Religion and Spirituality in Psychiatry

342 Elizabeth S. Bowman3.2.11. African Psychiatric Training: MalawiBritish psychiatrist Herzig (62) visited Malawias a missionary in the 1990s to find himself theonly psychiatrist in the country and the only psychiatrichospital staffed primarily by nurses andorderlies. He opined that specialist psychiatriceducation was a luxury beyond the means of thepoorest countries where clinical services are tooinadequate to provide experience for trainees.Malawi’s situation rendered Western psychiatriccurricula unusable. Most mental and behavioralproblems are treated by traditional healers, withthe most disturbed patients being brought to thehospital or left untreated. Herzig recommendedMalawi’s College of Medicine approach offocusing on teaching medical students to treatcommon mental illnesses in outpatient primaryhealth-care clinics and on supervising and trainingpsychiatric nurses to provide mental healthcare in hospitals and in rural clinics. Herzig’s(62) only reference to religion-spirituality intraining was to recommend medical students betaught to consider “local cultural explanationsfor abnormal behavior such as bewitchmentand spirit possession.” No information on psychologicaltraining in impoverished Malawi isavailable.3.2.12. African Mental Health Training:MoroccoMohit (63) reports Morocco’s World HealthOrganization (WHO) Collaborating Centre inCasablanca conducts psychiatric research and wasactive in collaborating with WPA-WFME in thedevelopment of the medical student core curriculumfor psychiatry. (1) Morocco contains morethan 2000 psychiatric beds and offers psychiatrictraining in Casablanca and Rabat. Psychiatricnursing courses are also available. No informationis available about religion- spirituality educationin training in Morocco.3.2.13. Psychiatric and Psychological Trainingin the Middle EastThe vast Middle East, stretching from northernIndia to northern Africa, contains a richarray of religions. Its ancient cultures spawnedZoroastrianism, Judaism, Christianity, and Islam.After the rise of Islam in the sixth century CE,medicine and mental health treatment flourished.Currently, psychiatric education in many middleeast countries occurs in conjunction with theWHO and WFME. Numerous Muslim-associatedmental health groups exist in the Middle East.The Muslim Mental Health Association (64)publishes the Journal of Muslim Mental Health .The MMHA web site ( http://www.muslimmentalhealth.com/index.php?option=com_weblinks&Itemid=14 ) features links to nineteenrelated Muslim mental health groups worldwide,including the International Associationof Muslim Psychologists and the World IslamicAssociation for Mental Health. (65) The ArabBoard of Psychiatry offers certification of psychiatristsin a number of Middle Eastern countries.Very little, if any, information is availableon education in religion-spirituality in most ofthese predominantly Muslim countries, so thischapter discusses mental health training.3.2.14. EgyptEgypt has approximately 9000 psychiatric bedsand 500 to 1000 psychiatrists. (66) Psychiatrictraining is offered in major medical schools andcertification is given through national examinationand the Arab Board of Psychiatry. TheInstitute of Psychiatry at Ain Shams University,a WHO Collaborating Centre, offers trainingin child psychiatry. Egyptian training is availablein psychiatric nursing and clinical psychology.No information is available on teachingreligion- spirituality to Egyptian psychiatrists orpsychologists.3.2.15. IranThe Islamic Republic of Iran has 9200 psychiatricbeds, about 1000 psychiatrists, 350 mastersand doctoral level psychologists, and morethan 50 psychiatric nurses. (63) Currently, tenuniversities offer specialty training in psychiatry,and several centers offer subspecializationin child psychiatry. Psychiatric certification isgranted through the Iranian Board of Psychiatry.Iran also offers doctoral and masters degrees in