The hidden face of mental illness in the Middle East

The hidden face of mental illness in the Middle East
A therapist comforting a young man who lost his parents, in group therapy for people in mourning. (Shutterstock)
Updated 14 May 2019

The hidden face of mental illness in the Middle East

The hidden face of mental illness in the Middle East
  • Two surveys suggest it is high time to talk openly about the issue to break the stigma surrounding it
  • GCC youth identified personal relationships as the biggest source of stress, followed closely by academic factors

DUBAI: Mental-health campaigners in the Middle East say it is high time for teachers, parents and policymakers to encourage young people to open up about their feelings and break free from the shame surrounding discussion of psychological disorders.

The warning comes after two separate surveys highlighted the scale of suffering among the region’s 200 million Arab youth due to depression, anxiety and addiction. 

The Arab Youth Survey 2019, released earlier this month by the Dubai-based communications company Asda’a BCW, showed mental illness to be a widespread concern among young people in the Middle East and North Africa (MENA). And a recent YouGov poll conducted in the UAE pointed to the existence of a stigma around mental illness, with fewer than half of respondents saying they would seek professional help if they were suffering from a psychological disorder.

“The Arab population is plagued by issues that are no different from any other population in the world: Depression, anxiety, eating disorders, addiction, suicide, self-mutilation, post-traumatic disorders, mood disorders and so on,” Fadwa Lkorchy, a psychologist at the Dubai-based German Neuroscience Center, told Arab News. “The difference now is that the Arab world is willing to admit the problem.”

The Arab Youth Survey, which explored attitudes among Arab youth in 15 countries and territories in MENA, found that one-third of them knew someone suffering from a mental disorder such as anxiety and depression. 

Half of the respondents — Arab men and women aged 18 to 24 — said there was a stigma attached to seeking medical care.

Youth in the Gulf Cooperation Council (GCC) countries are most likely to be accepting of mental illness, according to the Arab Youth Survey, with 62 percent saying it was a normal thing.

GCC youth identified personal relationships as the biggest source of stress, followed closely by academic factors.

“The young generations are more exposed than the older ones to what’s going on around the world,” said Lkorchy.

“They have higher expectations but not the same resilience, which may result in feelings of inadequacy in matters of education, career and lifestyle,” she added.

“Now is the right time to talk about mental illness, to help people deal with daily challenges and develop skills to improve their mental wellbeing.” 

Lkorchy said the polls’ findings point to at least two things: Young people should not delay seeking medical care for underlying psychiatric disorders, and medical professionals need to provide better and a wider range of platforms for young people to discuss mental-health issues or receive treatment. “The mental-health statistics aren’t surprising. We’ve seen for decades the neglect of mental health and focus solely on physical health,” she added. “The new generations, with help from social media, are more open and willing to seek help.”

Dr. Justin Thomas, professor of psychology at Zayed University in Abu Dhabi and author of “Psychological Wellbeing in the Gulf States,” told Arab News that the new focus of this year’s Arab Youth Survey on mental health is timely because disorders, despite being widely underreported, have reached “epidemic proportions in many nations.”

Stigmatization of people with mental illness is “very real, and in spite of the many brave celebrity self-disclosures, it persists and will undoubtedly continue to endure for generations to come,” Thomas said.

“While most nations no longer attempt to exterminate or sterilize people with mental-health issues, we do continue to shun, stigmatize, demonize and discriminate,” he added.

“People will often exclude or ridicule individuals known to have experienced mental-health issues.”

Lkorchy said although a number of clinics in the UAE and Saudi Arabia now offer mental-health care, the high cost is often a deterrent to using their services.

“All medical insurance should include mental-health services, not only for treatment but also for prevention,” she added.

“Mental illness can lead to psychosomatic disorders and autoimmune diseases, of which we are seeing more cases of late.”

One of the biggest obstacles to addressing psychological disorders in MENA is the stigma surrounding the topic. 

Iraqi boys attend a class at a school in west Mosul on July 27, 2017. (AFP)

Dr. Shaju George, a specialist in psychiatry at Al Zahra Hospital in Sharjah, the UAE, told Arab News: “Ignorance, lack of motivation, non-availability of facilities and properly trained professionals, lack of government funding and insurance coverage — each of these could be playing a role.”

He said: “Unidentified and untreated psychiatric disorders of tomorrow’s citizens could affect the future of the country as a whole.” He added: “If underlying mental-health issues go unnoticed, the results could affect young people’s scholastic achievements, work performance and ultimately their careers.”

Of the 1,085 participants in the YouGov poll, 72 percent said they would seek — or suggest seeking — help from a mental-health professional if they, or a person they are close to, were struggling with an issue. 

A majority would look for expert assistance for issues such as suicidal thoughts (62 percent), self-harm (61 percent), hallucinations or delusions (56 percent), anxiety (55 percent) and post-traumatic stress disorder (53 percent).

Since mental health is a taboo topic for many, “increasing awareness is the key,” said George. “Imparting the right knowledge and instilling hope can assist in removing the stigma, which in turn will prompt more people to seek professional mental-health care. We can see great initiatives in this area in the GCC.”

The importance of more research and data to ascertain the scale of the Middle East’s mental-health challenge in order to dedicate adequate resources cannot be overstated, he added.

