Mental Health and Clinical Psychology in UAE

1. Mental Health and Clinical Psychology in UAE Amber Haque Department of Psychology UAE University Email: amberhaque@yahoo.Com Webpage: uaeu.Academia.Edu/amberhaque

2. What I want to talk about • Indigenous beliefs and practices • Dualistic nature, the Fitrah, mental illness as spiritual disease, implications for clinical psych • Influence of Arab ancestors • Psychological services, programs and mental health laws • Challenges and opportunities • Possible solutions

3. Regional and Country Maps

4. The UAE • A small (oil rich) country in SE Arab Peninsula; per capita income $48,500 (2011), unemployment 2.3%. • Demographics: 5.5 million, 12% local (Arabs), 23% other Arabs/Iranians, 55% Indo-Pak, 10% Westerners/East Asians. 70% males. • Dubai popular for its real estate, financial investments, shipping and tourism industries. • Modern country, high standard of living, highly tolerant, great emphasis on education and entrepreneurialism

5. Concepts of Human Nature • Dualistic nature (body, perishable) and (soul, permanent). Their ongoing interactions reflect in the form of behaviors. • Behaviors are a result of material and non-material forces that are in control of human consciousness. • The body craves for physical pleasure but the soul invites man to strike a balance in his/her personality. • Observable? Certainly not! • A lot is based on metaphysics and morality

6. …cont’d • It is the knowledge and qualities of soul combined with good moral character that determine the quality of mental health. • Human soul is divided into three parts: • Ruh(spirit): God-like qualities breathed into man by God Himself • Qalb (heart): Cognitive faculties and seat of volition, intention and wisdom—the healthy (awareness), dead (denial) and sick heart! • Aql (reasoning): the ability of using and exercising free will • Soul is “king of the body” and organs its “servants”! • Soul functions at three levels: • NafsAmmarah(animal soul) • NafsLawwamah(rational soul) • NafsMutmainnah(peaceful soul) • A constant struggle and interplay eventually determine the psychological and spiritual condition of the person.

7. The Concept of Fitrah • Disposition, nature, or instinct, also refers to intuition or insight. • All humans are born with inclination to acknowledge the Creator and follow His commandments. • This disposition is centered in the soul and is the source of right and wrong. • The concept is theological and one cannot separate religion from everyday life including mental health. Everything boils down to S-R (spirituality and religion)! Skinner would be turning in his grave!! • If one follows fitrah, there are none or minimal conflicts in life and one is capable of facing the challenges; deviation from original positive nature creates illnesses. • Following fitrah is to know one’s primordial nature and follow divine laws as other creations follow. Humans are given intelligence and freewill and it is up to them how they use it.

8. Mental Illness as Spiritual Disease • Detachment from God increases the likelihood of difficulties • Person of weak faith may not appreciate the stressors in life and/or is affected by the various challenges • The role of whisperings of the soul (Satan), effects of magic, evil eye, possession by the Jinn. • Also tests and trials, expiation for one’s sins, increase in rewards (hereafter), etc.

9. …cont’d • Approaches to Mental Health • Two Pronged Preventive Approach • Developing Positive Qualities • Faith, repentance, patience, gratitude and contentment • Avoiding Negative Qualities • Extravagance, envy or jealousy, passionate bodily desires, pride, temptation, corruption, anger, etc. • External (doing good) and Internal (sound beliefs) virtues are necessary for attaining happiness and well-being • Biological bases: One can see a doctor for treatment but it will not cure the problem if it is spiritual-based • Scientific development is successive and cumulative effort leading towards discovering the “Laws of God” and science can be flawed if not based on faith. • Experimental studies prove these approaches work for Arab clients

10. Influence of Arab Scholars

11. Influence of Arab Scholars

12. Psychology in the UAE • Established at UAE University in 1973 (FOE, FHSS), MSc in Clinical Psych 2011. • EPA established in 2003 by Ministry of Social Affairs • Membership, philosophical statements, bylaws, restricted to “locals” • Developing Interest: • Until 2007, 78 articles from UAE were published (Psych INFO) • 11 major psychology conferences since 2003 (University or association based) • “UAE Psychologist” (2011) highlights what psychologists do • 1st Issue 15 pages, 2nd 44 pages.

13. Psychological Services & Programs • Government hospitals hire PhDs, masters and bachelor’s level psychologists trained in mainstream psychology • Many private hospitals, NGOs and clinics hire psychologists—based mostly in Dubai • Involvement of WHO and the WFMH • New degree programs in Universities • UAEU, British, American (NYU), and Australian Universities. Close to 100 universities in UAE!

14. Mental Health Laws • United law No. 28 (1972) covered aspects of mental illness and ways to treat without reference to local beliefs: emphasis was on patients rights on voluntary and involuntary admissions • 2011: Set of mental health laws based on both Secular and Shariah laws was submitted to the Federal Government. • In Shariah law there is no formal distinction between legal and moral duties • Shariah law on patient privileges, confidentiality, doctor-patient relationships, insanity defense, involuntary hospitalization and treatment, mental competencies, family laws, child abuse and witness, malpractice, etc. • Ministry of Health created special divisions for licensing laws (HAAD, DHA). • Senior Clinical Psychologist must have PhD/PsyD and current license in original country • Experience required is 4 years for expats and 2 years for nationals • HAAD and DHA have slightly different regulations for the practice of psychology

15. Current challenges • Resistance to change and bureaucracy • Bilingual issue (First language is Arabic) • Image of the discipline and competence of psychologists (those with minimal training or no license) • Lack of standardized tests, the use of DSM (IV-TR), lack of published research • Lack of knowledge of indigenous beliefs and practices (affects psych assessment and therapeutic outcome)

16. Recommendations/Possible Solutions • Integrating indigenous psychology in the curriculum • Enhancing the current image of psychology • Training and skills development in existing psychologists (ongoing workshops, diplomas, CE credits, postgraduate programs, professional regulation and licensing) • International cooperation in program development (University collaboration, WFMH, other professional org.) • Use of bilingual programs and standardization of tests • Openness to research and publication

17. Promoting Psychology in the UAE

18. References • Ahmed, S and Amer, M (Eds.) (2012). Counseling Muslims. Handbook of mental health issues and interventions. Pp. 396. Routledge Publishers. • Attas, S.N. (1990). The nature of man and psychology of the human soul. Kuala Lumpur: International Institute of Islamic Thought. • Chlaeby, K. (2001). Forensic Psychiatry in Islamic Jurisprudence. VA: International Institute of Islamic Thought. • Dwairy, M (2006). Counseling and psychotherapy with Arabs. Teachers College: Columbia University Press. • Haque, A. (2010). Mental health concepts in Southeast Asia: Diagnostic considerations and treatment implications. Psychology, Health, and Medicine. 15,2,127-134. • Haque, A. and Mohammad, Y. (Eds.) (2009). Psychology of Personality: Islamic Perspectives. Cengage Learning.

19. Thank You!