Holistic Healing: Islam’s Legacy of Mental Health
3 / 6
How Muslims Developed the First Psychiatric Hospitals in the World | Holistic Healing Series
The earliest presence of mental health hospitals can actually be traced back to 7th or 8th century Baghdad! Now, when people think about mental health institutions from the past, they often think of prison-like cells and abominable treatment. That was not the case in these early Muslim institutions. Join Dr. Rania Awaad as she describes the first homes of healing found throughout the Muslim world.
This series was brought to you in collaboration with the Stanford Muslim Mental Health Lab.
Transcript
This transcript was auto-generated using AI and may contain misspellings. Whenever I give a talk on the history of Islamic psychology, I always ask the audience if they know when the first mental health hospital was built in history and where. What's your guess? Usually, people guess somewhere between the 17th to 19th century, and the most common answer is usually Europe. What if I told you that actually the first psychiatric hospital was founded in the 8th century and some even say as early as the 7th century in Baghdad? That is a solid millennium before the most common answer that most people guess. Now, what image comes to your mind when I say psychiatric institutions of the past? Are you thinking patients in dehumanizing gowns strapped into electric chairs or locked away in cells somewhere? Guess again. Muslims became famous for humanistic medicine. So, if you had walked into a bimadistan or a dara shifa which literally is translated into the place of healing in the Muslim lands, you wouldn't find patients locked away in cells. Instead, you'd find yourself in the center of town because the Islamic emphasis of visiting the ill made hospitals built in the middle of town. They were not out of sight, out of mind, rather they were integrated into society. You would also find luscious gardens and beautiful fountains to help people keep calm when they were experiencing mental turbulence. You would also discover that upon discharge, patients were given monetary help to help them reintegrate back into society. So what's the story? When and how exactly did the first Muslim hospitals begin?
Although there were Muslim hospitals that preceded it, the first full-fledged hospital in the Muslim world was established in Baghdad in 803 by the Abbasid Caliph Harun Rashid. And the earliest evidence for institutional psychiatric care is a report of documents of psychiatric patients in the Fustat Hospital founded in Cairo in 872. From the 10th century onwards, hospitals sprung all throughout the Muslim world, from North Africa to Antolia. Major centers of Islam such as Damascus, Baghdad, and Cairo were all homes to prominent hospitals. They had specific treatments for psychiatric illnesses and even specialized wings for these treatments. Now, these treatments were diverse and many different types of medications were used, including compound drugs were created like stimulants, sedatives, and even suppressants. For example, they often referred to antidepressants as Mufarrah al-Nafs or the gladdener of spirit. And although physicians of these hospitals had access to these medications, they actually preferred to use them along with alternative holistic treatment methods in order to minimize side effects. There were also alternative treatments that were used, like auditory therapy, utilizing the Quran and musical natural tones like the sound of water or bird songs. They also gave patients regular baths and fed them healthy balanced diets. They used alternative treatments like bloodletting, cupping, massaging with oils, and also immersion in nature through the use of the gardens on site at these hospitals, and much, much more. Now in the treatments we're talking about, they paid special attention to the dignity and agency of the patients. Most patients were given their own quarters with storage space where they can accommodate their belongings.
