Middle Eastern Countries Combat Stigma Surrounding Mental Health

While the stigmatization of mental health issues is common worldwide, sociocultural factors specific to the Middle East often prevent individuals from seeking treatment.

A drawing depicting mental health issues. Pixabay.

Mental health services are more urgently needed now than ever before. The world is currently facing a mental health epidemic, with over 264 million people struggling with depression in 2019. The additional stress and uncertainty caused by the COVID-19 pandemic have caused anxiety and depression levels to skyrocket. For many individuals, it has become even harder to participate in counseling programs. According to the World Economic Forum, over 93% of countries have reported a disruption in their mental health services since the pandemic started. 

In the Middle East, mental health awareness continues to rise, especially in the Gulf countries among the nations’ youth. A recent poll conducted in the Gulf region reported that 62% of youth agree that mental health issues are important. Even so, a recent survey in Saudi Arabia revealed that 80% of people struggling with severe mental health issues do not seek treatment. Similarly, this year’s Arab Youth Survey, which interviewed 4,000 young adults ages 18-24 from 17 Arab countries, revealed that mental health issues are rampant, with the number of people affected continuing to rise. 

Difficulties in Obtaining Proper Mental Health Care

The Kaaba in Mecca, Saudi Arabia, the holiest site in Islam. Konevi, Pixabay.

A prevalent culture of stigmatization in Middle Eastern countries prevents many individuals from seeking treatment in the first place. Due to the shame associated with mental health issues, privacy between the client and their mental health professional is of utmost concern. In many cases, mental health issues place a burden on a family’s reputation and social status. Rania Raine, a 43-year-old British-Egyptian art teacher who struggles with mental health, states that, “It’s the ‘shame’ families have, that their child isn’t perfect, that their lives are not perfect and what will people say, what will the neighbors say, society say–and then it all leads to marriage, how no one will marry the child who has a mental health condition, or worse still, ruin the chances of marriage of the other siblings.” 

Although the stigmatization of mental health conditions is common in Muslim communities, Ph.D. researcher Mounira al-Dousari states that they are “reflections of cultural practices and discourse.” There is a growing movement among mental health professionals to include faith in therapy, which results in a faster recovery for some clients. It’s also important to note that many forms of therapy use predominantly Western practices, which need to be diversified to appeal to a larger audience. According to Dousari, “When it comes to Islam, Muslim scholars and those working in the mental health field are working harder than ever to establish well-structured Islamically integrated psychotherapy models.”

Additionally, the financial burdens of seeking mental health treatment raise another concern. Even though mental health care is free in some public hospitals, many people do not trust them due to privacy concerns. Prices for private mental health care sessions are quite expensive. For example, Dousari’s research sessions cost $225 an hour, a large sum even for well-off families. 

Historic Treatment of Mental Illness in the Middle East

An entrance to the Moristan of Kala’oon, a mental health hospital in Egypt, 1878. Werner. CC2.5

Although mental health remains a prevalent issue in the region, the Middle East was well known for mental health treatment during the Islamic Golden Age. The term bimaristan, Persian for “home for the sick,” refers to entire psychiatric hospitals where a patient’s mind, body and soul were considered part of the treatment process. First opened in Fez, Morocco, and in Baghdad in the eighth century and later in Cairo, Damascus and Aleppo in the ninth, the practice was initially introduced by physician Ahmed ibn Sahl al-Balkhi. A famous manuscript written by Balkhi called “Sustenance for Bodies and Souls” was written in clear, understandable language and helped make mental health education more accessible to the public. Unfortunately, the practice declined throughout the centuries and does not occur in the mainstream today. 

Additionally, Dr. Mamoun Mobayed, director of the treatment and rehabilitation department at Behavioral Healthcare Center in Qatar, emphasizes that the stigmatization of diseases is a global phenomenon. “Any disease thought to be infectious or bizarre-looking, like leprosy, has always been stigmatized. Even with COVID-19, there have been cases where paramedics working with COVID-19 patients have been avoided due to the fear and stigma attached to the virus.”

In recent years, mental health awareness in the Middle East has become a top priority, with many countries starting their own wellness initiatives and campaigns. 

Qatar Paves the Way in the Gulf

Sidra Medical and Research Center in Qatar. Sergeev. CC3.0

Qatar launched a new mental health program in conjunction with World Mental Health Day. Being the first country in the Gulf to start such an initiative, the Wellness Ambassadors program aims “to promote mental health support and break the stigma attached to mental health conditions at school level.” Program ambassadors received comprehensive training on mental health issues such as anxiety, depression and bullying while breaking cultural misconceptions surrounding mental health. Dr. Mobayed states that educating individuals about mental health issues serves “to remove the barriers associated with mental health and know they are normal humans with a disorder in the mind.” 

