress and the ability to build healthy social relationships with others.

She continues: “A disturbed individual can be distinguished by confusion in personal functions, or that the individual has thoughts, feelings, and behaviors that are distressing to them and others, causing a decline in their life performance.”

From Al-Fadhli’s perspective, individuals need to control their feelings and thoughts to exhibit normal and balanced behavior, and there are essential elements necessary for achieving mental health, including a healthy body, family warmth, and appropriate education that reflects society’s knowledge, civilization, beliefs, and values.

Ghanim, for her part, emphasizes that in the past there was a lack of acceptance from a large group of families for the concept of mental illness. While the lack of acceptance still exists, it is currently being met with awakening and awareness of these concepts. She adds: “We always work on correcting concepts through awareness, community messages, and psychological support activities for children and adults, creating safe spaces, and other activities and programs that help in the psychological aspect.”

It is important to change society’s view of mental health and raise awareness about the importance of psychological treatment. More mental health services need to be made available across Yemen to ensure all patients receive the care they need. Mental health is both an individual and a societal responsibility, and we must work together to achieve it and raise awareness about its importance in various Yemeni governorates.