MJP Online Early 02-06-18 BRIEF COMMUNICATION Islam and Mental Health: A Malaysian Profile Jean Anne Heng1, Joseph P Gone2 1Department of Psychology, University of Michigan, Ann Arbor, USA 2Department of Anthropology & Social Medicine, Harvard Medical School, Department of Anthropology, Harvard University, Massachusetts, USA Abstract The purpose of this research paper is to identify the intersectionality of religion, culture, and mental health in Malaysia and to expound upon the implications for future formulations of effective evidence-based practices. This review draws upon sources including primary ones such as studies as well as secondary sources of existing literature reviews on religious and cultural tenets in Malaysia. Keywords: Mental Health, Intersectionality, Culture, Intervention, Islam, Malaysia Introduction groups, this paper will focus specifically on the intersection of the religion of Islam and The discussion surrounding the the nuances of Malaysian culture. The paper interrelationship of culture and will discuss how this intersection is psychopathology has greatly advanced over manifested in the mental health landscape of the recent years, particularly with the advent Malay communities, and will culminate in of the field of implementation science, making a case for culturally-sensitive which is defined as “the scientific study of evidence-based practice in the mental health methods to promote the systematic uptake of service landscaping of Malaysia, in order to research findings and other EBPs into increase accessibility of mental health routine practice, and, hence, to improve the services to all. The nature of the paper is quality and effectiveness of health services” exploratory rather than definitive, and the [1]. The promotion of this systemic uptake initial portions aims to identify the main of research findings into routine practice tenets of the religion of Islam as well as the ought to happen within cultural contexts, aspects of certain cultural components of particularly when we take into consideration Malaysia that are imperative in forming a the scarcity of evidence regarding cultural comprehensive understanding of this minorities that often results in standard relationship. practices based on data from the majority population that have uncertain relevance for Religion in Malaysia specific cultural groups [2]. While the concepts of mental health in Malaysia differ The ethnic composition of Malaysia citizens vastly between various religious and ethnic is as follows: Malays (67.4%), Chinese MJP Online Early 02-06-18 (24.6%), Indians (7.3%) and Others (0.7%) admixture in this context. They subsequently as per a 2018 report by the Department of documented genetic structuring amongst the Statistics Malaysia, Official Portal. Among Malay populations among the Malay the Malaysian citizens, the Malays was the populations which could possibly allude to predominant ethnic group in Peninsular different historical origins [4]. As such, Malaysia which constituted 63.1 per cent. there is no present definitive conclusion as The Ibans constituted 30.3 per cent of the to the origins of Malays in Malaysia. total citizens in Sarawak while Kadazan/Dusun made up 24.5 per cent in The arrival of the Chinese and Indians into Sabah. The remaining population is made up Malaysia in the nineteenth century who were of indigenous groups, also known as the brought in by British colonialists resulted in Peninsular Aborigines (1.0%). While the a diversification of religious affiliations in Malaysian Constitution declares Islam as the Malaysia [3]. A substantial portion of the official religion of the country, other Chinese population subscribe to Christianity religions are granted freedom to practice. and Buddhism, while there exists an Amongst other legislative stipulations such extremely diverse system of beliefs amongst as allowing for the building of respective the Indians, amongst which include but are holy sites such as churches, temples, or not limited to Hinduism, and Sikhism. gudhwaras (Sikh sites of worships) in various states and districts, and granting Within the Malay population, cultural access to all devotees to demonstrate their differences exist from state to state but the religious affiliations through dress or overall Malay culture is overshadowed by a demeanor, the government of Malaysia also strong influence of religion [3]. This is not recognizes other religions by declaring an isolated occurrence as it has been found national holidays on certain days of the year that the traditional belief that spiritual forces during which religious festivals are play a great role over physical and mental celebrated, the main four holidays being health is a dominant one amongst all Christmas, Chinese New Year, Deepavali, Malaysians. Some examples of this belief and Hari Raya. can be found in a study done by Muhammad, Subhi, Zakaria, and The origins of the Malays of Malaysia have Mohammad Aun on cultural