For nearly 1 million Muslims living in the Netherlands, mental health challenges are not just medical problems—they are also tests of faith, spiritual battles, and opportunities for divine reward. A new scholarly review reveals how understanding these beliefs could transform psychiatric care.
Introduction: A Hidden Gap in Mental Health Care
The Netherlands is home to nearly 1 million Muslims—approximately 5% of the population. The majority are of Turkish and Moroccan descent, with smaller communities from Afghanistan, Iran, Iraq, Somalia, and Suriname. Among Moroccan-Dutch citizens, 94% consider themselves practicing Muslims. For Turkish-Dutch citizens, that number is 86%.
These communities face a troubling reality: they have a higher risk of developing psychiatric problems than the general population. Yet they are less likely to seek help from mainstream mental health services—or when they do, they often find the care poorly suited to their needs.
Why does this gap exist?
According to a new review published in the Tijdschrift voor Psychiatrie (Journal of Psychiatry) by Dr. Madelien van de Beek and colleagues from the University of Groningen and Dimence mental health group, the answer lies largely in religion and culture. Many Dutch mental health professionals feel uncomfortable discussing faith, lack knowledge about Islam, or worry that their own views might hinder an open conversation.
This article translates their findings for a general audience, offering both a window into the Muslim experience of mental illness and practical guidance for better, more compassionate care.
Part 1: How Muslims Understand Mental Illness—Three Explanatory Models
Everyone has an “explanatory model”—a set of beliefs about what caused an illness, why it started, how severe it is, and what might cure it. These models differ across cultures and religions.
Van de Beek and her team analyzed online forum discussions on the popular website Marokko.nl, where Moroccan-Dutch people anonymously discuss mental health problems. They identified three distinct explanatory models used by Dutch Muslims:
Model 1: Purely Religious Explanations
Some Muslims understand mental health problems entirely through an Islamic lens. Key themes include:
- A test from Allah (beproeving): The Qur’an states that every person will be tested according to their strength. A mental illness is seen as a trial—a sign of being strong enough to handle difficulty. Enduring it with patience brings divine reward.
- Lack of true faith (imaan): Conversely, some believe that strong faith protects against mental illness. If problems arise, they may reflect a spiritual deficit, leading to guilt and shame.
- Supernatural causes: Many Muslims consider the possibility of djinns (invisible beings created from smokeless fire), black magic (shur), the evil eye (harm caused by envy), or weswes (whisperings from the devil).
Model 2: Purely Biopsychosocial Explanations
A smaller group adopts the standard Western medical model—attributing mental illness to genetics, brain chemistry, trauma, stress, or social factors—with no religious interpretation.
Model 3: Combined Explanations (Most Common)
The majority of Dutch Muslims pragmatically combine both religious and biopsychosocial explanations. They may see a psychiatrist for medication, consult an imam for spiritual healing, and visit a primary care doctor—all at the same time or in sequence.
Key insight for caregivers: Religious and medical explanations are not mutually exclusive. Most patients hold both simultaneously.
Common Religious and Folk Explanations for Mental Health Problems Among Muslims
| Term | Meaning | Relevance to Mental Health |
|---|---|---|
| Djinn | Invisible beings created from smokeless fire; can be good or evil | May attack “weak” people, causing hallucinations, psychosis, depression, or anxiety. Can possess, whisper, or chase individuals |
| Black magic (shur) | Sorcery performed to harm others | Believed to cause unexplained physical or psychological symptoms |
| Evil eye | Harm resulting from another person’s envy or jealousy | Can trigger misfortune, illness, or mental distress |
| Weswes | Whisperings/insinuations from the devil (shaytan) | Creates intrusive doubts, obsessive thoughts, or religious scrupulosity |
| Test from Allah | Life difficulty sent by God to strengthen faith | Requires patience, prayer, and acceptance; can delay seeking medical help if seen as purely spiritual |
Source: Van de Beek et al., 2024; based on Hoffer, 2009 and forum analysis
Part 2: The Role of Djinn—Not Just Folklore
Of all supernatural explanations, djinn deserve special attention. Djinn are mentioned in the Qur’an as real beings created by Allah. They have free will like humans, can be good or evil, and possess special powers.
