Muslims in India struggle for access to mental health care

Sana, who, like many people interviewed for this article, asked that her real name not be used, has seen some 12 mental health professionals and, she said, has had her Muslim identity questioned on several occasions. 

She discovered psychotherapy and mental health counseling during her college days. It took her more than a year "to overcome the stigma and the shame associated with saying that she needed support."

In addition to the personal challenges that come with seeking mental health support, Sana faced with the additional challenge of navigating the mental health care space in India as a Muslim.

The 32-year-old development practitioner does not consider herself a very religious person, yet, because of her Muslim identity, she has faced hostile conversations while seeking psychological help.

"I am a Muslim, but I don't look or sound like the stereotypical Muslim. I am educated, can speak fluent English, am a single child, and at one point I had brightly colored hair," she said. "Often things said to me were very offensive that were rooted in deep biases against Muslims," she added.

Sana recalled her grim experience with a psychiatrist at one of India's top hospitals, All India Institute of Medical Sciences (AIIMS), in New Delhi. "While explaining the side-effects of the medicine for pregnant women, he said: 'I just want to flag this to you because you people [Muslims] have many children,'" she said.

"I picked up the prescription and never went back," Sana said.

Sana's case is not an outlier. For Muslims navigating the mental health space in India, the challenges are multifarious.

Muslim mental health needs 'almost invisible'

A report published in 2022 by Bebaak Collective, a coalition of autonomous women's groups working across multiple states, found that "the mental health of Indian Muslims has been severely underrepresented and almost invisible within the mental health or development literature in India."

According to a report by the Parliamentary Standing Committee on Health and Family Welfare published last year, India has only 2,840 accredited clinical psychologists. The report does not account for the socioeconomic backgrounds of the doctors, meaning that there is no data on how many of these psychologists are Muslim.

Studies do show that an increasing number of Muslims are facing mental health issues.

A report published during the coronavirus pandemic in the Journal of Health Sciences stated that "Muslims were found to be at a higher risk of anxiety compared with Hindus." The report added: "There is evidence from the study indicating a strong positive relationship between sociocultural adversities and psychological distress."

Additionally, a study conducted in 2020 concluded that Muslims and Dalits — a historically marginalized group from the lowest level of India's centuries-old discriminatory caste hierarchy — have worse self-reported mental health than upper-caste Hindus.

The research found that these gaps remain even after accounting for the fact that Dalits and Muslims have less education and own fewer assets.

Challenges in seeking mental health support

The World Health Organization (WHO) guidelines state that there should be at least three practicing psychiatrists per 100,000 population. However, India has a significantly low number of mental health professionals, with just 0.3 psychiatrists for every 100,000 people. This has resulted in severe challenges in accessing treatment.

According to data from the Health and Family Welfare Ministry, of the 150 million people in India who needed mental health care in 2016, fewer than 30 million actively sought help.

High costs, social stigma, limited awareness and a severe shortage of qualified professionals make mental health care largely inaccessible for most Indians.

Though the stigma around therapy has notably decreased among urban educated communities, the shortage of qualified therapists still makes finding the right one a significant challenge.

For urban and educated Muslims, these barriers are even greater. Many must first overcome the pressure to seek help from within a religious framework. Even when they do seek secular professional care, they often struggle to find therapists who understand and respect their socioreligious identity.

"The idea of mental health is not openly acknowledged in my family," said Faizan, 29, who has been seeing therapists since 2015 and asked that his real name not be used. "It's acknowledged when there is an extreme case," he said. "Otherwise, the approach is to 'rely on God.''

Zeba, 26, a journalist based in New Delhi who asked that her real name not be used, found herself trying to overcome a different hurdle. She struggled to find a therapist who could understand her religious beliefs and provide the required support accordingly.

"I was going through a problem where my religion had a role to play," she said. "I wanted someone to understand my relation with God and help me understand if I was being manipulated in the name of religion."

"I was in a lot of guilt, which came from the fact that I was in a premarital relationship with a guy, something that is forbidden in Islam," she said. "The therapist was unable to understand the religious aspect of my problems so I started looking for a Muslim therapist," she added.

Is religion relevant to mental health?

In recent years, mental health experts are increasingly exploring the incorporation of individual religious and spiritual systems into psychotherapeutic services.

This approach to psychotherapy, termed Religiously Integrated Cognitive Behavioral Therapy, has been developed for five major world religions: Christianity, Judaism, Islam, Buddhism and Hinduism.

In her research exploring the relationship between religiosity and mental health among Muslim youth, Shaheena Parveen, a Kashmir-based psychologist, found that religiosity had a positive role to play among the young Muslim respondents.

In 2013, Muslim mental health scholars in the United States also came up with Traditional Islamically Integrated Psychotherapy — a form of psychotherapy that combines traditional Islamic principles with modern psychology — which has been approved by the American Psychological Association.

"Our psyche is psychosocial. That means it is formed through our family, religion, social backgrounds, etc.," said Ayesha Hussain, a Delhi-based psychologist.

She said therapists needed to be socioculturally informed, but having a therapist from the same religion may not always be helpful. "Sometimes, fearing judgment, clients might hesitate in sharing something that is considered ‘un-Islamic' with a Muslim therapist," she said.

Pooja Priyamvada, a mental health researcher based in New Delhi, said it worked both ways. "Sometimes religion can perpetuate myths and misconceptions about mental health and illness," Priyamvada said, "and sometimes the same religious beliefs can bring in hope."

Edited by: Srinivas Mazumdaru