influences in been a widely debated topic, with differing mental health help-seeking amongst perspectives on this matter. An article by Malaysian caregivers [5]. The study found Haque and Maslan posits that the Malays of that all caregivers employed coping Malaysia were originally Hindus but began mechanisms of religious beliefs as a vital embracing Islam after the fourteenth strategy for managing the cultural issues century, before which animism was the main associated with mental illness due to the spiritual practice of Malays [3]. A more limited mental health resources that were recent study conducted by researchers at available in their respective communities, Universiti Sains Malaysia utilized 54,794 which was consistent with the high level of genome-wide single nucleotide religious affiliation claimed by Malaysians. polymorphism genotype data generated in four Malay sub-ethnic groups in peninsular Islam and Mental Health Malaysia (Melayu Kelantan, Melayu Minang, Melayu Jawa and Melayu Bugis) to For the sake of this article, the two points of explore the history of human migration and Islamic beliefs that will be addressed in MJP Online Early 02-06-18 detail will be concerning the view on forces that results in the psyche or nafs is in humanity and mental health. control of human consciousness. As such, a study of both these forces is necessary when The Muslim belief is primarily based on the trying to develop an understanding of man. idea that science and religion work together In conclusion, ongoing purification of as an integrated whole as part of the cosmic thought and deeds bring a person closer to reality [3]. Human beings are considered a God and keeps a person mentally healthy. microcosm of the larger cosmos; The Qur’an uses the term inshirah al sadr to demonstrating the affinity between humans refer to a state of mental health or and nature and the common elements that psychological well-being as indicated in the exist between them. According to Rahman following verses: 6:125, 10:57, 16:106, [6], when God creates something, it then 20:25, 94:1. The Qur’an also uses the term falls into a pattern according to the laws of dhaiq al sadr to refer to states of nature that governs it, becoming a part of the psychological imbalance as seen in these total cosmos. The concept of free will is verses: 6:125, 11:12, 15:97, 26:13, 29:33. present in Islam; while the created elements Psychological stress (dhaiq nafsi) is also of the universe such as the sun, the moon, mentioned in the Qur’an in these verses: and the cosmos are bound to Allah’s 6:125, 9:25, 9:118, 11:12, 11:77, 15:97, instructions, human beings are granted the 16:12, 18:6, 26:3, 26:13, 27:70, 29:33, 35:8, (limited) choice of whether or not they wish 65:5. The term hayatan dhaniqah is also to follow the commands of God. The reward used to refer to a life that has psychological and punishment that comes after is based on stress (20:124). Taqwa is associated with a the choices that are made, and if they are state of well-being and psychological or consistent with or against the commands of mental imbalance is attributed to ma’siyat Allah given in the Qur’an. The seat of true [7]. knowledge in human beings comes from the metaphysical elements, referred to in the Islam in Malaysia Qur’an as heart (qalb), soul (al-nafs), spirit (ruh), and intellect (al-aql). Knowledge and Article 3 in the Malaysian Federal ruh are inherent in the nature of human Constitution states that "Islam is the religion beings and are collectively known as al- of the Federation" and "Parliament may by fitrah, which directs human behavior law make provisions for regulating Islamic throughout their lives. Deviation from al- religious affairs." This allows for fitrah leads humans to go astray and leads to constitutional government intervention and suffering and pains in this world [6]. involvement in matters related to Islamic values, some examples of which will be This very idea of deviation from the provided in the next paragraph. The knowledge and teachings of Islam leading to integration of religion and culture is suffering and distress provides the basis for implicated in Article 160 of the constitution the concept of mental health in Islam. The which provides a definition of a Malay as “a suffering and pains in this world are a result person who professes the religion of Islam, of the struggle for the spiritual intelligence habitually speaks the Malay language, in man to intervene and strike a balance in conforms to Malay custom”. human personality when the physical body The effects of the synthesis of these two is in need of physical pleasure. The dynamic provisions include an increased government interplay between material and non-material presence in the regulation of Islamic MJP Online Early 02-06-18 religious affairs, and subsequently, the majority of the Malay population in enforcement of cultural practices amongst Malaysia, a large amount of administrative the Malay community.