Changing attitudes toward mental illness, treatment in Saudi Arabia

Changing attitudes toward mental illness, treatment in Saudi Arabia
With psychotherapy, therapists have guidelines for treatment that help them conclude the patient’s diagnosis, leading to the necessary course of treatment, which sometimes also require medication. (Shutterstock)
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Updated 18 June 2020

Changing attitudes toward mental illness, treatment in Saudi Arabia

Changing attitudes toward mental illness, treatment in Saudi Arabia
  • The younger generation of Saudis is already very open about seeking treatment, says expert

JEDDAH: Stigma toward mental health is something many Saudis still face, and can be measured through their reluctance to seek help, their inability to talk about their issues or to admit there is something wrong.
According to Saudi psychiatrist and cognitive behavioral therapy consultant Haifa Al-Gahtani, things have drastically changed in the past 20 years.

“I remember when I first began my career, people would cover their faces; even male patients would use their headpiece (shemagh) to cover their identity. Nowadays, in my center, people walk freely through the door and ask for a consultation,” she told Arab News.

She added: “The new generation is already very open about seeking treatment, and part of their openness is due to increased awareness.”

She said the prevailing attitude is not ideal and could be improved, but is much better than before. People have been using the internet to stay connected and read more, realizing that mental problems are not different from physical ones, she added.

With nearly 20 years in the field of psychology, Al-Gahtani has witnessed people who believe in and sympathize with victims of evil eye and envy — commonly believed in the Arab world — yet dismiss those with mental illnesses without compassion.

“Culturally, the evil eye and envy are accepted, but many people look at mental illness as a weakness of religious belief and weakness of personality,” she said.

The psychiatrist believes that everyone can play a major role in decreasing the stigma further through education in schools, colleges and workplaces.

Al-Gahtani believes that the stigma can disappear through people embracing their mental health issues and not being afraid to speak about them. 

“You don’t have to go everywhere and tell people you have depression, but at the same time, if people have depression, they need to perceive that it’s an illness and they can seek treatment and it is treatable,” she said, adding that encouraging others to get help is key.

Why is psychotherapy uncommon?

The notion among people is that a doctor is only meant to prescribe medication; it is evidence-based and researched enough to be proven efficient in treating many mental health issues, but according to Al-Gahtani, it is not always the best course of action due to “cases not responding to medication.”

“A lot of people have misconceptions about medication, that it will cause dependency, or destroy the patient’s brain. These are all myths. There are a few that can be addictive, but these are rarely used in practice. As long as a doctor prescribes the medication, there should not be a dependency on them,” she said.




For most mental health problems, in particular mood disorders, depression, anxiety, and phobias, cognitive behavioral therapy is very effective. (Reuters)

There are some cases where it is crucial for the patient to be medicated in order to help them concentrate; their level of energy and motivation is very low and therapy loses its efficacy, she added.

With psychotherapy, therapists have guidelines for treatment that help them conclude the patient’s diagnosis, leading to the necessary course of treatment.

“After sitting down with the client, sifting through a diagnosis, we set up a treatment plan, which usually is based on the severity of the patient’s illness. For instance a person with depression, mild, moderate or severe — we have set guidelines that direct us on the route to follow. For mild and moderate cases, international guidelines state that psychotherapy which is either cognitive behavioral therapy, interpersonal therapy, or psychodynamic therapy has proven to be efficient to treat them,” Al-Gahtani said.

The reason for the decline in psychotherapy in the Kingdom, she said, is that the number of trained therapists is low compared with the number of people seeking help.

FASTFACTS

• Chronic psychotherapy has been recently included in in the medical insurance system.

• There is a lack of trained therapists in the Kingdom.

• Depending on the therapist, the cost of a session may range from SR400 ($106) to SR800.

Most treatment courses conclude when medication is prescribed. Therapy needs time and effort, while being costly, with a single session costing from SR400 ($106) to SR800, depending on the therapist, she said.

Due to that, and lack of awareness, many people think they cannot afford therapy sessions.

“Thankfully, a recent mandate that includes chronic psychotherapy in medical insurance has been modified, when it used to only include acute mental health issues. Insurance companies would settle a medical bill for pills that cost SR100 per month and that would be it. But with costly psychotherapy sessions, as the doctor prescribing them, I have to write a strong statement to ensure that insurance covers my patient’s expenses for their sessions,” she added.

