Sikhism is no different

In many Eastern countries mental health is a taboo and in the Punjab where Sikhism is prevalent, it is no different. As a member of the Sikh community and a psychology graduate, I have found mental health issues are brushed under the carpet and are not openly spoken about within the Sikh community, as well as other religions. However the younger members are becoming more open about mental illness. This begs the question is it a cultural or religious taboo.

Sikhism is a faith of One God, Ten Sikh Guru’s and the Holy Guru Granth Sahib Ji (GGSJ). Sikhs believe in Karma, and hence believe any tragedies or ill health is seen to be a result of bad karma in either this lifetime or a previous one. Seva (services to others) is also a key component of Sikhism as well as living a moral and ethical life is a key belief in Sikhism.

Culturally Sikhism is just like Hinduism and Islam, mental health is a taboo and there is a very evident discrimination against mental health.  Families will conceal any one in their family with a mental illness or neurological defect (if possible). This idea of ‘family honour’ is a major issue amongst South Asians. The opinions of others is cast with very high importance, and it seems having a mental illness brings embarrassment to the family name, taints it and can leave the individual unlikely to marry due to its social impact.

Mental illness is not seen as an issue the GP can fix, it’s more of supernatural/spiritual issue. ‘Nazar’ (evil eye) is another major issue found amongst the south Asian community. The notion is someone has cast the ‘evil eye’ on you and your family. This belief of people casting an ‘evil eye’ as being the cause of an individual’s ill fate in life, is a phenomena which health care professional should take into consideration. Taking on board the cultural belief of the patient, and incorporating it in treatment plans, can help patients understand their diagnosis and be more acceptance to treatment.

Sikh’s believe in equality amongst human beings;

‘’ No one is Hindu or Muslim, all are children of God, so are equal’

(Guru Nanak Dev. Ji [8])

Here Guru Nanak Dev. Ji lays out the fundamental foundation of ‘’human rights for all of humanity’’ [8]. However, we do see hidden discrimination toward the ‘different’ and hence the individuals are cast out of the Sikh community.

However, Guru Nanak Dev. Ji, taught us to give up: pride and Haumai (ego) and to become humble. Guru Nanak Dev. Ji outlined Haumai is the greatest disease of humanity and that most of the global conflicts and the mental health epidemic is due to Haumai and pride. Guru Nanak Dev. Ji stated if we control our pride and Haumai, we can directly improve the mental health of the both the individual and the community [8].

It is this pride (self and family) being driven by egos, which is causing this taboo in mental health. If we let go of our ego’s and dismiss our own/family pride, we would be more acceptance of issues such as mental health. This removal of pride and ego, will not only benefit the individual but also the community for the long term. Also a global cultural change in attitudes towards mental health can occur, without the presence of negativity, judgement and discrimination.

From personal experience, working in the mental health sector, I have come to realise, there is an unspoken community of Sikhs suffering from mental illnesses such as; Depression, Anxiety, and Panic Attacks etc. Many of the individuals fail to recognise they have a mental health problem, and others put it down to a bi-product of their other medical illness; or medication. This was worrying for me, as a large population in the UK of Sikh individuals are dealing with an un-diagnosed/treated mental health issue.

This got me thinking:

‘’ How best can we support the mentally ill in a Sikh community who deny any problem’’?

•        Using a culturally based model of counselling

•        Respecting the daily routine of the individual

•        Respecting the 5 K’s

•        Support the family

Using a culturally based model of counselling

An abstract from the article written by Dr. Kala Singh (Singh, 2007):

‘’With the continuing migration of a large number of South Asians, especially the Sikhs, to Western countries, mental health professionals should be aware of their clients’ world-view and cultural/religious specific models of counselling. Use of Sikh spirituality can reduce stress; help in treating psychosomatic disorders; and improve mental health of the individual and of the community. [6]

Figure 1 Sikh Spiritual Model of Counselling [3]

Mental Health professionals should aim to use cultural specific models of counselling, to better support the individual. Understanding the Sikh religion/culture, will assist in implementing treatment plans more effectively. Also the individual is more likely to accept the diagnosis, treatment and speak about it more openly, as it’s within their religious understanding.

Dr Singh outlined mental health professionals should be self-aware of their own beliefs and values, to understand the perspective of all human beings based on different cultures. Then form this information plan and implement an appropriate intervention tailored for the individual [6].

This model is not just aimed at Sikhs, it is universal and can be used by other religions such as Hinduism and Christianity.The model is adaptable to people, situations and beliefs, which means the model can be used in conjunction with western beliefs as well as eastern beliefs, supporting those with conflicted views [1].

Respecting the daily routine of the individual

Individuals whom suffer from mental health issues, their family feel excluded from daily prayers and family occasions. However using the Sikh Spiritual Model of Counselling, prayer and medication adherence is encouraged, to help provide both spiritual, physical and medical support [1].

Respecting the 5 K’s

Baptised Sikhs and/or un-baptised Sikhs, whom are suffering from a mental illness, should maintain belief in the 5 K’s. This involves Kesh (refrain from cutting your hair), wearing the Kirpan (holy dagger), Kara (silver bangle), Keshara (shorts) and kanga (comb). The UK Sikh Healthcare chaplaincy group have special circumstances regarding the Kirpan, considering the situation. Ensuring all the 5 k’s beliefs are maintained can ensure the sanctity of a Sikh is not broken during this time [1].

