Over the past years, it has been refreshing to see the openness of how people speak about mental health. There's been a huge positive shift at the social micro-level visible on social media. It has really shifted from a taboo experience to something that is bravely shared to raise awareness. The idea of seeking help from a professional has become much more accepted within Arab societies compared to previous decades. This made me wonder whether we see the same anti-discrimination leap at a macro-level? Sure, most countries have policies that protect the rights of people suffering from mental illness but the existence of a mental health legislation in a country does not necessarily guarantee that the human rights of people with mental illness are protected.
"The Joker" is a movie that does a great job summing up the structural issues within global mental healthcare in the Western world. While it's always interesting to learn more about mental health practices from the West, at the end of the day, it's one of those topics that looks very different from one region to the other.
Mental Health status in the Arab World
A study in 2013 showed that the Eastern Mediterranean Region had a higher mental disorder burden compared to the global level, with the exclusion of Egypt, Palestine ranking highest due to the chronic exposure to trauma and military violence.
Beliefs that still stop people from seeking help:
Most diagnostic and therapeutic interventions used in the Arab region are exported from more developed countries; these need to be adapted in a culturally sensitive fashion. There are many factors that are specific to the values and beliefs of the region that shape how people view mental health. In the Middle East, strong family ties are viewed as something very sacred. While this is a beautiful value to uphold, it often translates into one's individual behavior being a mirror of the families reputation. The stigma that accompanies mental illness is reflected on an entire family rather than just the individual. Another factor is the belief amongst Muslims communities in the region that strong faith could help treat illnesses such as depression and schizophrenia. Rather than turning to psychiatrists, many would prefer seeking spiritual guidance.
Mental Health Stigma in Healthcare:
How many times have you visited your physician complaining about chronic physical or mental discomfort only to have it belittled and brushed away with some pain killers? How many times was unexplained pain not taken seriously? This is an issue with a lot of primary healthcare delivery institutions. Lack of training and stigma towards mental health still occurs within primary healthcare institutions which is sometimes the patient's first point of seeking help.
Real socio-cultural change will happen when patients with mental illness visit a healthcare setting where their human rights are openly respected and their condition is accepted by a health professional who has no stigmatizing judgments about the patient or their family. To normalize and increase mental health services, social and religious practices that shape how mental illness is viewed in the region need to be acknowledged and incorporated in to best practices to make seeking and following treatments more acceptable.
There are still milestones to be celebrated with more funds being directed into researching mental illness and promising legislations being rolled out in more countries. Psychiatric services in the Arab world are gradually being replaced by psychiatric units in general hospitals, and mental health training for physicians and other health workers at the primary health care level is becoming available in a large number of countries. This will hopefully reflect positively on how people experience mental healthcare in the years to come.