Cognitive behavioral therapy (CBT) is the most popular in the Kingdom.

By default, people go for cognitive behavioral therapy because of its availability in Saudi Arabia, said Al-Gahtani. For most mental health problems, in particular mood disorders, depression, anxiety, obsessive-compulsive disorder, phobias, it is a very effective course of treatment, but CBT is not for everyone.

According to the CBT therapist, consultant and trainer, CBT entails a patient coming in to discuss their issues with the therapist, who in turn helps them set goals.

After every session, the patient has an assignment to complete when they get home, writing thoughts, feelings, talking about a situation that made them angry, anxious or disappointed, depending on the issue they had discussed with their therapist.

From there, they come back and discuss their assignment with the therapist, analyze it and try to look at it from a different perspective, see if the set goals are achievable, and if they are, they move on to the next target, and so on.

“An example is a person who has a fear of public speaking, giving presentations or speeches to a crowd; what a CBT therapist does is ask them to write every situation that makes them anxious, praying in the mosque, speaking in a meeting, saying no, starting from the least worrying to most. We go through directing exposure gradually until it goes away, their confidence increases, and so on. It is fully dependent on the patient’s commitment to the work needed between each session,” Al-Gahtani said.


Saudi Arabia announces 14 more COVID-19 deaths

Saudi Arabia announces 14 more COVID-19 deaths
Updated 30 July 2021

Saudi Arabia announces 14 more COVID-19 deaths

Saudi Arabia announces 14 more COVID-19 deaths
  • The total number of recoveries in the Kingdom has increased to 505,003
  • A total of 8,226 people have succumbed to the virus in the Kingdom so far

RIYADH: Saudi Arabia announced 14 deaths from COVID-19 and 1,187 new infections on Friday.
Of the new cases, 256 were recorded in Riyadh, 212 in Makkah, 174 in the Eastern Province, 118 in Jazan, 64 in Madinah, 59 in Asir, 58 in Hail, 52 in Najran, 36 in Al-Baha, 31 in the Northern Borders region, 28 in Tabuk, and seven in Al-Jouf.
The total number of recoveries in the Kingdom increased to 505,003 after 1,176 more patients recovered from the virus.
A total of 8,226 people have succumbed to the virus in the Kingdom so far.
Over 26.3 million doses of a coronavirus vaccine have been administered in the Kingdom to date.


Saudi Arabia keen to protect human rights, HRC chief says

Saudi Arabia keen to protect human rights, HRC chief says
Updated 30 July 2021

Saudi Arabia keen to protect human rights, HRC chief says

Saudi Arabia keen to protect human rights, HRC chief says
  • In observance of Friday’s World Day Against Trafficking in Persons, Al-Awwad said the Kingdom is making significant and constant efforts
  • Al-Awwad wants to criminalize and combat human trafficking through a set of actions and measures that ensure human dignity

RIYADH: Awwad bin Saleh Al-Awwad, president of the Human Rights Commission (HRC) and chairman of the National Committee to Combat Human Trafficking, said Saudi Arabia is keen to protect and promote human rights.

Al-Awwad also wants to criminalize and combat human trafficking through a set of actions and measures that ensure human dignity and protect it from all forms of abuse and exploitation.

In observance of Friday’s World Day Against Trafficking in Persons, Al-Awwad said the Kingdom is making significant and constant efforts to combat human trafficking through the establishment of the Saudi National Committee to Combat Human Trafficking.

The committee enacts regulations and legislation that ensure protecting victims and safeguarding their rights on a local and global level.

Not only did the Kingdom issue regulations and legislation to combat human trafficking, but it was also keen to make the necessary efforts to enforce them, Al-Awwad said.


Saudi Arabia's Eastern Province conducts 1,524 COVID-19 health tours

Saudi Arabia's Eastern Province conducts 1,524 COVID-19 health tours
Updated 30 July 2021

Saudi Arabia's Eastern Province conducts 1,524 COVID-19 health tours

Saudi Arabia's Eastern Province conducts 1,524 COVID-19 health tours

DAMMAM: Municipalities throughout Saudi Arabia have ramped up efforts to monitor compliance with health and safety measures introduced to help stop the spread of coronavirus disease (COVID-19).

The Eastern Province municipality recently carried out 1,524 inspection tours in one day at shopping malls, commercial centers, and stores.

Checks resulted in nine commercial outlets being shut down, while 77 violators were issued with penalties for ignoring health regulations, which included breaches of overcrowding rules and failure to use the Tawakkalna app.

Officials have urged members of the public to report any suspected health breaches by phoning the 940 call-center number or contacting authorities via the Balady app.


Seven Saudi mosques reopen after sanitization

Seven Saudi mosques reopen after sanitization
Updated 30 July 2021

Seven Saudi mosques reopen after sanitization

Seven Saudi mosques reopen after sanitization

RIYADH: The Ministry of Islamic Affairs, Dawah and Guidance has reopened seven mosques in four regions that were temporarily closed for cleaning after coronavirus disease infections were confirmed among worshippers.

The ministry said on Thursday that two mosques were reopened in Riyadh, two in Qassim, two in Hail, and one in the Eastern Province.

Coronavirus infections have led to the closure of 1,909 mosques in the Kingdom in the past 173 days. The mosques were reopened after cleaning measures were completed.

The ministry urged worshippers and employees to follow precautionary measures, including wearing face masks, using their own prayer mats and maintaining social distancing.


21 members of Saudi-backed team killed clearing Houthi mines in Yemen

21 members of Saudi-backed team killed clearing Houthi mines in Yemen
Updated 30 July 2021

21 members of Saudi-backed team killed clearing Houthi mines in Yemen

21 members of Saudi-backed team killed clearing Houthi mines in Yemen

JEDDAH: Twenty-one members of a Yemen-based team of Saudi and foreign mine clearance experts have lost their lives over three years operating in what has become known as the world’s largest minefield.

The tragic death toll was revealed in figures showing the scale of the project being carried out in the war-torn country in cooperation with local Yemeni teams under the umbrella of the Saudi Project for Landmine Clearance (Masam).

Launched by the King Salman Humanitarian Aid and Relief Center (KSrelief) on June 25, 2018, the initiative has so far cost $133 million, Masam’s director, Osama Al-Gosaibi, told Asharq Al-Awsat newspaper.

He said the project’s field teams had dismantled 263,797 landmines, unexploded ordnance, and other deadly explosive devices. Since the start of the program up until July 23 this year, bomb squads dealt with 169,792 unexploded ordnances, 83,943 anti-tank mines, and 3,984 anti-personnel mines covering 25 million square meters of Yemeni territories.

The Yemen government said that the Iran-backed Houthis had planted more than 1 million landmines in the country since the start of the conflict in 2015, turning it into the most-mined nation since World War II.

KSrelief recently extended the Masam contract for another year, at a cost of $33.6 million. The project is carried out by Saudi and international experts through Yemeni teams that have been trained to remove all kinds of mines planted randomly by Houthi militias.

Al-Gosaibi pointed out that one of the main challenges faced by the teams was having to work without maps indicating the location of mines. In many cases they had to rely on local residents identifying suspected mined areas, which significantly slowed the clearance process, he added.

KSrelief’s general supervisor, Dr. Abdullah Al-Rabeeah, said that the renewal of the Masam contract with the executive partner was, “out of the center’s sense of humanitarian responsibility toward the Yemeni brothers.”

He added: “It is extremely important to clear the Yemeni territories of the mines that Houthi militias manufactured and planted in a random, unpredicted, and camouflaged manner and that have caused permanent disabilities and injuries and human losses, including women, children, and seniors.”

According to statistics published by the Yemeni Observatory on Landmines in March, devices planted by Houthis in Taiz alone had killed and injured 3,263 civilians since 2015.

Data from the Yemeni Coalition to Monitor Human Rights Violations, also known as the Rasd Coalition, showed 1,929 civilians, including 357 children and 146 women, have been killed in the past six years, and 2,242 civilians, including 519 children and 167 women, were disabled due to landmines.

During that same period, the coalition documented the destruction and damage of more than 2,872 public and private facilities in several Yemeni governorates, all due to anti-personnel and anti-tank landmines.