In recent years, public discourses on topics related to mental health have become increasingly popular within Singapore society and the local Malay-Muslim community. However, such increases have not lessened the stigmatisation and discrimination towards people with mental illnesses. A study conducted in 2016 revealed that Malays had higher prejudice and misconception towards mental illness but also noted that they also have greater tolerance for individuals with mental health issues.[1] Another study published in the same year also found that the Malay community’s knowledge of mental health is still lacking and stigmatising beliefs about mental health issues still exist within the Malay-Muslim community.[2]
Addressing mental health concerns in the Malay-Muslim community remains a struggle primarily due to the intricate intertwining of religious beliefs and cultural practices. A delicate balance between acknowledging traditional perceptions of mental health issues and integrating modern approaches to support holistic well-being is required to improve the community’s mental health literacy. To understand how the Malay-Muslim community navigates mental health, we must first understand what mental health is.
DEFINITION OF MENTAL HEALTH
According to the World Health Organisation, mental health is more than the absence of mental illnesses. It is a state of well-being in which the individual is able to realise his or her abilities, cope with the normal stresses of life, work productively and fruitfully, and contribute to his or her community. A person’s mental health may be affected by multiple interrelated social, psychological and biological factors.[3] Mental health issues can affect people regardless of race, religion, socioeconomic status and age. To put it simply, mental health is for everyone.
ATTITUDES TOWARDS MENTAL HEALTH
Previous studies have examined differing attitudes towards mental health ranging from acceptance, tolerance, and stigma to even fear.[4] Within the Malay community, mental health is often described using various terms specific to the region, reflecting different forms of mental illnesses. Expressions like gila meroyan (postpartum depression) and buatan orang (psychoses) are commonly used.[5] In addition, many within the Malay community hold on to the belief that certain mental disorders are the work of black magic or evil spirits.[6] Another common view is that mental illness is a test from God, or “illness of the soul”.[7] Yuen et al’s study also found that Malays had higher prejudice and misconception towards mental illness compared to the Chinese.[8] They postulated that religion, to some extent, shapes the Malay community’s understanding of mental health.
ISSUES WITH MENTAL HEALTH AS ‘A TEST FROM GOD’
Islam is the religion practised by the large majority of Malays in Singapore and the dominant view is that mental illness is perceived as a test from God or an illness that could be treated as an opportunity to remedy disconnection from God or resolve a lack of faith through regular prayer and a sense of self-responsibility.[9] Furthermore, a separate study also found that Malays were significantly associated with higher weak-not-sick scores. Scores on the ‘weak-not-sick’ scale gauge how inclined individuals or groups are to regard mental health challenges as personal weaknesses rather than as medical conditions. According to this study, Malays tend to view mental health issues as a weakness rather than an illness.[10] The stigmatising attitudes and misconceptions within the spirituality. This has led to many being ashamed to talk about a member of their family experiencing mental distress because of the negative perceptions society has of individuals with mental issues. Additionally, those who choose to share their struggles or stresses may be deemed to be emotionally ‘weak’, lacking in faith in Islam, or worse, choosing to be ‘mad’.[11] It is therefore unsurprising that many who face mental health challenges remain reluctant to come forward to seek professional treatment. They often feel belittled and view themselves as being a ‘burden’ to society. Prejudicial beliefs and misconceptions about mental health are a barrier to people seeking help.
