Conflicts and Disputes in Yemen: Catastrophic Effects on Mental Health in Society

Hanan Hussein – Sawt Al-Amal (Voice of Hope)

In October 2023, the Regional Office of the World Health Organization (WHO) for the Eastern Mediterranean issued a report mentioning the magnitude of the humanitarian crisis in Yemen and its impact on individuals and society. The report described Yemen as a “country torn by conflict,” where “mental health is nonexistent” due to “limited services” and the consequences and creation of the most dangerous and harmful psychological disorders for individuals and Yemeni society.

The World Health Organization warns of catastrophic repercussions for mental health in Yemen. Estimates mentioned in its 2023 report, “The Mental Health Crisis in Yemen,” indicate that 7 million people need mental health support, while only 120,000 receive assistance. The organization also confirms in the report that the crisis is worsening with the continuation of the conflict and the decline in access to specialized services, especially in rural areas.

According to the Ministry of Health and Population report for 2022-2023, a study conducted in 2019 diagnosed the prevalence of chronic diseases for the first time per 10,000 population, ranked by prevalence. The study revealed that mental illnesses ranked third, with a rate of 37 cases per 10,000 population.

According to the report, the prevalence of the most important mental disorders includes the following: Major Depressive Disorder: 27%. Anxiety Disorder: 25%. Schizophrenia: 18%. Post-Traumatic Stress Disorder (PTSD): 45%. Social Phobia: 4%

Real-Life Story

Manar Muhammad, a researcher and psychologist, talks about the most prominent stories she encountered during her work, saying: “One of the most significant stories I encountered personally was of a young man in his twenties whose father was executed for killing his wife. Afterward, this young man was subjected to several traumas, including the destruction of their home during the conflict. As a result, he suffered from poverty and unemployment, in addition to several consecutive traumas that led to his isolation and his choice to live among the graves. He became a gravedigger who buries the dead.”

She adds: “He used to find solace in embracing the corpses while burying them until one of his fellow gravediggers discovered him trying to exhume a grave. He threatened to report him, hold him legally accountable, and expose him unless he left this profession.”

She continues her story, saying: “The young man chose a path that he considered the easiest and most appropriate, which was the path of suicide. Every time he attempted suicide, he survived. One day, he was transferred by a team of hospital doctors to mental health specialists, and we diagnosed him.”

She continues: “We tried hard to treat him after he told us the details of what he went through and what he feels, especially when he embraces the corpses. He said that he remembers his mother every time he hugs a body and that he chose to be around the dead because of his inability to give his tenderness to living humans after his father killed his mother. Therefore, he preferred to be among the dead rather than the living. He was not afraid of death or the dead because he believed that all the dead did not wish to die; rather it was the living who caused their death.”

She explains that the reason for his choice of suicide is because his living personality is the one forcing him to kill himself. It is a personality that represents the evil side of him and wants to kill his personality that carries the good side, and that death will make him with the good people, but all the living are evil.

The Crucial Role of Mental Health

Regarding mental health, Manar says: “As a researcher in the vast field of psychology, I can assert that it is of paramount importance in the life of the individual and society. It helps all individuals live in a peaceful and tranquil environment, free from dangerous and multiple psychological disorders, which in turn lead to the decline of the individual and society, in terms of science, knowledge, economy, and so on.”

She adds: “The advancement of a nation is only achieved through good mental health prevalent among its citizens. Most of the competing civilized nations that enjoy independent sovereignty are those that have focused on the psychological aspect of their citizens.”

She continues: “Addressing mental health in Yemen is an absolute necessity to alleviate the suffering that most members of Yemeni society have begun to complain about. It plays a role in motivating Yemenis to establish institutions that organize the movement of the country’s development and progress, its organization, and the reconstruction of its vision and movement towards achieving general political and economic stability for the country, which in turn contributes to reducing unemployment by providing job opportunities for youth. This treatment is effective and efficient in addressing the confusion of the Yemeni citizen and filling the void that he lives in today, from which multiple psychological disorders have arisen.”

Most Prominent Disorders

Akram Abdul-Aziz, Director of a mental health institution, believes that the most prominent psychological disorders prevalent in Yemen are: post-traumatic stress disorder, depression due to difficult living conditions and loss of hope, anxiety as a result of fear of the future, sleep disorders due to constant anxiety and tension, and psychological disorders in children stemming from a loss of safety and inadequate education.

Researcher Manar reinforces her statement, believing that the most prominent and dangerous disorders are depression, followed by anxiety, post-traumatic stress disorder, and disruptive behavior disorder against society. We must not forget mania, obsessive-compulsive disorder, narcissism, schizophrenia, etc.

Regarding their arrangement according to age groups, researcher Manar explains that the disorders that the Yemeni citizen suffers from are numerous and have emerged gradually until they have escalated in this way among young people, who are the largest and most affected group, followed by children, and then older adults.