In a transcultural psychiatric outpatient clinic in The Hague, 43% of Muslim patients believed their symptoms were caused by djinn—yet they still sought help from mental health services. Believing in djinn does not prevent someone from also accepting psychiatric treatment.
Symptoms commonly attributed to djinn include:
- Auditory hallucinations (hearing voices)
- Psychotic symptoms (paranoia, delusions)
- Depression and anxiety
- Possession-like states
Importantly, Dutch researchers have even developed a cognitive behavioral therapy (CBT) protocol specifically adapted for patients who attribute their complaints to djinn. This shows that religious and psychological approaches can work together, not against each other.
Part 3: Barriers to Seeking Help—Shame, Taboo, and Solitude
Even when Muslims recognize that they are suffering, several barriers delay or prevent them from seeking professional help.
Taboo and Shame
Mental illness carries a heavy stigma in many Muslim communities. Key findings from the research:
- Loss of social status: A psychiatric diagnosis can reduce a person’s standing in the community.
- Family shame: The entire family may be embarrassed or blamed.
- Marriage prospects: Young people with mental health problems—or even a family history of them—may be seen as unsuitable marriage partners.
- Gossip (roddel): Fear that neighbors and extended family will talk negatively about the family.
- Hiding the patient: Research from Morocco found that families of schizophrenia patients were distrusted and mistreated by neighbors, leading them to keep the patient hidden inside the home.
Suicide: A Special Taboo
Suicide is particularly sensitive. It is criminalized in several Muslim-majority countries, and a suicide attempt can lead to legal prosecution. The Qur’an and Hadith contain strong prohibitions against taking one’s own life.
Practical advice for clinicians: Do not avoid discussing suicide. However, consider asking indirectly first: “Have you ever felt that you would rather be dead?” or “Do you ever wish that Allah would let you die?”
“Solve It Alone” Mentality
Many Muslims believe that problems should be solved within the family or by oneself. This cultural value, combined with the religious framing of mental illness as a personal test from Allah, can lead to passive coping—waiting patiently for relief rather than actively seeking help. This increases the risk of social isolation and delayed treatment.
Barriers to Mental Health Care Among Dutch Muslims (Summary)
| Barrier Type | Specific Example | Consequence |
|---|---|---|
| Cultural taboo | Family shame, fear of gossip, reduced marriage prospects | Delayed help-seeking, hiding patient at home |
| Religious framing | Mental illness as a test from Allah requiring patience | Passive coping, acceptance without action |
| Fear of judgment | Community will see patient as “weak” or “cursed” | Social isolation, loss of status |
| Practical barriers | Language barriers, unfamiliarity with Dutch healthcare system | Avoidance of mainstream services |
| Shame over suicide | Criminalization in home countries, religious prohibition | Silence, increased risk of completed suicide |
Source: Van de Beek et al., 2024; synthesizing multiple studies
Part 4: How Faith Provides Strength and Support
Despite the barriers, Islam is overwhelmingly a source of resilience for most practicing Muslims facing mental health challenges.
Research among young, highly educated Dutch Muslim women of Moroccan descent found:
- A strong sense of connection to Allah based on trust, not fear.
- Faith strengthens identity and provides stability during difficult times.
- Prayer (five times daily) offers structure and routine.
- Mosque attendance reduces social isolation.
“In our research, we saw that faith is experienced as a source of support even during mental health problems,” the authors write.
Practical ways faith helps recovery
- Daily prayers (salah): Provides structure, mindfulness, and multiple opportunities for calm reflection.
