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Islam, Mental Health and Law: a General Overview Georgios A Tzeferakos and Douzenis Ann Gen Psychiatry (2017) 16:28 DOI 10.1186/s12991-017-0150-6 Annals of General Psychiatry REVIEW Open Access Islam, mental health and law: a general overview Georgios A. Tzeferakos* and Athanasios I. Douzenis Abstract Islam is the dominant religion in about 56 countries around the globe, and has more than 1.2 billion followers. Islam represents a holistic way of life, and according to a large proportion of its followers, the Islamic law or Shari’ah should prevail over secular law and should be implemented as state law. The etymological root of the word Shari’ah can be traced back to the harsh life in the desert and it means “pathway to be followed” or “path to the water hole,” since the water was the basic element and preserver of life. At the dawn of its historical course and at its moral and ethical core, Islam introduced many interesting and innovative beliefs concerning the mentally ill. Islam underlines the moral necessity for the protection and care of the vulnerable individuals, as dictated by God himself. On the other hand, beliefs about “possession” and stigmatization infuence the peoples’ attitude against and apprehension of mental dis- orders. This strange admixture is refected upon the status of the mental health services and corresponding legislation found in the diferent countries of the Islamic world. Keywords: Islam, Mental health, Forensic psychiatry, Mens rea Background Legislation in the Islamic law Islam is a monotheistic religion, and its founder is the Te Islamic law or Shari’ah or Qānūn-e Islāmī started prophet Muhammad, who was born in 570 A.D. Muham- taking shape by Abu Hanifah (699–767 A.D) through mad was a merchant who meditated in a desolate cave the need for social reorganization, which should be near Mecca, when at the age of forty he started listen- based in the concept of solidarity and sympathy against ing to God’s speech (Allah), which was brought to him the corrupted governing of Umayyad (661–750 A.D) [4]. by Archangel Gabriel. Tis kept on for 23 years, until his Shari’ah is an archaic Arabic word meaning “pathway to death in 632 A.D. Due to the fear of political prosecution be followed” [5] or “path to the water hole” [6]. he moved from Mecca to Medina in 622 A.D. Tis event Shari’ah is applied in countries in the Middle East, (hijra) marks the beginning of the Islamic calendar, which Africa, and Asia [7]. Among these, Saudi Arabia applies consists of 12 lunar months; it has 354 days and is not its purest form. An interesting phenomenon, mainly related to seasons [1]. In Medina, he founded the frst resulting from the colonization of diferent parts of the community of his followers. Te followers of Islam are globe by Western countries, is the coexistence within the called Muslims and they believe that the orders of their same legal ambit of both secular and Islamic law [8]. In religion apply in every feld of their life and they repre- the beginning, the colonizing countries showed no inter- sent a complete life model [2]. Muslims are the majority est in interfering or altering the local customary and in 56 countries, and it is estimated that they represent the tribal laws, unless they hindered their economic goals one-ffth of the world population (more than 1.2 billions) and expansionism [9]. But later in an efort to expand [3]. the implementation of their law on the indigenous popu- lations, they tried to incorporate the customary—reli- gious laws in a comprehensive legal system by three main *Correspondence: [email protected] methods: “the codifcation of customary or religious law; 2nd Psychiatry Department, Attikon University Hospital, National the application by state courts of unwritten customary or and Kapodistrian University of Athens - Medical School, 1 Rimini Street, 12462 Athens, Greece religious law in a fashion analogous to the common law © The Author(s) 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/ publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Tzeferakos and Douzenis Ann Gen Psychiatry (2017) 16:28 Page 2 of 6 and the creation or recognitions of informal or custom- accepted ones are called Sunnah. Tere are six recog- ary courts run by local leaders” [10]. Nigeria, a former nized collections of Sunnah, which were written in the British colony which became an independent federation ninth and tenth century A.D, during the Sahih period [3]. in 1960, is a typical example of such a state. Te north- With historical evolution, diferent prominent Islamic ern part of the country is inhabited mostly by