TREATMENT APPROACHES IN THE MALAY COMMUNITY
As religion remains central in understanding mental health challenges among Malays, the dominant approaches in addressing its issues have also remained in the form of religious practices. A study conducted in 2020 investigated factors associated with using complementary and alternative medicine for mental illness among the three major ethnic groups (Chinese, Indians and Malays) in the general population of Singapore. Complementary or alternative medicine (CAM) is defined as “a broad set of health care practices that are not part of that country’s tradition or conventional medicine and are not fully integrated into the dominant health-care system.”[12] Practices such as prayer, recitation of the Quran, and other spiritual activities are considered as CAM. These alternative practices are frequently employed in treating mental health issues in the Malay-Muslim community.[13] Seeking remedies from traditional healers through practices like ruqyah shar’iyyah, involving spiritual healing through Quranic recitations and prophetic traditions is also common.[14] The preference for these alternative practices as compared to conventional healthcare services may be due to accessibility and lower costs of these practices. Relative to consulting healthcare experts, practices such as prayer and other spiritual practices are generally free or less costly than conventional healthcare.[15]
TOWARDS A HOLISTIC APPROACH
Despite these alternative approaches being highly accessible and cost-effective, a reliance solely on these methods in dealing with mental health issues has certain limitations. Dr Radiah Salim highlighted that many in the community usually turn to traditional healers as an immediate helpline to address mental health challenges and only go to the psychiatrist as a last resort. She explained that such approaches can lead to delays in diagnosis and hinder early intervention, potentially worsening the recovery process for individuals.[16] However, it is still worth noting that there are positive functions of religious practices in supporting individuals in difficult times. From a religious perspective, referring and relating to the Quranic and prophetic texts and internalising the meaning of the verses and sayings can help us to recognise and accept our strengths and weaknesses as humans, acknowledge Allah’s might and never give up on His Mercy.[17] On the other hand, from a practical standpoint, seeking professional help can provide greater support and effectively cater to the needs of the individual facing mental health issues resulting in a smoother recovery process. The issue of mental health is real and should not be taken lightly. Ultimately, an integrated approach combining both religious practices and conventional healthcare services is crucial for holistic mental health support for the Malay-Muslim community.
CLUB HEAL
Efforts have been initiated within the Malay community to improve the understanding and treatment of mental health issues. Dr Radiah, the founder of Club Heal, calls for a comprehensive approach that encompasses biological, psychological, social, and spiritual aspects while valuing religious beliefs and practices that can offer comfort to individuals when confronted with mental health challenges.[18] Club Heal adopts an integrative approach involving Qualified Practitioners of Islamic Medicine and psychiatric treatments. It also provides psycho-education, and supportive counselling to its clients and families at its Mental Wellness Centres and conducts outreach programmes to those facing mental health challenges and the general public. Currently, Club Heal is already working alongside Muslim leaders in Singapore to integrate psychiatric and spiritual approaches. It should be noted that while Club Heal caters to the needs of Muslims, their services are accessible to all regardless of race or religion.[19]
“ARE YOU OK, BRO?”
In addition to Club Heal, Lepak Conversations, an activist group with an advocacy platform that promotes lepak (accessible) conversations about contemporary issues recently partnered with the Singapore Association of Mental Health (SAMH) for a panel event named “Are You Ok, Bro?” held on 14th October. The fully booked event catered to young participants, drawing in 41 male attendees comprising both Malays and non-Malays/Muslims. Among them, nine individuals were above the age of 35, contributing to the event’s diverse demographic. This first-of-its-kind male mental health event not only offers a unique space for males to engage in somatic exercises that help participants release their stored emotions from the body but also encourages them to share deep insights and their lived experiences as Malay or non-Malay men. Throughout the event, the speakers identified similar experiences, notably the pressure to suppress emotions and project strength when growing up. They emphasised that their initial reluctance to seek help when dealing with mental difficulties originated from their socio-religious upbringing. This upbringing places significant importance on men avoiding vulnerability or any sign of weakness, while also expecting them to be self-sufficient and accomplished in their professional lives.[20] The event serves as a starting point towards understanding the challenges experienced by Malay men and by extension, the community, without dismissing the religious perspective.
MOVING FORWARD
Navigating mental health within the Malay-Muslim community involves acknowledging traditional beliefs, integrating modern practices, and fostering inclusive discussions to better support individuals in their mental health journey while respecting their religious and cultural perspectives. Stigmatising attitudes towards mental health coupled with misconceptions about mental illness is still pervasive within the Malay-Muslim community despite existing efforts to reduce stigma. Reducing stigma through encouraging open conversations together with providing accessible and integrated mental health services are pivotal steps toward improving the well-being of individuals within this community.
1 Yuan, Q., Abdin, E., Picco, L., Vaingankar, J. A., Shahwan, S., Jeyagurunathan, A., Sagayadevan, V., Shafie, S., Tay, J., Chong, S. A., & Subramaniam, M. Attitudes to Mental Illness and Its Demographic Correlates among General Population in Singapore. PloS One, 11(11), e0167297–e0167297. 2016.
