Let’s Not Medicalise Misery?


Sarah Waseem, UK

As we move through 2021 things are beginning to look more hopeful. The Covid19 pandemic which has wreaked havoc on our global economies and our health, has a new challenger – vaccines. They should, God Willing, limit the dreadful impact that the pandemic has had on the world.

Right now, many hospitals are at breaking point with capacity issues and burnt-out staff. Added to that, we have been warned of an increase in mental health problems. According to Dr Adrian James, the president of the Royal College of Psychiatrists, the pandemic will impact our mental health long after the virus is under control. “It is probably the biggest hit to mental health since the second world war.” [1]

The figures from the Centre for Mental health, suggest that nationally, in England, up to 10 million people (almost 20% of the population) will need either new or additional mental health support as a direct consequence of the crisis. 1.5 million of those will be children and young people under 18.

Those of us working in mental health services will not be surprised at these figures. There is emerging evidence that following recovery from Covid19, some are left with residual fatigue and other symptoms, now termed ‘Long Covid.’  The restrictions imposed by the pandemic has meant that many have been left dealing with complex grief reactions following the death of loved ones. Those who have been hospitalised for long periods of time, especially on ventilators may struggle with symptoms of post traumatic distress.  And then of course, there has been the impact on health care staff who have witnessed death in numbers that would probably have far exceeded their experience in a lifetime of health care. Apart from PTSD, there are concerns that some health staff may suffer from moral injury – the distress that results from actions or the lack of actions that violate someone’s moral or ethical code.

However, to just focus on the mental health issues being presented to us, is short sighted. We cannot resort to therapy alone in many cases to alleviate suffering, for that implies that the whole solution lies with the sufferer. We must instead also look beyond at the roots of this. We must not medicalise misery.

The Build Back Fairer: The Covid19 Marmot review (2020) [2] demonstrates how pre-existing health inequalities in the UK exacerbated the impact of the pandemic, particularly for deprived populations.

‘Even prior to the pandemic and the first lockdown, the UK ranked poorly in child wellbeing. UNICEF Report Card 16 ranks children in 38 rich (OECD and EU) countries using three measures: mental wellbeing, physical health and academic and social skills. The UK ranks 27th out of 38’. [3]

‘Rates of child poverty increased between 2010 and 2020, with greatest increases for families with an adult in work. Even before the pandemic, increasing numbers of children were living in temporary accommodation, and this is set to increase as poverty rises and housing costs remain high.’ [4]

© Tressie Davis | Shutterstock

Stresses related to deteriorating family finances, poverty, larger family size and overcrowded households have impacted on parents’ capacity to support their young children during lockdowns. [5]

We know that from March 2021, unemployment is projected to increase significantly as the government withdraws its financial support to businesses. This will result in greater poverty and deprivation. Figures from the Trussell Trust which has a network of food banks show that 1.2 million emergency parcels were handed out by Trussell Trust foodbanks in the six months to September, with more than 470,000 of the parcels going to children.

With these figures, it is little wonder that many will be experiencing an increase in mental health problems. We need therefore examine our values as a society and plan as to how we are going to take care of those less fortunate than ourselves.

Research also indicates that debt and financial strain are certainly associated with depression and anxiety, and increasingly the evidence is suggestive of a causal association. [6]

Islam reminds us that we have 2 responsibilities – our duties to Allah and our duties to our fellow beings.

Quoting verse 7-18 of Surah Balad in the Holy Qur’an [7], Hazrat Khalifatul Masih II (ra) reminds us,

‘The last part of the verse asks why ‘a poor man lying in the dust’ was not fed. The Arabic expression dha-matrabah, or ‘lying in the dust’, in this verse implies the kind of extreme poverty that reduces one to near non-existence. Persistent destitution can deprive one of even the ability and energy to raise a voice. ……. God expects us to have such sympathy and love that we must seek out the helpless poor who do not even have the capacity to protest and beg at someone’s door. Such a person is not a member of a ‘trade union’ of beggars; his lips remain sealed even though his stomach may be empty; he remains hidden away in sickness and grief; he is friendless with no hope or energy left’. [8]

That sentiment is echoed in the conclusion of  Build Back Fairer: The COVID-19 Marmot Review: [9]

‘The evidence suggests that poverty leads to poor choices, not poor choices to poverty. For example, we have cited data from the Food Foundation that households in England in the bottom 10 percent of household income would need to spend 74 percent of household income on food were they to follow official healthy eating advice. We repeat: the problem is not poor ‘choices’; the problem is poverty. During the pandemic this has become even more clear. Frontline workers were at high risk because they were doing essential work. People did not feed their children well not because they were spending money on the wrong things, or because they hadn’t taken cooking classes, but because they lost their jobs. The rhetoric of the “undeserving poor” as justification for harmful social policies should have no place in Building Back Fairer’.


Speaking as a clinical psychologist, I know that we change lives. But we cannot do this in a vacuum. We cannot expect hungry children to concentrate in school and then label them as having learning difficulties when they do not. We cannot expect to treat hopelessness or anxiety over ones’s ability to provide for their family when as a society we do not provide jobs or training to help people out of their desperation.

According to Hazrat Mirza Bashir ud Din Mahmood Ahmad (ra), the second Khalifa of the Ahmadiyya Community,

“Islam expects the rich to reach out to such hopeless poor and strive to heal their bruised hearts. Islam expects the rich to achieve such heights of moral advancement that, after doing everything in their power in the service of the poor, they do not regard themselves as superior for being charitable. Instead, Islam expects the rich to remain humble before God and constantly prod their hearts to ascertain if they have truly fulfilled their duty towards the poor. The rich must not remind the poor of their help, nor should they consider it as a favour to the recipient. Rather, they should constantly engage in self-examination if they have fulfilled their God-given obligations.” [10]

God Willing, as we move out of this pandemic, we must invest in mental health services and also in the support systems around these. We must remember that the causes of mental ill-health can also be connected to our social circumstances. We must reach out and help those around us who cannot help themselves, for this is how we create compassion in our society.

About the Author: Dr Sarah Waseem is a Clinical Psychologist with over 25 years experience in the NHS in both Primary Care and Secondary Care Settings. She is currently working in Women’s Health at an NHS London Hospital. She has also served as a senior editorial board member for the The Review of Religions for over 20 years.



[2] The Build Back Fairer: The Covid19 Marmot review (2020)

[3] Ibid pg 23

[4] Ibid pg 29

[5] Ibid pg 24) 


[7] The Holy Qur’an with English translation and commentary: ISLAM INTERNATIONAL PUBLICATIONS LIMITED

[8] Economic System of Islam

[9] The Build Back Fairer: The Covid19 Marmot review (2020)

[10] Economic System of Islam