Turkish Counseling Services Provide Assistance

Taksim Square in Istanbul. Pixabay.

A crisis helpline in Turkey helps those struggling with mental health issues during the pandemic. Supported by the World Health Organization, the service is accessible in all of Turkey’s 81 provinces and consists of 418 staff members trained in helping individuals manage stress and access mental health resources. So far, the service has offered more than 80,000 consultations since its inception. 

Social Media Campaigns in Kuwait Lead to Legislative Action

Youth in Kuwait. Wikimedia Commons. CC2.0

Kuwait enacted its first mental health law in 2019, which passed unanimously through the national assembly. Instrumental to this success were numerous social media campaigns led by youth, artists and mental health advocates. The founder of ASAP Beauty, Sheika Majda al-Sabah, credits her involvement in the campaign to her own struggles with depression. Other campaigns include “Mind Me”, “Human Line Organization” and “Taqabal”, with trending hashtags such as #noshame working to spread awareness. Outreach events helped to create a welcoming climate where people could speak more openly and denounce negative stereotypes surrounding mental illness. Since the onset of the COVID-19 pandemic, an online program called Corona Care provides mental health services for those in need. Additionally, the Gulf Program for Mental Health encourages countries to develop comprehensive mental health programs that adhere to international standards. 

Although there is still work needed to break down barriers surrounding mental health treatment, Middle Eastern countries seem ready to rise to the challenge. 

To Get Involved: 

Check out social media campaign pages “Mind Me”, “Human Line Organization” and “Taqabal” working toward mental health awareness in Kuwait. Visit the website of the Institute for Muslim Mental Health, which focuses on providing support for Muslims in the United States. The Journal of Muslim Mental Health is an excellent resource to learn about issues affecting the Muslim community in the United States and globally. 

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Megan Gürer

Megan is a Turkish-American student at Wellesley College in Massachusetts studying Biological Sciences. Passionate about environmental issues and learning about other cultures, she dreams of exploring the globe. In her free time, she enjoys cooking, singing, and composing music.

Mental Health Awareness in Developing Countries

When it comes to building awareness about global issues, it is simple to access information about the world’s most pressing, media-enhanced problems. It’s not difficult to come across a long list detailing the burdens of the developing world… Physical health and medical shortcomings are largely common knowledge, even to the disengaged…Mother’s die regularly from child birth, treatable diseases- avoidable diseases- run rampant through communities, slowly bringing more disadvantage into the lives of the underprivileged. Health issues in the developing world are not privy to an elite group. In fact, medical teams are regularly dispersed around the world to supply people with basic medical care. As prominently as physical health is talked about within society, mental health and wellness awareness are becoming increasingly important to acknowledge.

With the United States as a model, mental health is at the forefront of social efforts. In recent years, at the expense of those who suffer from mental illness expressed in one form or another, the country has grieved school shootings, public shootings, and regular suicides of those who seem to “have it all.” Within the past month, the country lost two well-known figures, Kate Spade and Anthony Bourdain, to suicide connected with depression and mental struggle. According to CNN’s report of the CDC’s 2018 study, suicide has increased by 25% since 1999. The study suggests many relevant factors, including economic troubles, personal conflicts, having a rural residence, and limited exposure to mental health care or communities that acknowledge its value all contribute to the increase. Simply understood, mental disorders are certainly impacting both the individual and the larger society. Therefore, it is no stretch to suggest that these concerns pose an international challenge.

The very same issues of financial struggles, limited access to healthcare professionals and understanding communities of mental strife, and of course, rural geography are all extremely relevant to developing countries. While mental wellness campaigns have become more frequent and nationally recognized around the United States, it has taken the country years to work towards de-stigmatizing mental disorder. For those countries who are socially and economically behind the United States, what happens to the people who experience the hidden diseases that develop out of the most critical of environments?

With the knowledge that poverty and rural isolation produce greater mental struggle, those impoverished peoples of the developing world are starved for advocacy about a problem many don’t even know can be blamed for their personal burdens. Just as mental health has been stigmatized in the United States, countries with ancient cultural depth have also formed their own insights and rationale about mental illness. For many cultures around the world, mental disorders have been considered a form of possession or devilish curse. Thus, mental health is strongly associated with isolating qualities. Like an issue of physical health, disease does not play favorites or avoid the rich and famous, it is a generalized concern. With its far reaching capacity, mental illness must be addressed on a larger global scale as its impact reaches deep into the negative realities of societal dysfunction. As this stigma around mental illness slowly melts from the inner workings of American society, there remains a question of how mental health is treated, recognized and perceived in countries that must prioritize the most tangible of problems.