Support for the family

Sikhs live and have very close families. Even though one individual is suffering from the mental illness, the reality is this is seen to have detrimental effects on the parents, partners, and siblings. It is imperative that immediate family are fully supported as well, so they are able to provide a strong network to help recovery of the individual and providing them with all the knowledge surrounding the condition [1].

More and more individuals from the South Asian communities are speaking up and raising awareness of mental health. Individuals across the globe have stood up against the discrimination and hush-hush nature of mental health and voiced their experiences. Many people are using their social platforms to dis-courage this stigma and encourage people talk about it and deal with the issue together, educating the next generation of Sikhs

So, living as a British Sikh, born I have a conflict between my western upbringing and the Sikh culture. For me I do not let my religious or cultural views impact my thought about mental health. But this doesn’t mean I escape the prejudice and discrimination in my family life.

Be it cultural or religious the future of South Asian Mental Health doesn’t look bleak. Through focussing on the individual’s religion and using this as the driving mechanism for treatment, mental health will be recognised and treated more effectively in these communities.

’if the human race is free from caste, creed, colour, religion and gender, there is equality amongst all human beings. If ego, pride and Haumai is removed, may mental health problems may be prevented’

(Dr Kala Singh {Guru Nanak Dev. Ji teachings] [7])

References

[1]Chaplaincy), S. S. (2016). Guidance note on dealing with mental health issues and Sikh patients Dealing with mental health issues: Perspectives in Sikhism. Retrieved from UK Sikh Healthcare Chaplaincy Group: http://www.sikhchaplaincy.org.uk/~sikhchap/images/publications/guidance_note_on_dealing_with_mental_health_issues_and_sikh_patients.pdf

[2]Guide, S. (2007-2015). Sikhism Guide. Retrieved from Basic beliefs of Sikhism: Introduction to Sikhism

[3]Jodha. (2009). Sikh Spiritual Model of Counselling. Retrieved from Sikhnet: http://www.sikhnet.com/news/sikh-spiritual-model-counseling

[4]SikhNet. (2009). Introduction to Sikhism. Retrieved from SikkNet Sharing the Sikh Experience: http://www.sikhchaplaincy.org.uk/~sikhchap/images/publications/guidance_note_on_dealing_with_mental_health_issues_and_sikh_patients.pdf

[5]Singh, D. (2005). Sikh Religion and its values in Mental Health.

[6]Singh, D. (2007). The Sikh Spiritual model of counselling. Spirituality and Health International, 9(1), 32-43.

[7]Singh, D. (2015). Mental Health Teachings of Guru Granth Sahib Ji. Asian Journal.

[8]Singh, D. (2015). Teachings of Guru Nanak Dev. Ji and Mental Health. Asian Journal.

[9]Singh, D. (2016). Mental Health and Waisakhi. Asian Journal.

I don’t want to go home

“I can’t believe it I finally have overnight leave!! Gosh!! Oh my days!! This is a closer step towards discharge, because next will be two overnight leaves, than discharge……

I need to speak to the consultant I don’t want my overnight leave to be at my parents house any more, I want to go back to my supported living my own flat… last time I went home my dad picked me up with my mum and I cried all the way in the car journey……my dad was shouting at me saying this wouldn’t have happened if I would have stayed at home with them……my dad doesn’t understand that I moved out to get better, not party, smoke, drink and have sex…….

My dad emotionally abuses my mum who also isn’t mentally well herself…. she tries but she can’t stand up for me as my dad puts her down…

I don’t want to go back home…………..’’

Anonymous

Mental health is in its infancy in today’s society, perception and understanding towards it is still cautious. However treatment is available in abundance but access to resources fails the right people gaining the most out of the treatment. South Asian communities feel, not following parents rules, rituals and beliefs can lead to an ill-fated mental health diagnosis. Seeking help for this unknown territory is hard, often ignored and cases of abuse; emotional, physical, financial or neglect, occur due to lack of understanding

Many individuals up and down the country are in a similar situation to this person’s. For so long they have waited for the moment they receive positive news from the hospital, knowing that this is a step closer to discharge. However this positive step towards getting better comes at a great cost for some. Once out the hospital and back in the care of loved ones, they feel isolated and trapped. Loved ones fail to understand and recognise their mental health and blame the individual for the way they are.

Advice for anyone who can relate the above situation is stay positive, allow yourself to be happy that you are recovering. It’s not always easy to ignore what your loved ones saying but try and realise they may not understand. Help them understand sit down and speak to them, show them literature which can explain the mental illness, show them how you have recovered. Most of all like the individual in the statement above, recognise yourself that the situation your in is not the best for you, that it could set you back, realise you need to have distance to recover.

Everyone needs to stand up and speak up. Individuals like the one above need to be positive feel overjoyed and elated that they are doing well, but reality shows the opposite.

Let’s work together to help not only mental health sufferers but their families too.