And this was done in order to allow the patients to foster a sense of familiarity and comfort and to allow for privacy. We also know from historical sources that the mentally ill were very rarely obligated to check into hospitals for treatment. In fact, according to the Ottoman court records, it shows that judicial decisions only vary only occasionally were made to hospitalize individuals suffering from psychiatric illnesses. In other cases, even the severely mentally ill were able to refrain from being hospitalized if family members agreed to act as their guardians. In all cases, people with psychiatric illnesses were heard by the court and given the right to oppose the diagnosis of their severe mental illness. Their voices were recognized by the legal system, and their cases were evaluated individually with multiple community and institutional pathways provided for their well-being. Recent research has highlighted the impact of social support on all kinds of illnesses, particularly mental illness. And so it's amazing that more than a thousand years ago, the Muslim medical institutions knew this and acted upon it. For example, in order to encourage visitors, the hospitals were often built as part of the mosque complex called the Quliyya, which was located centrally in cities and designed to be reached by many. According to the Ottoman traveler, Evliya, both family members and members of the general public saw it as an Islamic social responsibility to visit people in hospitals and did so often. There are also numerous accounts of travelers who were able to observe and report the conditions of the mentally ill in these hospitals with great detail, which also demonstrates how accessible these hospitals were in reality. But as accessible as they were, the hospitals also strove to maintain a sense of safety
and security for the patients that were staying there. A doorman stood watch over each of the limited numbers of entrances and monitored who came in and out of the hospital. Windows in the patient rooms were actually faced inwards towards the hospital private courtyard and not to the main streets in order to ensure privacy. And the stewards were hired to watch over patient storage areas so they could feel safe to leave their belongings in their room. In addition, historians reported endowment records that emphasize personal characteristics like kindness for those who would be hired as the staff in these hospitals. It is clear that these hospitals were invested in with great detail into the sense of a patient's psychological well-being and safety. And probably the most forward-thinking practice that's related to the patient's material needs was observed by a medieval traveler, Rabbi Benjamin, who mentioned that when patients were discharged from these Islamic hospitals in Baghdad, Dar al-Mirastan, they received financial support for some time. And this was thought to lessen their stress and help them in order to transition back into the demands of everyday life. Taking care of the patient's material needs also included their dietary needs. For example, the Waqf Endowment Deed of Atik Valid Complex in Istanbul asked that the cooks ensure that the food was cooked so well and in such a way that it brought appetite to the patients. This excellent care for patients could also be witnessed through the architectural design of the hospital itself. For example, in choosing where the hospitals would be built, there was additional thinking about how accessible and secure these institutions would be.
Architects also considered things like the air quality and the proximity to natural water sources. Buildings were designed with a water drainage system in order to maintain the cleanliness and air quality that was constantly monitored. In the Mansouri Hospital in Cairo, there were giant fans called pankhas that were used for air circulation, and the floors were covered with branches of hinnah, pomegranate, and mastic to make makeshift medieval air fresheners. From an administrative perspective, these hospitals were impeccably organized. This was recognized by Muslims and non-Muslims alike. For example, the Muslim traveler Ibn Jubayr reported that the Nasri Hospital in Cairo and the Nur-e-Din Hospital in Damascus had mentally ill patients examined daily by staff. These examinations were in turn inspected by the ruler as a measure of quality control. And the well-known French traveler Jean-Baptiste Tavernier also mentioned exceptionally well-organized management of the Enindoun Hospital in Istanbul in his travel in his book published in 1675. He described a large staff working in the service of the ill, who had regular visits by two head physicians who came to the hospital every day at the same time for checkups. And he says in his account, a man cannot imagine a better place ordered and regulated than this. Much of the excellence described here was inspired by Islamic values, and as we've discussed in previous videos in this series, because seeking treatment for every disease and because providing the necessary services for those in need are core concepts encouraged in Islam, we find that sponsoring medical services was actually seen as highly prestigious.
The tradition of philanthropy in the form of waqf or charitable endowments for the sake of God was something that was really highly sought after, and it meant that these hospitals were generously supported by the sultans and the royal families and the bureaucrats in Islamic societies. And because there was such great financial support, it meant that there was free and high quality medical services provided for all. And interestingly, the strong emphasis on the dependence for Islamic values on these hospitals meant that they were open for Muslims and non-Muslims alike, irrespective of their creed or social status. The physicians in these hospitals looked after patients, but they also carried out research and trained the next generation of practitioners, whether they be Muslim or not. Now, this is in contrast to Byzantine hospitals, for example, that were always under the direct control of the clerics. Something that we hear often from Western institutions and knowledge sources is that before Europe and before the Age of Enlightenment, there was nothing. That the world was simply dark and that humanity was in the dark ages. But here you can see that this is simply not the case. Nearly a millennium before the humane treatment of the mentally ill even reached Europe, you had Muslims who were exercising and practicing holistic therapy in their hospitals that emphasize patients' agency, social inclusion, and their social economic needs. So, the next time you hear or read about the dark ages, challenge yourself to think critically about where this knowledge is coming from and why. It may be that they have neglected to mention at all any of the things that we discussed here today. It may be that it was the dark ages in Europe, but it was certainly bright in the Muslim world.
It's time that we shine a light on our own rich Islamic intellectual history and take pride in our heritage and legacy as it relates to mental health. والحمد لله رب العالمين
Welcome back!
Bookmark content
Download resources easily
Manage your donations
Track your spiritual growth
1 items
1 items
1 items
25 items
50 items
9 items