She adds: “Depression, with its three degrees (mild, moderate, and severe), is the most prominent among other types of disorders. It has become competing with the effect of bullets, leading to the country’s decline and exacerbating its crisis in not reaching a rational solution that uplifts this society.”

She adds: “Through my practical experience in the field of mental health, we as specialists are no longer able to use the Beck Depression Inventory – consisting of 21 questions – as the primary scale for assessing depression in Yemeni society. This scale is no longer appropriate or valid for measuring the disorder due to the severe conditions faced by the Yemeni people, who have been torn apart by conflicts and exhausted by poverty, hunger, unemployment, idleness, ignorance, backwardness, and so on.”

She points out that anxiety is another prevalent issue among Yemeni citizens, especially during the height of the conflict, due to the violations of their safety and security.

The Rate of Disorders Compared to the Past

Regarding the rates of mental illnesses between the past and present, researcher Manar confirms that the prevalence of mental disorders has increased compared to the past, which in turn gives rise to alien behaviors and thoughts in Yemeni society, such as rape, murder, theft, and other acts of chaos that are hostile to society.

She continues: “The abusive mentally ill person is a victim just like the abused; he is not aware of what he is doing, especially if he is afflicted with mental disorders that were previously classified under the umbrella of mental disorders, which require rapid therapeutic intervention through medication and sessions first, and monitoring and therapeutic isolation second. The most important and common of these disorders is schizophrenia.”

Dr. Akram Abdul-Aziz agrees with her. He believes that the rate of mental disorders has increased in the present time compared to the past as a result of the conflict.

The Causes of Disorders

Regarding the causes of mental health crises, psychologist Munira Mahdi says: “Conflicts, disasters, and material and economic conditions have all had a significant and negative impact on all members of society and were the main reason for mental health crises. Through my work in this field in more than one psychiatric hospital, I see that there is a significant deterioration in the mental health of individuals in society.”

Psychotherapist Sa’adia Abdullah Al-Awlaqi speaks from her side and says: “There are reasons for the spread of mental illnesses in Yemen that are unknown, due to the lack of awareness and the stigma that people fear. But we cannot deny that in recent times, people’s view of this aspect has been changing, and people have become more likely to seek treatment compared to the past. Due to the current situation in Yemen, many psychological disorders have increased noticeably, and this is due to the unstable political and economic reasons, which played the largest role in the emergence of these disorders.”

Roles and Responsibilities

“Our role as specialists, psychologists, and human rights activists is to urge those in charge and appeal to them to come up with solutions by activating the studies and research we conduct; to mitigate the severity of psychological disorders that have paralyzed Yemeni society and inflicted it with the disability it is experiencing today. The responsibility must be shared between the country and individuals in society,” according to researcher Manar.

She adds: “From my point of view, there is no person with sound mental health who would obstruct plans aimed at addressing this crisis facing Yemeni society and living in an environment free of tension and conflict that qualifies the Yemeni citizen to enjoy a life dominated by tranquility, reassurance, and happiness; the individual who enjoys good mental health is happy with himself, compatible and peaceful with those around him, loving his community.”

Necessary Treatments

Among the most prominent solutions from Sa’adia Al-Awlaqi’s point of view: “Spreading awareness among citizens, making optimal use of social media in all its forms, and also the media to raise awareness about the importance of psychological treatment for psychological disorders in their early stages so that their danger does not increase.”

She adds: “One of the solutions is to develop programs and host specialists in this field, talk about the causes that lead to the emergence of these disorders, and address the means that can help, including consulting specialists as soon as possible, in addition to publishing the names of specialized centers and hospitals.”

According to researcher Manar, there is a set of proposals to avoid the outbreak and spread of psychological disorders, which include designing awareness-raising programs that discuss the importance of mental health for the individual and society, and its effective role in stimulating increased productivity for the individual and society in all scientific and practical aspects, as well as contributing to reducing deviations from law and public order.

She adds: “It is essential to create a system for mental health and improve infrastructure by addressing public institutions concerned with mental health and private hospitals, in addition to activating many actors in civil society, including international, governmental, and private organizations that specialize in providing psychological and social support services.”

She stresses that the most important of these treatments is to stop the conflict and reach a solution that satisfies all individuals and segments of society. Stopping conflicts and disputes is one of the most important treatments to limit the spread of psychological disorders, which have recently increased.

Akram Abdul-Aziz believes that there is a set of treatments to alleviate the psychological disorders of the Yemeni citizens, and a set of integrated measures and policies can be implemented that target individuals and society as a whole, including enhancing access to mental health services, establishing and distributing mental health centers in various regions to be accessible to all citizens, training doctors and nurses, by providing training to doctors and nurses on identifying mental disorders and providing initial support.

He continues: “Social support and establishing community support programs that provide emotional support and counseling to individuals, establishing support groups for people with psychological disorders to exchange experiences and support, as well as improving living conditions and implementing economic programs to improve living conditions and provide job opportunities, and implementing various sports activities.”