Abstract
Little is known about how clinicians make sense of Muslim religious beliefs when the client may have psychotic symptoms. Limited literature suggests that psychiatrists draw on a Western empiricist epistemology and implicit cultural norms in utilising the DSM’s diagnostic criteria. Concerns have been raised that practitioners can overlook religious beliefs and pathologise religious beliefs from non-Western cultures. No research has specifically explored psychiatrists’ understanding of religious beliefs. This research aimed to explore how psychiatrists understand Islamic religious beliefs when assessing clients referred with possible psychotic symptoms. It also hoped to explore how they understand the impact of their views on subsequent assessment decisions. Interviews were conducted with five psychiatrists and analysed using Interpretative Phenomenological Analysis. In contrast to expectations, the participants did not view their understanding of religious beliefs as central to their assessment decisions. Service pressures and psychiatrists’ sense of accountability for clients appeared to inform the emphasis of psychiatric assessments; risk assessments and case management decisions were prioritised above all else. This appeared to limit the participants’ opportunity to engage with clients’ religious beliefs, to fully understand their presentations or to make fluid assessment decisions they felt were often appropriate. Participants also demonstrated a more intricate, nuanced understanding of religious beliefs than previous literature has suggested. In keeping with best practice guidelines participants viewed religious beliefs as a normal manifestation of a person’s culture and existing on a continuum. The participants showed an awareness of the impact of their cultural position on their understanding of religious beliefs. However, their understanding remains embedded within a psychiatric framework informed by the secular, empirical, bio-medical paradigm of the DSM. This provides an important insight into some of the barriers between mental health services and Muslim clients who present with religious beliefs.