A 2017 study titled “Predictors of adolescents’ mental health problems in Saudi Arabia” examined feedback from 12,121 students and found a strong correlation between “poor relationship with parents, negative body image, and chronic illness” and worry, sadness and hopelessness.

The study’s authors said: “Symptoms suggestive of mental health problems among adolescents in Saudi Arabia are prevalent and deserve special attention.” 

They recommended that “annual screening for depression ... should be implemented in schools. Effective professional counseling services should be implemented at all schools to help … students better cope with their problems.”

George said mental illness should be understood and treated as a medical or physiological disorder, rather than as an abstract condition.

“This alone will bring about a major change in the attitudes of people and their readiness to seek medical care,” he added.

“This idea needs to be introduced into school and college curricula, discussed at gatherings by religious heads, incorporated into government-funded mental-health programs and community outreach events, and adopted by media to raise public awareness.”

Health is a state of complete physical and mental wellbeing as defined by the World Health Organization, George said, “therefore good physical health means good mental health, and vice versa.”

UN envoy calls for greater sense of urgency in Syrian peace efforts

UN envoy calls for greater sense of urgency in Syrian peace efforts
Updated 23 January 2021

UN envoy calls for greater sense of urgency in Syrian peace efforts

UN envoy calls for greater sense of urgency in Syrian peace efforts
  • Geir Pederson wants enhanced international diplomacy, and tighter focus on progress in drafting new constitution
  • The fifth session of the Small Body of the Syrian Constitutional Committee begins in Geneva on Monday

NEW YORK: Geir Pedersen, the UN’s special envoy for Syria, on Friday called for “more serious and cooperative” international diplomacy as part of political efforts to improve the lives of the Syrian people and develop a vision for the future of their country.

Speaking ahead of the fifth session of the Small Body of the Syrian Constitutional Committee, which begins on Monday in Geneva, he also urged committee members to focus their efforts and work more effectively to speed up progress on constitutional reform.

Pedersen expressed hope that much-needed international engagement with the peace process is now possible.

“After all, despite the differences, key states are continuing to reaffirm their commitment to Resolution 2254,” he added, referring to the UN Security Council resolution, adopted in 2015, that calls for a ceasefire and political settlement in Syria.

Pedersen, who briefed the Security Council this week on the latest developments, highlighted the fact that five foreign armies are active in Syria and “violations of Syrian sovereignty and territorial integrity (have been) going on for years.”

Although the ceasefire agreement reached by Russia and Turkey in the northwest of the country resulted in a de-escalation of hostilities, Pedersen warned that this relative calm remains fragile.

UN Special Envoy for Syria Geir Pedersen. (AP Photo/Kathy Willens, File) 

“All of these issues cannot be sorted out by the Syrians alone,” he said. (They) need an international cooperation (and) a real exchange of views (among all parties).

“If that political will is lacking it would be very, very difficult to move this process forward ... if you leave this to the UN alone, we will not be able to succeed.”

Top on the agenda on Monday will be discussion of the basic principles of the Syrian constitution. Pedersen said he has been meeting with the two co-chairs of the committee on a regular basis, and has also had intensive discussions with the “Middle Third” civil-society group, which includes society activists and experts and other independents from inside and outside of Syria.

His experiences during the past year, he said, lead him to believe there is potential for finding common ground. No single actor or group of actors can impose its will on Syria or settle the conflict alone — they must work together, he added.

The time has now come for the co-chairs of the Constitutional Committee to organize and focus its efforts by establishing “more effective and operational working methods,” Pedersen said, so that they can begin to move forward from preparing constitutional reforms to actually drafting them, and agreeing on clear agendas and discussion topics for future meetings.

“There needs to be more urgency (in) delivering progress in this process,” he added.

As he saluted the work of civil society groups and “all the Syrians who do what they can to improve the situation on the ground and support a political process,” Pedersen singled out women in particular for praise. He has been particularly proactive in seeking input from the Women’s Advisory Board.

“It is a priority for all of us to make sure that we have full participation of Syrian women in the political process,” he said. “(Promoting) their core constitutional rights is central for me, as the facilitator of the work of the Constitutional Committee.”

Asked about plans for large-scale prisoner swaps, Pedersen said that although this is not on the agenda for the talks in Geneva this week, it is always part of his own agenda. The disappointment over the lack of progress on the issue so far means “that we should work even harder” on it, he added.

“This is a file that really has an impact on nearly every Syrian family, and it needs to be addressed,” he said. “(I) have appealed (for) more information on the missing. (We) need to see the early release of women, children, the elderly and the sick, and I think (nothing) should stop that from happening.”

The members of the Small Body of the Syrian Constitutional Committee are due to arrive in Geneva on Saturday, and Pedersen will consult with the co-chairs over the weekend before the main talks begin on Monday.

Asked whether he expects this latest round of negotiations to be a success for the UN, Pedersen said: “I really do not think this is the question; the question (is) whether it is a success for the Syrian people and (their) aspirations.

“My hope has been that the Constitutional Committee, if it is handled in the correct manner, could start to build trust and (be) a door-opener for a broader political process.

“But the (committee) cannot work in isolation ... we need political will from the different parties to be able to move forward.”

He added: “The (committee) is just one aspect, and it is not the one aspect that will solve the Syrian crisis. If we are to see changes in the situation on the ground, there are other factors that need to be discussed.”