“I will keep [the sick] from harm and injustice(1).” Thus we are taught in medical school as we recite the Hippocratic Oath. The reality is though, in many situations, we break the oath and are unjust. We are already aware that some doctors display some forms of inequality towards their patients on the basis of socioeconomic and ethical factors (2-3). But I would like to describe here another type of discrimination, especially coming from an Arabic society where this is common: the discrimination against individuals with mental health problems.
We, the medical community, discriminate against psychiatric patients through the fact that fewer medical students choose to go into psychiatry. Although there are no reliable statistics from the Middle East about this topic, it is an international issue, as backed up by statistics from the USA and the UK (4-6). However, to relate to my community and from many personal experiences, whenever I mention my interest in psychiatry as a field, people always show their amazement at what they just heard. One of my relatives mentioned to me that I should not go into psychiatry because, as the prophet Mohammed said in the Islamic Religion: “He who has lived with a community for 40 days becomes one of them”. And even though this saying, religiously speaking, pertains to allegiance in the times of war, that person implied that if I, God Forbid, choose to treat people with mental health problems, I will develop one myself. These points of view about mental health are not unheard of in the Arabic community.
When looking at Middle Eastern societies, we discriminate against psychiatric patients in two ways: First, people with mental health problems and their families are scared of admitting that there is a mental problem, and second they are often reticent to seek professional help about that problem. To this day, many people who have mental diseases would rather rely on traditional remedies, where presumed people of religion are sought to banish the demons, magic, or evil eyes within the individual, often through practices that are harmful such as physical trauma to the patients (to exorcise evil Djin).
Relieving the stigma and disparity associated with mental health problems should be something to work on, at least to honour the Hippocratic Oath we swear to in medical school. Fortunately, we can see the beginning of change, especially in Middle Eastern societies where it is becoming common that you see psychiatrists in the public media urging the people who suspect mental illness to refer to professionals for help. However, there is still work to be done. We should develop a better understanding of the mental health problems, by having more interest within the medical community, and further increase our efforts of public awareness that a patient with bipolar disorder needs sympathy and help, much like a patient who is infected with an influenza virus.
Ahmad H Adi is a 5th year medical student at Alfaisal University, Riyadh, Saudi Arabia. He aspires to have a global view on medicine, which is why he travels a lot to experience different health care systems, with a particular interest in the neurosciences and mental health. Ahmad has worked with many student organizations, notably the International Federation of Medical Students’ Associations (IFMSA).
- Tyson P. The Hippocratic Oath Today. Nova Beta. 2001. http://www.pbs.org/wgbh/nova/body/hippocratic-oath-today.html. (Accessed Sept,16, 2012)
- Graham, J. A Chicago Doctor Talks about Racism in Medicine. Triage, Chicago Tribune. 2008. http://newsblogs.chicagotribune.com/triage/2008/07/a-chicago-docto.html. (Accessed Sept,16, 2012)
- Subtle Racism in Medicine. Unknown Author. The New York Times Health. 2002. http://www.nytimes.com/2002/03/22/opinion/subtle-racism-in-medicine.html. (Accessed Sept,16, 2012)
- Fewer US Med Students Choose Psychiatry: Report. Unknown Author. Health Day News. 2012. http://health.usnews.com/health-news/news/articles/2012/03/30/fewer-us-m.... (Accessed Sept,16, 2012)
- Gray, A. Stigma in Psychiatry. Journal of the Royal Society in Medicine. 2002. 95:72-76 [Electronic Version]
- Stanley, C. Overcoming Psychiatry’s Stigma: Taking Pride in Healing the Mind. The New Physician. 2004. 53:8 [Electronic Version]