Veiled communication: is uncovering necessary for psychiatric assessment?

Facial expressions are significant to decipher information during a dialogue and more so in a clinical consultation. Veils (Niqab) worn by Muslim women may pose a clinical dilemma for the psychiatric assessment especially if clinicians are not aware of their religious significance. To investigate whether clinical judgment is affected if full facial expressions are not accessible, we conducted an email survey of psychiatrists and psychologists across the world who frequently work in these situations. Of 25 colleagues contacted 16 responded and 11 of them agreed for their comments to be included in the study. Nine out of 11 believed clinical assessment may be compromised, although respondents were aware of cultural sensitivity around the issue. Two out of 11 however, felt fully able to assess the mental state of a veiled woman. Some professionals reported that they feel unable to assess or treat if the request to take the veil off is declined. This small survey demonstrates the diverse opinions on whether unveiling is necessary for psychiatric assessment. Further qualitative examination of this area is needed to develop wider consensus and guidance to mental health care professionals who may be dealing with these groups.