In an effort to expose whether mental illness “exists” in the developing world, the World Health Organization (WHO) presents some findings. WHO reported that the world is “facing a global human rights emergency in mental health.” Andrew Chambers of The Guardian recorded that in countries like Zambia, Africa, mental disorder is largely unaddressed. That said, the same individuals who are uneducated in any sort of physical health maintenance are more severely uneducated in mental health issues. The terms, the diseases, the treatments, the community affected, the causes- all inter-related and important information- are not structures available to those who struggle within these impoverished communities.

Mental illness in a young child is much easier to overlook than when that same child suffers from a broken arm or a high fever. The solution is arguably quick, and the answer is material. The child can heal and carry on with his/her life. Mental illness is an intangible issue that is much harder to treat, much harder to understand, and far more difficult to confront due to its associated stigmas. All that said, it is no less of a real problem. Moreover, the dilemma of not addressing mental disorder is its extent into impacting the cycle of poverty and lack of opportunity. Several studies have been done to confirm the idea that mental disorders “further impoverish the individual.” One study on mental wellness in developing countries suggests, “People who live in the poor income groups, those who are less educated, those who are faced with acute economic difficulties (for example, consequent to unemployment), those who face debt, and those who face hardships in acquiring basic necessities (such as food) for survival, are at much greater risk to suffer mental disorders.” The same study goes on to conclude, “In turn, the disabling effects of mental disorders impair the ability of persons to search for and sustain productive employment.” Therefore, mental wellbeing is much more than meets the eye, so to speak. The study provides the evidence that, while medical teams are making a large impact in many ways, large amounts of people remain debilitated by their mental incapacities.

Mental health advocacy remains an issue stunted by the stigmas and ancient beliefs that coined their categorization. In developing countries, mental disorders are especially hard to treat. They are costly to integrate into societies and they are harder to acknowledge as the majority population is widely uninformed about the different types of disorders and how they manifest in the individual. This lack of education is only further inhibited by the population who refuse to accept mental disorder as anything more than some sacrilegious behavior or cursed punishment.  

While many developing countries remain uninformed and thousands go undiagnosed and untreated, the WHO is working to build a foundation of awareness. Uganda, as of 2015, was working to implement awareness, education, treatment, and western practices to address mental illness throughout the country. A study by Global Health Consultant, Janice Kopinak records, “There is recognition by the national government that the challenges faced in mental health services poses serious public health and development concerns.” To that effect, and despite many of their best efforts, the access and the capacity by which healthcare professionals in Uganda can make an impact still meets many obstacles. In developing countries, with Uganda as a strong representation, the education for treatment is feeble, the financial system is unsupportive, and the reach is limited. In short, mental disorders are just as prominent in countries where there is little to no awareness as it is in countries with large wellness advocacy campaigns. With time, and more concentrated efforts,  there is hope for a better future. However, for developing countries, the road ahead is long and arduous.
 

ELEANOR DAINKO is an undergraduate student at the University of Virginia studying Spanish and Latin American Interdisciplinary Studies. She recently finished a semester in Spain, expanding her knowledge of opportunity and culture as it exists around the world. With her passion to change the world and be a more socially conscious person, she is an aspiring entrepreneur with the hopes of attending business school over seas after college. 

VIDEO: Who's Developing Who?

The common assumption is that the rich countries of the global north, through foreign aid programs and by participating in projects like the SDGs (Sustainable Development Goals), are helping the less wealthy countries of the global south develop. But how true is this? 

Right now, for every $1 that is given in foreign aid to the global south, around $18 is taken out by other means, most notably rigged trade deals than benefit the most powerful countries and corporations, debt repayment on debts already paid off many times over, and massive tax evasion and other forms of corruption, committed by political and business elites north and south, and facilitated by the large and growing web of tax havens. So in the grand scheme of things, who’s actually developing who?

The answer to this question will also affect your opinion of the SDGs. They don’t have a lot to say about this dynamic, and in fact riff pretty heavily on the basic idea that it’s the north that is the generous party. They do acknowledge both the vast level of illicit finance, and that the global financial system is relevant to their project, but capture their level of concern in vague statements about the need to “enhance global macroeconomic stability” through “policy coordination”. There are no specific responsibilities for anyone, or any actual targets.