2 Subramaniam, M., E. Abdin, L. Picco, S. Pang, S. Shafie, J. A. Vaingankar, K. W. Kwok, K. Verma, and S. A. Chong. Stigma towards People with Mental Disorders and Its Components – a Perspective from Multi-ethnic Singapore. Epidemiology and Psychiatric Sciences 26, no. 4 (2017): 371-82. doi:10.1017/S2045796016000159. 2016.
3 World Health Organization (WHO), Mental Health: Strengthening Our Response accessed. 2023, December 7. Retrieved from https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response.
4 Yuan et. al. Attitudes to Mental Illness and Its Demographic Correlates among General Population in Singapore.
5 Razak A. A., 2017. Cultural Construction of Psychiatric Illness in Malaysia. The Malaysian journal of medical sciences: MJMS, 24(2), 1–5. https://doi.org/10.21315/mjms2017.24.2.1
6 Radiah Salim. State of Mental Healthcare in the Malay/Muslim Community in Singapore – “Tak Kenal Maka Tak Cinta”. The Karyawan. 2017, October 15. Retrieved from https://karyawan.sg/state-of-mental-healthcare-in-the-mmc-in-singapore-tak-kenal-maka-tak-cinta/
7 Yuan et. al., 2016. Attitudes to Mental Illness and Its Demographic Correlates among General Population in Singapore.
8 Ibid
9 Ibid
10 Subramaniam et. al. 2016. Stigma towards People with Mental Disorders and Its Components – a Perspective from Multi-ethnic Singapore.
11 Salim, R. State of Mental Healthcare in the Malay/Muslim Community in Singapore – “Tak Kenal Maka Tak Cinta”. The Karyawan. 2017, October 15. Retrieved from https://karyawan.sg/state-of-mental-healthcare-in-the-mmc-in-singapore-tak-kenal-maka-tak-cinta/
12 Seet, Vanessa, Edimansyah Abdin, Janhavi A. Vaingankar, Shazana Shahwan, Sherilyn Chang, Bernard Lee, Siow A. Chong, and Mythily Subramaniam. The Use of Complementary and Alternative Medicine in a Multi-Ethnic Asian Population: Results from the 2016 Singapore Mental Health Study. BMC Complementary and Alternative Medicine 20, no. 1 (2020): 52–52.
13 Ibid
14 Razali, Z. A., Rahman, N. A. A., & Husin, S. (2018). Complementing the Treatment of a Major Depressive Disorder Patient with Ruqyah Shar‘iyyah Therapy: A Malaysian Case Study. Journal of Muslim Mental Health, 12(2).
15 Seet et. al. The Use of Complementary and Alternative Medicine in a Multi-Ethnic Asian Population: Results from the 2016 Singapore Mental Health Study.
16 Salim, R. State of Mental Healthcare in the Malay/Muslim Community in Singapore – “Tak Kenal Maka Tak Cinta”. The Karyawan. 2017, October 15. Retrieved from https://karyawan.sg/state-of-mental-healthcare-in-the-mmc-in-singapore-tak-kenal-maka-tak-cinta/
17 Muhammad Zulkarnain Bin Azman, What Does Islam Say About Mental Health, accessed. 2023, December 7. Retrieved from https://muslim.sg/articles/what-does-islam-say-about-mental-health.
18 Salim, R. State of Mental Healthcare in the Malay/Muslim Community in Singapore – “Tak Kenal Maka Tak Cinta”. The Karyawan. 2017, October 15. Retrieved from https://karyawan.sg/state-of-mental-healthcare-in-the-mmc-in-singapore-tak-kenal-maka-tak-cinta/
19 Club HEAL. Retrieved from https://www.clubheal.sg/about-us
20 LepakConversations, “Male mental health isn’t just about toxic masculinity”: A nuanced conversation about Malay male mental health, accessed. 2023, December 2023. Retrieved from https://www.linkedin.com/pulse/male-mental-health-isnt-just-toxic-masculinity-nuanced-clgie/
Siti Nuraliya Binti Azman is currently pursuing her undergraduate studies at the National University of Singapore (NUS), majoring in Sociology. Her research interests include studying social inequality and the sociology of religion.
