Events

NOTE: This month’s Ethics For Lunch will be held virtually.

Join us online here.

Case

MN, a 24-year-old graduate student, was found disoriented in his apartment by his roommate and brought to the Emergency Department (ED). Originally from a Middle Eastern country, MN has been in the U.S. for the past three years pursuing advanced studies. He was known to be a high achiever and active in the local Muslim student community. Before this event, friends observed social withdrawal, peculiar behaviors such as muttering about being watched, and complaints of stress linked to perceived sabotage at school.

His family was contacted after he went to the ED, and both of his parents traveled to the U.S. to support him. Despite the medical team’s recommendations for psychiatric admission, MN’s parents expressed discomfort with the psychiatric admission. At the time he did not pose an imminent risk to self or others, and he agreed with the discharge. The ED psychiatric team prescribed antipsychotic medications and set up outpatient appointments. On two more occasions, MN was brought to the ED for evaluation and on both occasions, he was discharged without admission. During this time, his parents were not too keen on MN continuing with the prescribed medications, due to concerns about safety and side effects, and instead encouraged him to seek alternative treatments, including prayer. Also, during this time, MN’s parents arranged for a visit to a spiritual healer who performed ruqya (recitation of Quranic verses for healing), which brought the family some reassurance without any significant improvement in his symptoms. The spiritual healer did not recommend seeking further mental health treatment, which delayed psychiatric intervention.

Following another episode of acute psychosis, marked by paranoia and disorganized behaviors, the patient and family agreed to psychiatric hospitalization. Throughout the course of care, the family placed significant emphasis on finding an underlying medical or neurological cause. They repeatedly requested additional imaging and blood tests, despite prior evaluations being unremarkable. Although he never lacked decision making capacity, MN often deferred to his parents for his medical decisions and remained compliant with their wishes for his care.  MN was diagnosed with schizophrenia. Antipsychotic medications were restarted. The medical team held regular family meetings to educate the family about their son’s diagnosis, the importance of medications in treating psychotic illnesses, the impact of delaying treatment on his prognosis, and ways the family could support their son after discharge.  The family informed the team of their belief that returning MN to their home country would benefit his mental health and expressed plans to travel back home immediately following his discharge. He was transitioned to long-acting injectable antipsychotics given his history of poor adherence to oral medications.

Questions

• What demographic, cultural, and religious factors influence the mental health of Muslim patients?
• How do Imams and spiritual leaders contribute to addressing the mental health needs of the Muslim community?
• What strategies could healthcare providers use to navigate stigma when addressing psychiatric diagnoses with Muslim families?
• How can clinicians balance respect for spiritual beliefs while advocating for evidence-based treatments?
• How do families and parents influence medical decision-making for young adults, and how can providers balance respect for autonomy with respect for cultural norms?
• What role should chaplains play in coordinating care for patients with strong religious/cultural influences?

Learning Goals and Objectives

• Explore demographic, cultural, and religious factors influencing the mental health of Muslim patients.
• Explore how stigma impacts help-seeking behaviors and treatment adherence in the Muslim community.
• Identify approaches to build trust in navigating perceptions of explanatory mechanisms of illnesses.
• Discuss the importance of involving spiritual care providers in healthcare to provide holistic care.
• Examine the tension between respecting cultural/religious preferences and ensuring evidence-based psychiatric care.