Egypt’s forgotten mental health crisis | Mental Health

Sara and her family fled Syria for Egypt in 2012 after the outbreak of civil war. They have since lived in Cairo, where she is studying to become a doctor.

As a 23-year-old Arab woman with Atypical Bipolar Disorder and Attention Deficit Hyperactivity Disorder (ADHD), mental health issues have plagued her for many years. However, seeking help for her problems was not easy.

“There is a lot of stigma and public health services in Egypt are bureaucratic. There is so much paperwork and the wait times are very long. Fortunately, my family could afford that I was deprived. But it was hard to convince my mother that I had a problem at first. She didn’t believe me until things got really bad,” she told Al Jazeera over the phone.

Sara, whose name has been changed at her request to protect her identity, is just one of many people suffering from mental health issues in Egypt. Between 30 and 35 people committed suicide each month last year, according to the Arab Foundation for Human Rights.

Suicide has been a source of concern in this North African country for several years. In 2016, the World Health Organization reported that nearly 3,800 people had attempted suicide, which was the highest figure in the Arab world.

A 2018 report by the Ministry of Health and Population found that a quarter of Egyptians suffered from mental health issues.

Sara said she believes part of the problem stems from the way people with mental illnesses are treated and perceived. As a medical student, she followed doctors in some Egyptian public mental health hospitals and said patients needed to be treated better.

“It’s very depressing and inhuman. Some staff are very understanding and know how to help their patients, but some are not. They treat them as if they are violent and have no rights. It’s as if they don’t understand the mentally ill.

“To go back in time”

Due to the high suicide rate, one MP, Ahmed Mahana, proposed that the act be criminalized. If that happens, those who attempt suicide could be punished for up to three years in a rehabilitation clinic and face a fine of up to $3,200.

Kate Ellis is a clinical psychologist and assistant professor at the American University in Cairo. She told Al Jazeera via email that criminalizing suicide would be counterproductive.

“The outdated and misguided proposal to criminalize suicide in Egypt completely ignores the root of the problem and will only serve to increase the deeply rooted stigma in society around the issue of mental health. This proposal, if successful, will see Egypt set back in time rather than grow as a country that protects the mental health of its people.

Like Sara, Ellis said she believes the government needs to raise awareness of the issues at play and should focus on tackling the causes of the problem, while improving services.

“Tackling the societal issues that often contribute to depression and suicide should be a central concern of the Egyptian government, in a society where bullying, sexual harassment and victim shaming are significant social issues, especially especially among the younger generations.

“The government needs to focus on national awareness campaigns around mental health and suicide. Access to mental health services needs to be significantly improved and services need to be increased in primary health care settings, rather than in stand-alone psychiatric hospitals, which unfortunately also carry a lot of stigma. In recent years, the government has increased the presence of these services, but there is still a long way to go.

Cultural barriers

Talking therapies are one of the most popular forms of treatment for mental health issues, including depression and anxiety. Psychotherapy, cognitive behavioral therapy, and other contemporary techniques, however, originated in the West.

As a result, many people in the Middle East and North Africa experience difficulty with this type of treatment due to social and cultural barriers. The strategies used are based on scientific research and Western ways of thinking, and were not developed with the Arab world or other regions and cultures in mind.

The online therapy platform Shezlong was launched in 2015 by Mohamed Alaa and Ahmed Abu Elhaz with the aim of helping clients overcome these social and cultural barriers. It matches patients with therapists and primarily serves Arabic speakers. It is the first platform of its kind in the MENA region and over 100,000 appointments have been booked through it.

Alaa told Al Jazeera via email that conversations about mental health in Arab countries are improving, but more needs to be done.

“There has been a huge improvement in awareness of the benefits of therapy in our region. Additionally, celebrities are now speaking publicly about their mental health, as well as actors. But I think governments need to start working on national projects, including awareness campaigns that familiarize people with the benefits of asking for help when needed.

War and sectarian violence

Egypt is not the only Arab country to see a decline in mental health, with Iraq and Kuwait both seeing an increase in suicides, according to reports. Academics say the MENA region would benefit from funding more mental health research, with many people suffering psychological and physical trauma from war and sectarian violence.

A study published in 2020 by researchers at the American University of Beirut suggested it could help people get back to normal life.

Last Saturday, Egypt’s Minister of Higher Education and Acting Health Minister Khaled Abdel Ghaffar said the government was closely monitoring mental health support services available to the public, at a conference in Cairo on related issues.

He also encouraged trainee doctors to choose mental health as a specialty and said the government plans to expand and improve mental health services.

Al Jazeera contacted the Ministry of Health and Population for comment, but did not receive a response.

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