- Ramadan fasting: When medically feasible, fasting can increase spiritual connection and self-discipline. (Important: Discuss medication adjustments with patients who choose to fast.)
- Mosque community: Reduces loneliness and offers social support.
- Religious coping: Trusting Allah’s plan can reduce anxiety about the future.
The review encourages clinicians to explicitly ask patients how their faith might be used as a resource in treatment.
Part 5: Religious and Folk Healing Practices—Ruqya, Imams, and Amulets
When Muslims experience mental distress, their first step is often religious or folk healing, not a GP or psychiatrist.
Ruqya (recitation of Qur’anic verses)
This is the most common religious healing practice. It is part of formal Islamic teaching, recognized by imams, and involves reciting specific prayers and Qur’an verses over the afflicted person. Ruqya is considered legitimate and complementary to medical treatment.
Other folk practices (volksgeloof)
These are not part of formal Islamic doctrine but are widely practiced:
- Exorcism rituals (to drive out djinn)
- Veneration of saints
- Wearing amulets (containing Qur’anic verses or other symbols)
Sometimes these rituals are performed by traditional healers, often during visits to the patient’s country of origin. In some cases, family pressure—or outright coercion—leads the patient to consult such healers.
A word of caution
Most religious healers provide comfort and do no harm. However, the review notes that harmful practices and exploitation do occur in a minority of cases. Clinicians should:
- Ask openly about visits to religious healers (without judgment).
- Do not dismiss these practices outright—they often address different aspects of the patient’s distress.
- Consider collaboration with imams or Muslim spiritual caregivers, who can serve as bridges between the community and the mental health system.
Part 6: Practical Recommendations for Clinicians (And Anyone Helping a Muslim in Distress)
The authors conclude with clear, actionable advice for mental health professionals—but these principles apply to anyone supporting a Muslim friend, family member, or patient.
1. Acknowledge the role of faith explicitly
Do not assume that because a patient is Muslim, they are religious. But do ask. Most practicing Muslims consider their faith central to their identity and coping.
2. Use a semi-structured cultural interview tool
The Brief Cultural Interview (available in Dutch) asks open-ended questions about the patient’s background, beliefs, and explanatory model. Using such a tool strengthens the therapeutic alliance.
3. Ask about what happened before the consultation
Before coming to you, the patient may have tried to solve problems alone, endured suffering quietly, consulted an imam, or traveled abroad for traditional healing. Ask about this journey. Understand their expectations.
4. Accept combined explanations
Do not force a choice between “religious” and “medical.” Most patients use both. A treatment plan that integrates both is more likely to succeed.
5. Address taboo directly
Normalize the conversation about stigma, shame, and suicide. Use gentle, indirect wording if needed, but do not avoid the topic.
6. Involve spiritual resources when appropriate
- Encourage daily prayers as a structuring activity.
- Discuss Ramadan fasting and medication adjustments together.
- Consider inviting an imam or Muslim spiritual caregiver to co-create a treatment plan.
7. Stay curious, not judgmental
If a patient mentions djinn, black magic, or amulets, do not dismiss it as “superstition.” Explore what this belief means to them, how it affects their distress, and whether it can be integrated into a broader care plan.
Conclusion: Small Changes, Big Impact
Providing culturally and religiously sensitive mental health care to Dutch Muslims does not require a complete overhaul of psychiatric practice. It requires curiosity, openness, and a few simple conversation starters.
The key insight from Van de Beek and colleagues is this: For most practicing Muslims, faith is not separate from mental health—it is woven through every aspect of suffering, healing, and hope.
By asking about Allah, djinn, prayer, and community taboos, clinicians can transform a confusing or intimidating consultation into a partnership rooted in respect. And for the nearly 1 million Muslims in the Netherlands—many of whom already face higher risks of mental illness—that respectful partnership could be life-changing.
“It does not need to be complicated to provide appropriate care to Muslims in the Netherlands,” the authors write. Just have the conversation.
Reference: here
Other Articles:
