The Middle East's Mental Health Crisis

19/09/2016 16:39 | Updated 17 September 2017

There's a silent crisis in the middle east that is hectically expanding when looking at health reports, the number of specialised services available and the number of clinicians employed in the region. I'm talking about the lack of attention and care given to one's mental health, within their communities and on a larger scale, within their countries. The stats have shown that mental health is a worldwide problem: there's no single country that is unaffected. According to a study conducted at Cambridge University, 1 in 13 people globally will suffer from anxiety - a finding that debunks the old myth that it is a western phenomenon. So why isn't mental health being addressed more seriously in the middle east? Nowadays, there is only one psychiatrist for one million people in some Arab states. For example, Iraq; a country that has been destroyed by war and conflict, it inevitably carries a population that has been traumatised emotionally and psychologically. Its population is made of 30 million people, yet there are only 100 psychiatrists available, according to Iraq's Psychiatric Society. Demand has clearly skyrocketed, and supply is at the lowest level possible. Sadly, this is reflective of several Arab states.

Looking back at the history of mental health treatment in the middle east, it is enlightening to learn about the medieval Islamic hospitals, called märistäns, that were once designed to provide therapeutic care. These märistäns were known to be a safe, aesthetic and pleasing environment, in aim of encouraging recovery. Naturally, these places took in people diagnosed as mentally ill - nearly always with melancholia, the historic term coined by Hippocrates used to describe schizophrenia. Michael Dols, author of Majnun: The Madman in Medieval Islamic Society, described the märistäns as impressive buildings with pools, fountains, flowing water and flower gardens. Great care was taken to decorate the hospital wards to 'cheer the deranged'. Generally, the hospitals were in good conditions. There were beds with mattresses and space for patients to wander about in. More interestingly, something that was striking about such institutions in the Arabic empire, compared to the early asylums in Europe that emerged over 500 years later, was that they were not isolated institutions but always in the centre of cities. This means that they were easily accessible by most inhabitants. Not only was it easy to receive help, but it also meant that patients could be easily visited by family and friends, and society even. These medieval Islamic hospitals seem to contrast with what is seen today in Arab states. That is, the lack of accessible mental health services.

In addition, there is an unavoidable growing problem of not wanting to seek help out of fear of rejection, embarrassment and the stigma attached to labels of mental health. Therefore, unless there is a change in attitude at the grassroots level, things will not change much in the middle east. But of course, mental health is culturally dependent. Despite the fact that illnesses are the same across the world, the manifestation of such will vary depending on the societal norms. In less developed countries, mental illness is less characterised: risk factors, signs and consequences are less understood. For this reason, it may be why mental illness is harder to treat and often ignored or as the common saying goes: "brushed under the carpet".

As a result, information about mental health is missing in the middle east. In such countries, it's difficult to keep track of who is suffering, who is accessing help and who is on treatment. The number of suicide attempts goes unrecorded. The number of people who are experiencing delusions and hallucinations goes unnoticed. Without such action of recording this data, not much can be done on a larger global scale. In order to achieve this, there needs to be a higher number of well-trained physicians that have received training in mental health. Moreover, we need to see more efforts being directed towards raising awareness about the nature of mental health too, from its signs, treatment and recovery routes. Hopefully this will lead to a positive transformation of attitudes.