Muslims, legal scholars developed diferent models of interpreting while in the southern part the majority of the population and applying the divine law, as depicted from the sacred is Christian. In the south, the legal system is based on scripts. Tese diferent approaches, collectively constitut- the Anglo-Saxon common law, while in the north, a dual ing the Islamic jurisprudence or Fiqh, fnally evolved in judicial system, consisting of both common and Islamic the diferent schools or Maḏāhib of the Islamic law. In law, is applied [11]. Unfortunately, the country is dev- the early years of Islam, there were many Maḏāhib, but astated by clashes, fueled by religious hatred. In Egypt, eventually they were consolidated to very few. Te Sun- Shari’ah controls specifc areas of social life, such as mar- nis have fve Maḏāhib: (1) Mālikī, (2) Shāf‛I, (3) Ḥanbalī, riage, inheritance, property rights, and applies to both (4) Ḥanafī, and (5) Ẓāhirī, while the Shiites have three: (1) Muslim and non-Muslim populations. As far as other Ja’fari, (2) Zaydi, and (3) Ismaili [15, 18]. issues are concerned, the common law is applied [12]. Dual judicial systems can be found even in EU member Mental health in the Islamic world states. For almost one century, in the north-east area of Te three basic trends for explaining the mental disor- Greece called Trace, the Muslim citizens have the right der, from antiquity till today, are [19, 20]: (a) Te Organic to settle their legal matters, apart from the Greek civil approach, based on biology and pathophysiology, (b) the courts, with the help of Islamic judges, the muftis [13]. Psychological which examines and analyzes the intrapsy- Te mufti in Greece has a tripartite role being an Islamic chic processes and conficts and (c) the Magical or Sacred legal scholar, an Islamic judge (qâdi), and the religious which apprehends insanity through a supernatural and leader of the Muslim citizens [14]. divine scope. Tese three components in the Islamic Te legislation is formed by the scripts which are called world are in a dynamic and ever changing balance. A bal- Naṣṣ, and has a divine and not a human origin. Te ance between prejudice and social stigmatization on one scripts of the Islamic law are [15]: hand and intense religious and moral commitment to support the weak on the other. 1. Te Aḥkām of Qur’an (Koran), which is divided into Te Islamic world, in its early years, had a pioneering 114 Suwar (chapters) and consists of about 6236Ᾱyāt approach concerning mental health and psychiatry. Te (verses). frst psychiatric hospitals were founded in Arabic coun- 2. Hadith, which is the record of Muhammad’s life. tries [21, 22]: Baghdad 705 A.D (during the kingship of the caliph El Waleed ibn Abdel Malek), Cairo 800 A.D, Te length of the Suwar is uneven, with the short- and Damascus 1270 A.D, whereas the frst psychiatric est one (Al-Kawthar) containing only three verses while asylum in the West Europe, the Bethlem Hospital in Lon- the longest (Al-Baqara) has 286 verses. Te Suwar are don, was founded in the thirteenth century [23]. Impor- divided into Meccan (87) or Medinan (27), depending tant fgures of the Arabic medicine are Razis (860–932 on the location of revelation, that is before or after Hijra A.D) and Avicennas (980–1037 A.D) [24]. Tey have rich [16]. Te Qur’an contains about 500 commands. Since authoritative work as for example the Kitab al-Hawi and Qur’an is the revelation of God’s will, these commands the Al-Qanun f al-tibb, which are multivolume medical are to be strictly followed, without any hesitation or dis- books. Tey fought of superstition, which had already pute. Some of these lines-commands have a direct and dominated the Christian world [25]; they adopted the specifc meaning, while others have a vaguer context. Te Hippocratic organic psychiatry and they applied psycho- clarifcation and the adaptation of the commands deriv- logical methods of therapy [1]. ing from Qur’an and Hadith to the contemporary social, Currently, there are more than 50 Islamic states, and political, and historical conditions are called ijtihad. Ijti- therefore, it is difcult to simply describe the mental had, practiced by the legal scholars of Islam, is based on health services in these countries. Some of them provide strictly defned orders which are sources of law as well advanced therapies [26], and they have a modern legal [17]. Te most important of them are: (1) Te Ijmā‛, framework (Sudan 1998, Jordan 2002, Oman 1992), while which means legal consensus and (2) Te Qiyās, which in some others, the therapy of the psychiatric patients means analogy.
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